Billing Codes / Códigos de facturación

Billing Codes are a company configuration under Financial Settings. To configure billing codes you must click on Settings in the top navigation and select billing codes.

Based on your company’s needs private payers and, Medicaid policies, you can add more billing codes, edit pre-existing billing codes, or delete billing codes.

Title. is just a label for you to know what the billing code is for. This can be whatever you want.

Billable document flag. Meant to be used when you are going to bill a flat rate per document instead of per time. This will make the Unit min Time field be 0 and Unit Complete Time 1440. Anything between 1 minute and 24 hours will be reflected as 1 single unit in the billing summary when this billing code is selected. 

Telehealth. To be used when the visit is going to take place over a telehealth solution (ours or not). This will be the billing code Behaviorsoft uses when case B (below) is used.

Training. To be used when the rendering provider will be supervised. This will be the billing code Behaviorsoft uses when case B (below) is used.

Unit Min Time and Unit Complete Time.

Therapist type.

Therapist Level.

Rendering provider override. 

Payer

Billing code.

Modifiers.

When you schedule there are several things Behaviosoft will check for in the active billing code list. It will look for a billing code with the same type of therapist, same level (if any), same payer, and the combinations of flags that can be seen below. If you see "Automatically generated" it means that Behaviorsoft was not able to find a billing code that matches with all the conditions of the visit (type of therapist, same level (if any), same payer, and the combinations of flags). An automatically created billing code should be edited to whatever it is supposed to be.

After all billing codes exist, a default can be selected so it's the one that appears as default when that combination (type of therapist, same level (if any), same payer, and the combinations of flags) is scheduled.

Billing codes are then reflected on  Client AuthorizationsBilling Summary for a client, and Payroll Summary for a therapist.


Billing Code Flags

When adding or editing a billing code, there are certain flags that can be used to  

1. CASE A: Visit with no flags.

SAB.pngSAA-Corregido.png

2. Case B: Visit with telehealth flag

Visit
SBA.png
Billing Code
SBB.png

3. Case C: Visit with training flag

Visit
SCB.png
Billing Code

SCA.png

4. Case D: Visit with telehealth and training flag

Visit
SDB.png
Billing Code

SDA.png

Autogenerated codes 

These are generated when there aren't any billing codes created for a specific combination of therapist type, therapist level, flag, and payer. 

The way you can fix this is by simply going into settings > financial settings > billing codes and by clicking on edit.

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Códigos de facturación

Los códigos de facturación son parte de la configuración en la categoría general. Para configurar los códigos de facturación, debe hacer clic en ajustes en el menú de navegación superior y seleccionar códigos de facturación.

Basándose en las necesidades de su compañía, usted puede añadir códigos de facturación y editar o eliminar los preexistentes.

Los códigos de facturación se despliegan en las autorizaciones (Client Authorizations), el resumen de facturación (Billing Summary) para un cliente y el resumen de planilla (Payroll Summary) para terapeutas.

Códigos autogenerados

Se generan cuando no hay códigos de facturación creados para una combinación específica de tipo de terapeuta, nivel de terapeuta y pagador. 

La forma de arreglar esto es simplemente ir a la configuración > códigos de facturación y hacer clic en editar.

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