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Helpful Knowledge

Click View on your applicable funder, and then scroll down to add a Service Line

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  • Billing-Claim/Invoice Submission Method is not currently an active feature

    • Recommended to leave it as it is already selected

Click “+” to add Billing Codes to the Funder Profile:

Add Service and Billing Code details (any fields marked with an " * " are required)

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  • If you have funders authorizing units by specific modifiers for the same billing code you can do the following: Create Service names in your Settings that include the modifier or add language to the service name that matches the authorization. Then when adding the billing code to your funder set up, make sure you select the restrict by credential option so you can add the modifier(s) for the matching staff credential.

Does NOT require Authorization

  • This field is not recommended to be selected unless you are an international customer or building a Private Pay Funder and do not wish to track authorizations for scheduling/utilization purposes

  • Selecting this option will break the authorization functionality and you would no longer be able to utilize authorizations for billing or tracking purposes

  • You can mark on the individual client authorization page if an authorization is not required but marking it here would break that functionality for all clients with that funder

Restricting staff from providing a service or to bill multiple rates for a service

  • To restrict which staff can provide a service and/or to be able to bill multiple different rates for this service click "yes" then complete the required fields. This will prevent any staff who do not hold the appropriate professional credential from being scheduled with that service

  • If you select “no” any staff could be scheduled with that service

  • You will want to select “yes” if you need to add in modifiers or telehealth services as well

Select a Service and Choose a Template to pair your services with the applicable billing code

  • If your billing code is not present in this templated list, select “custom” and manually type the code into the billing code for claims/invoices section

Unit Type: Select the unit type that is appropriate for your billing code

  • If you have selected one of the templated 9 codes, the unit type will default to 15 minutes

Rounding Rule: Insurance providers do not allow partial unit billing so you must choose a rounding rule

  • Please see the Rounding Rules chart below

Contract vs. Billing Rate

  • This feature holds no functionality as of right now so it is recommended to leave it set as contract rate

  • The rate you enter is whatever you want to see on your Billing Export whether that be your Funder Contract Rates or your Company’s Rates

Add Credentials and Rates

  • Click “Add New +” to add all the professional credentials who can provide this service

  • Option to add modifiers

  • Option to add Telehealth Services by selecting the same credential more than once, entering in the modifier and the Service Description of “Telehealth” (See example below)

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