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Zero Rate Codes for Residential Services

Overview

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
  1. Double-click on the code you want to update.
  2. Click on the Billing tab.
  3. Allow zero rate (under the General section): Select Yes.

    codes zero rate
     
  4. Click Save save.up.gif.
Payers Module
  1. Double-click on the payer requesting the zero rate code.
  2. Click on the Rates tab > Program/Codes sub-tab.
  3. Follow the instructions for entering a residential code and rate.
  4. Rate/Unit: Enter 0.00

    payers mod zero rate

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.

  1. Click on the Rates tab > Codes sub-tab.
  2. Enter the zero rate code:
    1. Code: Use the pick list pick list.png to choose the zero rate code.
    2. Rate/Unit: Enter 0.00.
    3. When to use this payer: Select Always.

      zero.rate.codes.tab.jpg
       
  3. Click Save save.up.gif.
Clients Module
  1. Double-click on the client you need to add an authorization to.
  2. Go to the Payers tab > Authorizations sub-tab.
  3. 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.

If the payer does not require a real authorization, you can create a "bogus" one. A bogus authorization has all of the same parameters as a real authorization, with the exception of the Authorization Number field. For bogus auths, the Authorization Number field is always left empty.

  1. Click Save save.up.gif.

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.