Adding funders into your company account 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.
Adding Funders
Step | Description | Helpful Knowledge |
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Navigate to your Company Account and select Funders |  Image Modified | |
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 |  Image Modified | |
Once you click EDIT or ADD FUNDER, choose the Funder Type from the drop down |
Image RemovedPlease note, if you have signed up for the Rethink Self-Billing product, you are required to enter in the Vendor IDs for each funder. Specifically for our billing, you can find this information from the TriZetto Clearinghouse Image Added Image Modified | Insurance: Group Health Plans, Commercial Payers, Medicaid, Tricare Other: Schools, Regional Centers, etc. Private Pay: Self Pay
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Add a Vendor ID (if applicable) |  Image Modified |
Vendor ID/Payor ID
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Type out the Funder Name |  Image Modified | |
Enter Funder Address |  Image Modified | |
Set the Billing Rules: These will be based on your funder contracts |
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Select your Combine Rules based on your funder contracts |
Image Removed Image Added | 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
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Procedure Procedure |
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 |  Image Modified | Select Don’t Allow, Allow, or Warn & Allow to the first few Scheduling Rules based on your Funder Contracts 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
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Option to add Medicaid ID # |  Image Added | 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 Company Account>Basic Information This information does not pull through into the Billing Export Report
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Option to add Insurance Plans |  Image Modified | 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
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Select the Coverage Type (only applicable for insurance type funders) |  Image Modified | |
Select Service Facility (only applicable for insurance type funders) |  Image Modified | 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
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Select whether to Omit Session Note Header fields |  Image ModifiedAllows 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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CLICK "SAVE" when finished
Adding Billing Codes to your Funder Profile
Step | Description | Helpful Knowledge |
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Click View on your applicable funder, and then scroll down to add a Service Line |  Image Modified | |
Click “+” to add Billing Codes to the Funder Profile: |  Image Modified | |
Add Service and Billing Code details (any fields marked with an " * " are required) |
Image Removed |  Image Added | If you have funders authorizing units by specific modifiers for the same billing code you can do the following: Create Service names in your company account 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.
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Does NOT require Authorization |  Image Modified | 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
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Restricting staff from providing a service or to bill multiple rates for a service |  Image Modified | 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
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Select a Service and Choose a Template to pair your services with the applicable billing code |  Image Modified | |
Unit Type: Select the unit type that is appropriate for your billing code |  Image Modified | |
Rounding Rule: Insurance providers do not allow partial unit billing so you must choose a rounding rule |  Image Modified | |
Contract vs. Billing Rate |  Image Modified | 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
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Add Credentials and Rates |  Image Modified | 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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Example Service: Assessment, Billing Code: 97151
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Here is how the Rounding Rules work: (Based on ABA recommendations)
Rounding Type | Rule |
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No Rounding | System Default: System will round unit to next 2 decimal place, not whole units |
Round to Nearest | 15 min unit (less than 8 min = 0 greater than 8 min =1 ) 30 min Unit (less than 16 min = 0 greater than 16 min = 1) 60 min Unit (less than
31 min = 0, greater than 31 min = 1) |
Round Up | IF length of appointment breaks the threshold by at least 1 min into the next unit, the system will round up. |
Round Down | Any partial units are thrown out 15 min unit (less than 15 min = 0 greater than or =15 min =1 ) 30 min Unit (less than |
19 29 min = 0 greater than or = 30 min = 1) 60 min Unit (less than 59 min = 0, greater than or = 60 min = 1) |