The Facilities tab houses all of the information for the facilities within the Practice. This includes Facility profile information which can be used to populate claim details, service references, and rendering provider references.
You can access Facilities from Practice Admin.
Create a Facility
To create a new facility for the organization:
- Navigate to Practice Admin > Facilities and click Create Facility.
- Enter the following information:
- Name: The facility name.
- Description: A description for the facility, i.e. Residential Substance Abuse Facility.
- Address: Street address as well as City, State, and Zip Code for the facility.
- Phone: The phone number for the facility.
- Email: The Facility’s email, if applicable.
- NPI Number: The NPI for the facility. This is required for billing insurance.
- Is Active: Toggle to Yes.
- Click Create.
- Once the Facility has been created, you can add additional information and settings as needed. From the Facilities list, click on the Facility Name to open.
- Click on the Edit icon for the Baseline profile.
- In the Update Scheduled Change Set window, you can add the following options:
- Tax ID Number: If you want to bill under the Facility Tax ID, add that number here. You can create a Claim Form Rule to write the Facility Tax ID to institutional claims.
- Is Outside Lab: Toggle to Yes or No. This is designed to support laboratory billing on professional claims.
- Blue Shield Provider Number: Add the Blue Shield Provider Number if required to be billed on professional claims. You will need to create a Claim Form Rule to pull this information onto the claim.
- Payer Assigned Provider ID: If required, add the Payer Assigned Provider ID and use a Claim Form Rule to pull this information onto the claim.
- CLIA Number: If applicable, add the CLIA number and use a Claim Form Rule to pull this information on the claim.
- Facility Taxonomy: Add the facility taxonomy and use a Claim Form Rule to pull this information onto the claim, if applicable.
- Click Save.
Once you've created the Facility Profile, the next step is to add the services that will be provided at this specific facility location. This is done by referencing the Service added to the Practice this facility is situated under. If you don't see a particular Service, confirm you are in the correct Practice, then add the Service to the Practice Admin.
- Open Practice Admin > Facilities.
- Open the Facility, then click on the Facility Services tab.
- Click on Add Service Reference to add a service to this facility.
- Select the Service from the drop-down.
- Select the Service Billing Profile.
- Next, add in the institutional (or patient billing unit rate) and professional rates for this service.
- Please note that if professional service lines are not active for the billing profile, the professional service line unit amount option will not appear.
- Click Add.
- Repeat this process as many times as necessary until all the services provided at the facility have a service reference and rate structure.
Once the services have been entered, the next step is to add the Facility's Rendering Providers. These are referenced from the Practice, just like services. If you don't see a particular Rendering Provider, confirm you are in the correct Practice, then add the Provider to the Practice Admin.
- Open Practice Admin > Facilities.
- Open the Facility, then click on the Facility Rendering Providers tab.
- Click on Add Rendering Provider Reference to add a Rendering Providers to this facility.
- Select the Rendering Provider from the drop-down and click Add.
- Repeat for each Rendering Provider in the facility.
Making Updates to Facilities
Once you've created your facility and begun billing from the facility, we recommend updating facility information including Profile, Services, and Rendering Providers using Scheduled Change Sets. This helps maintain claim continuity and allows you to set a date for when the change should go into effect, allowing you to prevent or minimize the number of claims impacted by the change.