Overview
This feature is used to consolidate codes for billing. A consolidated code takes multiple service lines for a client, and rather than combining them and billing out the total units for all of the individual service lines, the system consolidates all of the service lines down to one and bills out a single unit, for a flat rate. A code may be consolidated by day or month. This article will explain the options and required setup.
Step 1: Add the Professional Codes
Step 2: Create a Consolidated Group
IMPORTANT: All consolidated codes will need to be assigned to a group, even if there will only be one code in the group.
- Click on the Codes Module.
- Double click on one of the consolidated codes.
- The Change Codes window will open.
- Click on the Billing tab.
- Click on the Group Setup link in the Consolidated section.
- The Group Setup window will open.
- The Group Setup window will open.
- Click Create New.
- Name: Enter a name for the Consolidated Group.
- It could be the name of the code. The name needs to be distinct enough for you to know which codes are going to be consolidated.
- Consolidation Period: Select Daily or By Month depending on how the code will be consolidated (by day or month).
- Billing Date: Choose from the dropdown.
- Date of First Consolidated Service Line: The system will assign the date of service (DOS) for daily consolidated codes. For monthly consolidated codes, the system will select the first DOS for the month.
- First of the Month: The system will convert the DOS to the first of the month, regardless of when the first service was recorded. This should be used when the Consolidation Period = By Month.
- Codes: click on the picklist button
.
- A window will open with a list of active codes in your database.
- A window will open with a list of active codes in your database.
- Click on (highlight) each code that will be part of this consolidated group.
- Click OK.
- The chosen codes will now display in the Code field of the Group Setup window.
- To the right of each code, there will be a letter B.
- Click on the B for the code that should serve as the main billing code for this consolidated group.
- The B you selected will turn red.
- So, if a client receives all of the codes within this consolidated group over a day or month, the system will use this code (and its rate) on the claim for billing.
- Click Save.
- Close the window.
Additional Notes
- Once this setup is complete, you will be able to see which Code Consolidation Group each code belongs to in the Codes Module, Billing tab.
- You may bill these services as you would any other code. At the time of billing, Procentive will correctly consolidate these codes for you based on the consolidated group setup.
- The Add window in the Billing Module (where new invoices/claims are generated) has an option to filter by this Code Consolidation Group, allowing you to bill your consolidated codes separately. This is recommended as it will make it easier to verify your codes and rates are traveling correctly.
