Users can Manage Payment Types from both the Client Center and the Claim Center. Starting from either location will achieve the same result. Managing Payment Types allows users to add new Payment Types, edit existing Payment Types as well was delete existing Payment Types that haven't been previously used in transactions. However, it is not recommended to delete Payment Types. Instead Payment Types should be made inactive if they are not needed. Payment Types are normally setup by users during initial ElderSuite Setup and should be setup accurately and completely before using ElderSuite. When Payment Types are setup ElderSuite will use this information to track clients by Payment Type, calculate amounts for claims, calculate units based on the Unit Definition and create and billing claims. Providing Payment Type Information before using ElderSuite allows ElderSuite's Automation Services to automatically use the pre-defined information and prevents human error that can occur when inputting separately for each client. See the First Steps documentation for more information.
To display the Payment Types list, with your mouse click the Client Center button or the Claim Center button located on the ElderSuite Navigation bar as pointed out in the image below.
Depending on the option you chose, the Client Center or the Claim Center will be displayed. I chose the Client Center for these instructions and it is shown below. However, both the Client Center and the Claim Center will contain a Related Activities panel in the lower portion of the window. With your mouse, locate and click the Manage Payment Types link found in the Related Activities panel as pointed out in the image below.
After the Payment Types List windows appears you will see all Active Payment Types displayed in the Payment Types List. To display All Payment Types including any Inactive Payment Types you can change the View to All by clicking the View Drop Down List as pointed out in the image below.
Change the View to "All" by selecting "All" with your mouse. All Payment Types will be shown in the Payment Types list. Any Inactive Payment types will have their Inactive column checked.
To add a new Payment Type, with your mouse click the Add New button located on the Payment Types List menu bar as pointed out in the image below.
The Payment Type Information window will appear as show below allowing you to input the Payment Type Information for the Payment Type you wish to add.
Payment Type Information Window Explained
Item 1 is the Save & Close button. Click to save changes and close the Payment Type Information window.
Item 2 is the Delete button. Click to delete the Payment Type. It is not recommended to delete Payment Types. Use the Inactive field instead.
Item 3 is the Inactive field. Check to make the Payment Type Inactive or leave unchecked to make Active.
Item 4 is the Payment Type field. Use this field to name your Payment Type. This field is required and must contain a value. Users will not be able to save any Payment Type if the Payment Type field is empty.
Item 5 is the Clearing House Payer ID field. It is needed when the Payment Type will be billed electronically via a Clearing House. To find a Clearing House Payer ID, you can request if from the Payer. Alternatively, you can visit the Availity Clearing House website at www.availity.com and search their Payer List. However, it is best to confirm the Clearing House Payer ID with the payer to ensure you are using the correct Payer ID. Payers normally have multiple Payer IDs and if you are not using the correct Payer ID then you risk electronic claims being denied.
The Default Billing Codes Group should contain required codes for billing purposes. You can view other Payment Types to see examples. However, you should consult the Payer for this information if you plan to submit claims electronically the Payment Type being created.
Item 6 is the Place of Service Code field.
Item 7 is the Procedure Code field.
Item 8 is the Modified Code field.
The Pay Rate Settings Group contains default Pay Rate Settings that will be used when the Payment Type is assigned to a client. If different pay rate settings are required for a client they can be changed after the Payment Type is assigned. These are simply defaults and are pre-filled automatically when the Payment Type is assigned.
Item 9 is the Pay Rate field is the amount charged per Pay Rate Type found in Item 10.
Item 10 is the Pay Rate Type field and has the following types available. (Unit, Days, Week or Month).
The Unit Definitions Group is where Units can be defined when "Unit" is selected as the Pay Rate Type (Item 10). Payment Types that reimburse based on Units of Service would need this information provided for ElderSuite to calculate Units of Service correctly. You can define the Unit Definitions by assigning a number of attendance hours required to equal 1 unit and 2 units. For example, if you define 1 Unit = 3 Hours and 2 Units = 6 Hours then ElderSuite will calculate the Units of Service based on this definition when Attendance & Transportation Times are input for any clients assigned to this payment type. Using our sample definition of 1 Unit = 3 Hours and 2 Units = 6 Hours then when a client attends less than 3 hours (i.e. up to 2 hours 59 minutes) the calculation would be 0 Units of Service. If the client attends for 3 hours to 5 hours 59 minutes then ElderSuite would calculation 1 Unit of Service. If a client attends for more than 6 hours, ElderSuite would calculate 2 Units of Service. Assign these definitions to Item 11 and Item 12.
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