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.
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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. Is Active This indicates the facility's status in the RCM N/A -
- 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.
- From the Practice Admin, click Facilities.
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.
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Name Definition Service This is the name of the Service associated with the rate. Inst./PB Unit Rate This displays the service rate on 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 rate of service. Active This indicates whether the referenced rate is still active. -
- From the Practice Admin, click Facilities.
- Click on the facility name to open the profile.
- Next, click Facility Service Rates.
- Click on the Service.
- Next, click Create Scheduled Change Set.
- Select the Effective Date for when the changes will take effect and click Save.
- Next, click the pencil icon to edit the service rate.
- Make the desired changes and click Save to complete the process.
- From the Practice Admin, click Facilities.
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.
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- From the Practice Admin, click Facilities.
- Click on the facility name to open the profile.
- Next, Click Facility Rendering Providers.
- Select the provider's name.
- 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.
- From the Practice Admin, click Facilities.
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