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How to Configure Services & Rates in Payors

This Article will demonstrate how to add services and rates to payors.

Step 1: Access Payor 

  • Within your “Payors” tab on the menu bar, click on the name of the payor you would like to add services and rates to. 

Step 2: Add New Service 

  • You’ll be brought to the “Services & Rates” tab by default 
  • In the top right corner of your screen, select the “Add New” button. The “Add Payor Service” pop-up window will appear 

Step 3: Complete Service Information 

  1. At a minimum, please add the following fields:  

Payor Service Configuration

  • Service Code: The abbreviation of the service you’d like to add (i.e Personal Care = PC) 
  • Bill Rate: The amount you bill per Unit for performing this service
  • Bill Type Override: Sets the Default Value for all visits with this selected service.
    • Billable
    • Non-Billable
  • Units: The unit of measure on how your bill rate calculates (per hour, per 15 minutes, etc.) 
  • Round Units: The rounding unit that applies to the billing duration.
  • Rounding Rule: Determines how your "Rounding Units" are calculated.
  • Effective Date: The date that the service rate applies to. We highly recommend making the effective date immediately or backdated. Applying a start date in the future will block users from scheduling for visits prior to this effective date +
  • Duration Type: Determines which time is used to calculate your billing units.
    • Electronic Duration: Recommended for most EVV mandated services as EVV aggregators use the electronic times (unless an adjustment is added) to calculate the billing units for EVV visits and claims matching.
    • Official Duration: Recommended when you want to match your payroll to your billing. Uses the Duration displayed in the "Official Time" of the visit which is also used to derive payroll.
  • Additional fields may be required for EVV submission, verify what information will submitted and enter in this area
  • Example:
    • Billing Unit: Hour
    • Rounding Unit: 15 minutes
    • Rounding Rule: Round to Nearest.
    • Billing Duration: 2:08 (2 hours, 8 minutes)
    • Billing Units calculated: 2.25
      • 2 hours = 2 units.
      • 8 minutes = .25 units (Round to nearest 15 minutes)

Step 4: Save Service and Repeat 

  • Once complete, select “Save” 
  • Repeat these steps for each service under each payor