This document will instruct users on how to navigate the Services tab of the Funding Source record in NPAWorks. The screenshots in this document will use a Private Insurance funding source as an example, however, these instructions will apply to all funding source types.
It is possible to add an Activity Note Template in the Services of your Funding Source to have it automatically populate in the Appointments for you. See Activity Note Template for more information.
Jump to a Section: [Services] [Charge and Reimbursement Rates] [Rounding Rules] [Unit Size] [Minimum Units] [Rounding Rule] [Unit Handling Rule] [May Exceed Duration] [Mileage] [CPT Code] [Direct / Indirect Default] [Modifiers] [Notes] [Credentials]
Funding Source: Services Tab
The Services Tab is divided into 2 sections: Services and Credentials required for the selected Service.
1. Services
2. Credentials required for selected service
Services
Selecting a Service on the top half of the screen will display the Credentials required for Selected Service on the bottom half of the screen.
Charge and Reimbursement Rates
Clicking on the Charge Rate or Reim Rate fields for the selected Service will open the Rate Propagation window.
In this window, you can set your Charge Rate (Fee Schedule) and Reimbursement Rate (Negotiated Rate) per unit.
Click OK when finished making all your selections.
NOTE: When generating claims in the system, it will display the Charge Rate.
NOTE: If you want to charge the negotiated rate instead, you would enter that number in the Charge and Reim Rate fields.
Rounding Rules
Clicking on Unit Size, Min Units, Rounding Rule, or Unit Handling Rate for the selected Service will open the Rounding Rule window.
In this window, you can set your Unit Size, Minimum Units, Rounding Rule, and Unit Handling Rule.
Unit Size
Your unit can be set to a duration from 1-90 minutes. Or you can set it to a per Appointment (session) or a daily Per Diem unit.
Minimum Units
In rare instances, your Funding Source may require a certain number of units for a service to be billed. You can enter that here, or if this is not required, leave at 0.
Rounding Rule
Some carriers will not allow you to bill fractions of units, so here is where you will set how you want the system to handle those fractions.
Unit Handling Rule
Here is where you will tell the system where you want the rounding to take place. You can decide (in the first two choices).
- If you want the system to round to the appointment level, select FS Service to appointments.
- You will see this when working in or adjusting time in an appointment. With this option, your reporting will be highly accurate.
- If you want the system to round to the claim level, select FS Service to claims.
- This option will not produce accurate reporting as the reports pull from the schedule and this is happening independently in the claims. An example of when you might want to use this rather than rounding at the appointment level is if you see a kiddo for the same service more than once a day. In that instance, the claim rounding would collapse both services into 1 line on the claim and round then.
Click OK when finished making all your selections.
NOTE: FS stands for Funding Source.
May Exceed Duration
If you previously set your Rounding Rule to Round to Nearest or Round Up, you will also need to check the box for May Exceed Duration. This tells the system that it is acceptable if the billable time is greater than the length of the appointment.
Mileage
If your Funding Source reimburses for mileage, you can enter that by clicking on the Mileage field. This is used very rarely.
CPT Code
Clicking on CPT Code for the selected Service will open the CPT Code Propagation window.
In this window, you can manually type in the CPT Code you want to be associated with this service.
Click OK when finished making all your selections.
NOTE: If you prefer this to be a drop-down option with all the ABA CPT codes to choose from, contact our support department for assistance.
Direct / Indirect Default
Clicking on Direct/Indirect Default for the selected Service will open the Direct / Indirect Propagation window.
This is for internal tracking of direct vs indirect services, however, if you utilize the RBT Supervision Tracking or the Parent Portal feature, you will need to use this option.
In this window, you can select the Direct / Indirect Appts option you want to be set for this service.
- Default To Direct will make this service always be considered direct service.
- Default To Indirect will make this service always be considered indirect service.
- Set At Appointment is for services that can be either. If you choose this option, you will set this option when creating the appointment.
Click OK when finished making your selection.
Modifiers
Clicking on Mod 1, Mod 2, Mod 3, or Mod 4 for the selected Service will open the Modifier Propagation window.
In this window, you can enter up to 4 modifiers for this service.
Click OK when finished making your selections.
Notes
Clicking in Notes for the selected Service will allow you to type in any notes you want to be associated with this service.
Credentials
At the bottom of the screen, you will see the list of credentials from your master list of credentials. Here you will specify the minimum required credentials for this service. Doing this allows the system to check during scheduling to make sure that the staff that is scheduled has the credentials required to perform this service.
Check the box next to the Credential that is required for providing this Service.
You may also check the box for Primary Cred. so that this can be included in certain service logs.
Click the Save & Close button on the top left when you are finished.
NOTE: If you click the orange Cancel button or the X in the top right, it will close without saving any of your changes.