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Adding funders into your Settings is a critical component of your Rethink platform. In order to add funders to your account, you first want to ensure your Service Lines and Services are entered appropriately. For more information on this step please refer to our resource guide on Understanding Service Lines and Services. Done

Table of Contents

Adding Funders

Step

Description

Helpful Knowledge

Go to Settings

Settings.jpg

Select Funder Settings from the menu at the top

funder settings.jpg

Click Add Funder to add a new funder to your account. Click View for an existing Funder, then click EDIT to set up the Billing and Scheduling Rules for that Funder

add funder.jpg

Once you click EDIT or ADD FUNDER, choose the Funder Type from the drop down

  • Insurance: Group Health Plans, Commercial Payers, Medicaid, Tricare

  • Other: Schools, Regional Centers, etc.

  • Private Pay: Self Pay

    • Please note for Private Pay, you may have to enter some fake information to fulfill the requirements. You will also choose your scheduling rules based on what you want to allow

OPTIONAL: Add a Vendor ID (if applicable)

  • Used for California customers to appear on the Parent Verification Form and BHPN Invoices

Type out the Funder Name

  • If you are setting up a Private Pay funder, you can name it “Private Pay”

Enter Funder Address

  • Phone, Email, and Fax are optional

  • For Private Pay: Enter in a placeholder address

Set the Billing Rules: These will be based on your funder contracts

  • Select the checkbox if you want to convert session times to military times on your billing export

  • Select the check box if you want to require the referring provider be entered on client authorizations and show up in your billing export

  • Select the check box if you want the appointment time on the claim line in your billing export

    • The verified appointment time will be listed on the billing export regardless. If your Funders request it to be specifically in the claim line, select this

Select your Combine Rules based on your funder contracts

Combine Charge Rules.PNG

  • These are not the combining of appointments. This is on the backend for billing purposes and will dictate how appointments are seen on the Billing Export Report pulled from the Reporting Dashboard

  • Oftentimes Self/Private Pay will choose “Don’t combine charges”

  • Some Funders want you to combine charges for the Same Day, Client, and Procedure & others want you to combine charges only if it is for the same Day, Client, Procedure, AND Rendering Provider

Set Scheduling Rules: this allows you to decide if concurrent billing should occur or what type of warnings you will or will not receive when scheduling appointments

  • Select Don’t Allow, Allow, or Warn & Allow to the first few Scheduling Rules based on your Funder Contracts

    • Warn & Allow will give you a soft warning when trying to schedule but will still allow you to save that appointment

  • Select the Checkbox if you want staff to be able to verify appointments on expired certification

  • Option to restrict users from scheduling on specific dates

Option to add Medicaid ID #

 

  • This area would allow you to choose the applicable Medicaid ID # from the drop down to attach to the funder

  • The drop down will be a list of the Medicaid ID#'s that are entered in the Settings>Company>Basic Information

  • This information does not pull through into the Billing Export Report

Option to add Insurance Plans

  • This area would allow you to keep track of the different plans within that funder such as if the funder had a Platinum or Silver plan option

  • When you set up your clients you can then assign which insurance plan they have according to that funder

  • If you have signed up for the Rethink Self-Billing product, your Self-Billing Implementation Specialist will train you on this area

Select the Coverage Type (only applicable for insurance type funders)

  • Most commercial plans will be classified under “group health plan”

Select Service Facility (only applicable for insurance type funders)

  • If you have more than one location available you would want to choose your main office location/the location your funders have on file for billing purposes

  • Please note that the service location is pulled from the location assigned to the client in Rethink, this area is just for documentation purposes

Select whether to Omit Session Note Header fields

Allows users to exclude the client-assigned facility/location, service, or service line from the header details on billable or non-billable session notes (with a selected service) saved to the client file cabinet.

  • When changing selections, existing session notes will not be impacted. The changes will take effect for new session notes

  • Users will need to edit existing session notes if they desire the updated selections to be reflected on the saved session note in the client file cabinet

  • This feature does not apply to non-billable appointments with no service selected.

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