Combine Charges Settings and Rules

Many payors require claim charges be "combined" if there were multiple sessions for the same client, same service provided in the same day.

This tutorial will outline the 3 options available and how they work.

IMPORTANT: Be sure to confirm with your insurance payor their requirements related to combining charges.

#	Description	Steps	Good to Know
1.	Accessing the Combine Charge Feature	Company Account >Funders>Select Funder CLICK "VIEW" THEN CLICK "EDIT" CHOOSE 1 OF THE 3 OPTIONS	Users must have permissions to access the Company account to enable this feature. By Default when adding a new funder "Combine Charges for Same Day, Client, and Procedure" will be selected.
2.	Designating Rendering Providers	The Rendering Provider must be selected when entering a client authorization if the payor is an "insurance" type. The Rendering Provider selected will have a direct impact on the Combine Charge Feature if it has been enabled.	Kareo Users: We recommend selecting only: "Provider Assigned to Appointment" or a Specific Rendering Provider Only. If "Agency" is selected as the option, Kareo must also have the agency listed as a rendering provider.
3.	Do Not Combine Charges	When selecting this option all appointments for each day will be displayed in the billing export as their own line item.
4.	Combine Charges for Same Day, Client, and Procedure	All charges for the same day, same client, same Billing Code will be combined regardless of the Rendering Provider	Select a specific staff (Usually the BCBA Supervisor) The NPI of the Rendering Provider option selected will display on the billing export. The rendering provider for a client authorization can be adjusted or modified over time, although it is recommended to start and end a new authorization when updating a rendering provider to maintain accurate historic data. If a staff is not listed this means an NPI has not been entered in their profile. Charges will NOT be combined for: Different Place of Service Different Modifiers Different Rates Overlapping Times, unless the option for "allow overlapping appointment times for different scheduled providers' is selected." If this option is selected, then the rollup will add up the units for the separate appointments, including the times that overlap. **Please note that Rethink combines by Billing Codes, without regards to the Service Name. We discourage against having different service names linked to the same Billing Code under any one funder because these would 'roll up' when combine charges is enabled.
5.	Combine Charges for Same Day, Client, Procedure, and Rendering Provider	All charges for the same day, same client, same Billing Code will be combined based on the Rendering Provider selected.	Select "Provider Assigned to Appointment" Charges will NOT be combined for: Different Place of Service Different Modifiers Different Rates Overlapping Times **Please note that Rethink combines by Billing Codes, without regards to the Service Name. We discourage against having different service names linked to the same Billing Code under any one funder because these would 'roll up' when combine charges is enabled.
6.	Billing Export: "Roll UP"	If either of the "combine charges" options are selected; "Roll Up" will display in the Start and Stop columns of the billing export. This means that the system has applied the combine charges rules for that specific date of service.	There may be appointments on any given day that are not included in the Roll Up due to those not meeting the appointment requirements that were selected when running the billing export. We recommend running a billing export without the combine charge feature on or run a report in the Scheduler via the Appointment List then export for the same time period the Billing export was run. Include ALL Appointment Statuses. This will allow you to see ALL appointments per day.