Some payers require that a client's Room and Board code be submitted at a "zero rate" on residential claims. Here is how to set up and use a zero-rate code so that it saves and bills correctly. Note: This requirement is payer specific. Please verify if your payer requires you to submit Room and Board codes at a zero rate.
Zero Rate Code Set-Up
Make sure to complete the setup steps in all three of the following modules, in the order that they appear below.
Codes Module
- Double-click on the code you want to update.
- Click on the Billing tab.
- Allow zero rate (under the General section): Select Yes.
- Click Save.
Payers Module
- Double-click on the payer requesting the zero-rate code.
- Click on the Rates tab > Program/Codes sub-tab.
- Enter the residential program and code.
- For the Rate/Unit: Enter 0.00
NOTE: Right now, it is possible you have these Room and Board codes listed with a rate of 1.00 or a 0.01. If so, you will need to go to the Payers Module and change the rate to 0.00 for any payer that uses these codes.
- Click on the Rates tab > Codes sub-tab.
- Enter the zero-rate code:
- Code: Use the picklist
to choose the zero-rate code. - Rate/Unit: Enter 0.00.
- When to use this payer: Select Always.
- Code: Use the picklist
- Click Save.
Clients Module
- Double-click on the client you need to add an authorization to.
- Go to the Payers tab > Authorizations sub-tab.
- Enter an authorization for the Zero Rate code.
- You must have an authorization with the Zero Rate code. The authorization is what will cause the code to appear for the given client in the Residential Time Module.
NOTE: If the payer does not require a real authorization, you can create a "silent" one. A silent authorization has all of the same parameters as a real authorization, with the exception of the Authorization Number field. For silent auths, the Authorization Number field is always left empty.
- Click Save.
Recording and Billing Zero Rate Codes
If the above three steps have been completed properly, you will be able to save the code in the Residential Time Module for any client that needs one. After you save the code in the Residential Time Module, you will be able to send the claim electronically. The rate for the Zero Rate code will be $0. No special changes are needed.