Page Comparison

Validation

Red flags for potential billing issues

• EX: No Authorization - System is flagging there is no authorization attached to that appointment. Refer to your funder, if your funder needs authorization, you may need to attach that before you bill

• EX: Staff Overlap and Client Overlap

  • Staff Overlap: One staff member providing services to more than one client at the same time (Could be group service – maybe your funder allows this. IF they don’t, make adjustment)

  • Client Overlap: More than one staff member is providing services to the same client – Maybe a two on one service or a direct therapy and parent training is happening. Lots of funders allow this.

  • Can always adjust the spreadsheet instead of adjusting appointments in the system and rerunning

    • EX: Alter the start time so appointments don’t overlap (client/staff overlap)

Appt Type

Should all be billable

Appnt Tag

Any billable tags that were added to the appointment

Cancellation Type Name

Best practice recommendation is to not pull for cancelled appointments

Appt Status

Best practice recommendation is to only pull for complete appointments

Office Location

Pulls the Location/Facility assigned to the client in the Client Profile>Demographics section

Funder

Name of funder

Date of Service

Date the appointment took place

Actual Start Time

Verified start time

• May see the term “Rollup” based on your Funder Setup if you designated you need to combine charges

  • EX: If combine for same day, client, and billing code is selected, then when multiple staff go out to see that client in a day for the same service, it will roll those appointments into one Claim Line on your billing export

Actual End Time

Verified End time

• May see the term “Rollup” based on your Funder Setup if you designated you need to combine charges

Claim Line Note

Optional component to add to this report. Allows users to list the appointment start and end time on the actual claim itself (some funders require this). If you need a claim line note to be the start and end time, you can set this up under the Settings>Funder Settings set up. If you need it to be in military time, you can set that up there as well

Client Name

Name of client

Provider Name

Name of staff providing the service

Service

Service Name

Late Entry

This column will display ‘Yes’ or ‘No’ depending on whether the appointment was ever pulled as a late entry

Late Entry First Pulled By

This column will display the first and last name of the staff member who first pulled the appointment as a late entry

Date/Time Appt Marked Late Entry

This column will display the date and time the appointment was first pulled as a late entry

Billing Code

Billed CPT Code

Modifier 1-4

Will show modifiers if added to that billing code under the Settings>Funders/Billing Code area

Unit Type

Pulls from the Funder/Billing Code setup within Settings

# of Hours

Number of hours the appointment(s) took place

# of Units

Number of units

Unit Rate

Rate per unit as entered on the Funder/Billing Code setup within Settings

Total Charges

How much to charge

Authorization #

Pulls the authorization # that was added to the Client Profile>Authorization Tab

Service Line

The Service Line used

EX: ABA, OT, PT, Speech

Place of Service

As entered on the appointment level (POS is required on appointments)

Location Name

Will show if entered on the appointment level

Location Address

Will show if entered on the appointment level

Diagnosis Code 1-4

Pulls the diagnosis selected on the Authorization of the Client Profile>Authorization Tab

Only one diagnosis can be selected on a client’s authorization. If more need to be added, you can do so manually on the BER

Client Address

Pulls the address added to the client in the Client Profile>Demographics section

Service Facility Location

Pulls from the Funder setup within Settings

Vendor ID

Will show if entered in the Funder setup within Settings

Funder Address

Pulls from Settings>Funder area

Insured’s Name

Pulls from the Funder information added to the Client Profile>Funder section

Insured’s ID

Pulls from the Funder information added to the Client Profile>Funder section

Group #

Will show if entered on the Client Profile>Funder section

Client DOB

Pulls the Date of Birth added to the client in the Client Profile>Demographics section

Agency Name

Company Name as entered in the Basic Information area of the account

Group Agency NPI #

Company NPI # as entered in the Basic Information area of the account

Rendering Provider Name

As selected on the client authorizationFor services set up to ‘require an authorization’, the Rendering Provider will display based on the selection made for this field in the authorization.

• EX: If you selected Agency as the rendering provider on a client’s authorization, you will see your company’s name and NPI #

For services set up to not require an authorization, the Rendering Provider will display based on the selection made for the billing code in the Settings>Funder Settings>Service Line area

Rendering Provider NPI #

As selected on the client authorizationFor services set up to ‘require an authorization’, the Rendering Provider NPI# will display based on the selection made for this field in the client authorization

For services set up to not require an authorization, the Rendering Provider NPI# will display based on the selection made for the billing code in the Settings>Funder Settings>Service Line area

Company Client ID #

Will show if entered on the Client Profile>Demographics section

Rethink Client ID #

Autogenerated from Rethink

Staff Verification

Should be “Yes” as this it the minimum requirement for a session to be considered complete unless you are pulling for incomplete appointments

Staff Verified Address

If location services were turned on when verifying, the address where that staff verified will appear here

Parent Verification

Yes or No if obtained

Parent Verified Address

If yes and location services were turned on when verifying, the verification address will appear here

Session Note Entered

Yes or No if obtained

Should be “Yes” if that is your company’s criteria for a completed session

Session Note Reviewed

Optional component

EX: Supervisors can review session notes

Company Staff ID #

If Staff ID # was added to staff’s General Information section of their profile

Rethink Service ID #

Auto created by Rethink

Staff Verification DateTimeStamp

The date and time the staff verified the appointment

Appt Requirements Completed

The date and time the appointment requirements were completed

• Verification AND a session note obtained for example if that is your company’s requirements for a billable appointment to be considered complete

Appt Notes

Any notes written on the appointment details

Rethink Appt ID

Auto Created by Rethink

Referring Provider Name

Will show if entered on the Client Profile AND Client Authorization Tab of the Client Profile

Referring Provider NPI

Will show if entered on the Client Profile AND Client Authorization Tab of the Client Profile

Client Policy Copay

Will show if entered on the Client Profile>Funder Tab

Appointment Copay

Will show if copay was received for an appointment AND marked on the appointment level

Last Modified By

Who last modified the appointment

Last Modified On

When a user last modified this appointment

Last Billing Exported

Date and time this report was ran

Last Payroll Exported

Will show if the appointment has been pulled for payroll yet