Editing Funders and Billing Codes in the Company Account

Read below for tips and best practices for making updates to your Funder page of the Company Account. Certain changes or edits to the funders in Rethink are prevented in order to preserve data integrity and to prevent errors in your system. Additionally, preserving historic data in the system, with limits on certain edits/changes, also aides providers in preserving data in the event of a funder audit.

Topic

Visual Support

Helpful Information

Topic

Visual Support

Helpful Information

  1. Editing the Funder set up or rules:

    1. On the Company Account>Funder page, click ‘View’ and then ‘Edit’ to review and/or edit the settings for that funder.

    2. Changes/Edits can be made to most fields on the funder>General Information, including Combine Rules, Scheduling Rules, etc.

    3. Click ‘Save’ on the popup to populate the changes

  • The ‘Remove’ button is only visible if there are no service lines or services attached to the funder.

    • Service Lines & Services cannot be removed from a Funder if attached to clients' authorizations or scheduled against.

  • Changes made to the Funder General Information will be applied once saved

2. Deleting and/or Inactivating Services:

  • The delete icon(circled in red to the right) is only visible next to services that have not been attached to client auths nor have been scheduled against.

  • Check the boxes to Inactive individual services/billing codes for future use.

 

  • Inactivating codes does NOT remove these codes from client authorizations nor does it prevent scheduling against clients with Active current authorizations with these codes.

  • Inactivating the codes at the funder level prevents adding these codes to NEW authorizations moving forward.

 

  • If you are needing to delete a service/code that was entered in error, please follow steps 2a.-2d. below and then return to Step 2 to delete.

2. a If there are existing authorizations or appointments that need moved to new billing codes, follow the steps for Adding New Billing Codes to the Funder:

  • Under the relevant funder, Click the “+” sign to add billing codes

  • On the popup, add your billing code, rounding rules & credentials

  • Click ‘Save’

 

  • Please review your funder contracts and/or provider manuals to determine appropriate codes, unit type, and rounding rules for each service.

  • Please note that selecting “Base Rate” or “Contract Rate” has no functionality in the system

  • If you mark a service as NOT requiring an authorization here on the service page, you will NOT be able to enter even a placeholder authorization for this service on the client’s authorization page. Rethink recommends using authorizations as a best practice and therefore would not typically recommend marking a service, here on the Funder page, as not requiring an authorization.

2.b. : Adding new authorizations for the client:

  • On the Client profile>Authorization page, click to ‘add new authorization’

  • Enter all required fields

  • Enter services, units, and frequency

  • Click Save

https://rethinkautism.atlassian.net/l/cp/irmgD9W7

  • It is important to add the new authorization prior to end-dating the old authorization, so that you can adjust any future appointments, if needed.

2.c. Adjust/Edit any future dated appointments to the new Services/Authorization:

  • On the Appointment List view, filter the list for future billable appointments for the client(s) needed.

  • Edit the appointments (or series of appointments) to the new services/codes & save

 

  • All future dated appointments must be adjusted to the new authorization, if you are wanting to delete or end date the former authorization.

2.d. End dating or deleting authorizations:

  • Click the small 'x' icon under actions to Delete the authorizations. Delete will only be an option if there are NO appointments scheduled.

  • OR Click ‘edit’ on the client’s authorization that you wish to end date

  • Update the end date

  • Save

 

  • You will not be able to DELETE the authorization if any appointments exist in the past or future for this authorization.

  • You will not be able to end date the authorization if any appointments remain for future dates.

3. Editing the Billing Codes/Services:

  • Once a billing code has been added to a client authorization or scheduled against, certain fields on the Funder page>Billing Code/Service popup will be locked from any edits

    • Service name

    • Unit Type

    • Rounding Rules

    • Removing credentials

  • Make any edits to the other fields and click ‘save’

  • When saving changes, a popup for how to apply the changes will appear.

    • ‘Apply these changes to all existing appointments & new appointments’ will impact everything scheduled for this service in your account. This option is typically only selected if you made a prior error in your set up that needs corrected.

    • ‘Apply these changes to all existing appointments on and after a certain date & new appointments’, if selected, will a start date field

  • ‘Apply changes to new appointments only’ will impact only appointments scheduled after these changes are saved (no existing appointments, even if scheduled for the future)

  • If any of these ‘locked’ fields are requiring changes then follow the Steps 2 to 2.d. above for inactivating the prior codes and adding new codes with the needed changes.

  • Rethink will not be able to overwrite or make changes on the ‘backend’ to your billing codes as this will create data integrity issues in your system. These fields are locked from changes to protect your data.

 

  • The option to ‘apply these changes to all existing appointments on and after a certain date & new appointments’ is the most common option for making changes as of a certain date, such as a new rate.