Facilities Overview

The Facilities section shows the name of each facility created within the practice. Clicking on a facility name opens the profile where you can update demographic information, reference services, and manage rendering providers.

User Permissions

Only users with an admin-level designation can manage facility information. To learn more about user types and permissions, click here.

Facility Profile

The Facility Profile displays the facility's demographic information, such as location and contact information, as well as the NPI, Taxonomy, and location-specific IDs required on some claims.

Name	Definition	Claim Rule Required
Name	This is the name of the facility.	The system will display this name by default. A claim rule is available for using a custom name.
Description	This is the description of the facility.	N/A
NPI	This is the facility's assigned NPI.	The system will display this name by default. A claim rule is available to use the facility's NPI as the billing
Facility Taxonomy	This is the facility's taxonomy number.	Yes- a claim rule must be created to add the facility taxonomy. The same rule can be used to apply a custom taxonomy.
Tax Identification Number	This is the facility's FEIN.	The system will display the FEIN by default. A claim rule is available to use the facility's FEIN as the billing provider's. Additionally, a rule is available for using a secondary tax ID.
Address Information	This is the facility's physical location.	N/A
Phone and Email	This is the facility's contact information.	N/A
Is Outside Laboratory	This indicates whether the facility is an outside laboratory.	N/A
CLIA Number	This is the facility's CLIA information.	Yes- a claim rule must be created to add the CLIA to a claim.
Facility Payer-Assigned Provider ID	This is the facility's payer-assigned provider ID.	Yes- a claim rule must be created to add the facility's payer-assigned provider ID to a claim.
Blue Shield Provider Number	This is the facility's Blue Shield Provider Number.	Yes- a claim rule must be created to add the Blue Shield Provider Number.
Location Number	This is the facility's (payer-assigned) location number.	Yes- a claim rule must be created to add the location to a claim.
DOH License	This is the facility's Dept. of Health license number.	Yes- a claim rule must be created to add the location to a claim.
State License Number	This is the license number assigned to the facility by the state.	Yes- a claim rule must be created to add the facility's State License Number to a claim.
Is Active	This indicates the facility's status in the RCM	N/A

Manage the Facility Profile

Let's review how to manage a facility profile!

From the Practice Admin, click Facilities.
Click on the facility name to open the profile.
Next, click Create Scheduled Change Set.
Select the Effective Date for when the changes will take effect.
Make the desired changes and click Save to complete the process.

Facility Service Rates

Service Rates are referenced and managed at the facility level on a per-billing profile basis. Each billing profile created for a service must be referenced at the facility level to ensure the correct service rate is applied. This includes services for both insurance-billed and private-pay services. For information on creating and managing Facility Service Rates, click here.

Name	Definition
Service	This is the name of the Service associated with the rate.
Inst./PB Unit Rate	This displays the service rate for institutional claims and private-pay billables when the Patient Billing module is enabled.
Rev. Code	This is the revenue code associated with the referenced billing profile.
Institutional Procedure Code	This is the HCPCS associated with the referenced billing profile.
Prof. Unit Rate	This displays the service rate on professional claims.
Prof. Procedure Code	This is the HCPCS/CPT associated with the referenced billing profile.
Service Rate Type	This field determines whether a service rate will be applied based on the patient's admission or service date.
Effective Date	This is the effective date of the current service rate.
Active	This indicates whether the referenced rate is still active.

Facility Rendering Provider

Rendering Providers are referenced at the facility level but managed in the Practice Admin. Referencing the provider at the facility level generates the list of selectable rendering providers when a new U/R plan is created or a new standalone service is recorded.