PERMISSIONS REQUIRED: There are no specific permissions as this template should be completed prior to other staff being entered into the system, however, the Location Administrator and/or Billing Manager should insure proper entry of the data.
The Billing Template is included in your Implementation Checklist in the Set Up Billing section, or you can download it here. Please fill out the Billing Template, as shown below and return it to our Billing department in order to begin your Billing and Remittance setup in the system.
IMPORTANT: Before you can begin the Billing setup process, you must complete your Implementation process.
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Before you Begin
In order to complete the Billing Template, you will need the following:
- Organization NPI - Verify or create NPI here: https://npiregistry.cms.hhs.gov/
- Organization Credentials - Provider ID, Taxonomy, and Tax ID.
- Payspan and Avality Login Credentials (Username & Password).
- Payers Setup - Ensure that you are credentialed with each Payer prior to Billing setup.
- Service Codes - Setup your Service Codes in the system.
Billing Template Explanation
All organizations must fill out this section to setup Billing and Remittance.
- Enter Company Information: Company Name, NPI, Provider ID, Taxonomy, and Tax ID.
- Location Name(s) (optional) - If no additional Locations are entered, there will only be one Main Location.
- Is your Organization Atypical? Atypical Agencies submit their APN as well as NPI. If you don't know this, it is most likely not applicable for you. Skip this step if you're not sure.
- Enter the Note Types your agency will be using. Each type requires a separate profile in our system. Enter only necessary options (discussed with your sales person ahead of time).
- Enter Payspan and Availity Login Credentials - Required for Electronic Remittance setup.
- Enter Service Codes & Description - Export Service Codes from the Services Manager and attach them to your Billing Template submission.
- Add the Payer Names and IDs of your MCO or the Insurance Companies you are Credentialed with.
- Indicate if you are actively billing them or if you plan to bill them in the future.
- If you are utilizing our RCM Billing Support Service, jump to the next section. If not, your Billing Template is now complete. Attach necessary documents (e.g. exported Service Codes) and return it to our Billing Department.
RCM Only
RCM (Revenue Cycle Management) is a Professional Billing Support Service we offer at an additional charge. If you have subscribed to this service, complete the RCM PROVIDERS ONLY section of this form as well.
NOTE: If you are interested in this service, please speak to your Sales Team Member or connect with Support. (Only users documented as Owners can request this information for your agency.)