During setup, start by setting up your payers and creating your service codes. Once these are completed, you can create budgets for clients.
Set up your payers
Click Finance in the left menu
Click Payer Management in the left menu
Click Create Payer
Fill in the required fields
Name
Description
Click Save
Repeat this process to add all entities you bill to (e.g., Medicaid, private pay, counties).
Note: This must be done before creating service codes or assigning codes to individuals.
Create your billing codes
Click Finance in the left menu
Click Code Management in the left menu
Click Create Billing Code
Fill in the required information
Basic Info:
Code Name: enter the code name as listed in Medicaid or the billing entity (e.g., T2003)
Modifiers
Display Name: this is the name displayed for the DSPs (e.g., Respite Level One)
Group Code
Code Details:
State
Place of Service
Description
EVV Required: skip this unless the code requires EVV
Billing Configuration:
Split at Midnight: decide if you want to separate overnight shifts at midnight
Unit Type: select Minutes, Day, or Distance
Enable rounding: if toggled on, enter Minutes worked to round up
Rate: e.g., $15.50
Click Save Code
Repeat for all codes your agency uses.
Create budgets and assign codes to clients
Click Clients in the left menu
Search for the client and click Profile
Click Budget in the slide-out menu
Click Create Budget +
Fill in the required fields:
Service Code (i.e. billing code)
Payer (i.e. entity billed for services)
Available Units
Rate: default rate populates once Service Code is selected, but rate can be individually changed on the client level
Start Date and End Date
Reference ID (e.g., Authorization number, PCP number, or another state identifier)
Restrictions
Click Save
Note: The service code and payer will first need to be added to Payer Management and Code Management.
For questions or support:
Contact your Customer Success Manager
Or email: [email protected]