Private Pay (Non-Medical) Service Configuration

Services that can be billed to insurance payers are classified as Medical/Behavioral. Services that are billed directly to the patient instead of the insurance are set up as Non-Medical in the RCM. Common examples of non-medical services include fees associated with housing or amenities while the patient is in treatment.

User Permissions

Only user profiles with an admin-level designation can create and manage non-medical services. For more information on user profiles and permissions, click here.

Create a Private Pay Service

Similar to creating a commercially billed service in the RCM, creating private pay services is a two-step process that involves making the service and referencing it at the facility to assign a rate. Let's review that process together!

1. Navigate to the Practice Admin and click Services.
   
2. Click Create Service.
   
3. Select Non-Medical using the drop-down in the Billing Classification field. Note that this field cannot be updated once the service has been created.
   
4. Enter the service name and description of the service to be displayed on the statement.
   
5. Next, click Create to finish the service creation process.
   
6. Finally, reference the service at the facility level following the steps outlined here.

Manage a Private Pay Service

Let's review how to manage a private pay service!

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  1. Navigate to the Practice Admin and click Services.
  2. Select the desired service.
     
  3. If the service has not yet been recorded, click the pencil icon next to Baseline.
     
  4. If the service has already been recorded and needs to be updated as of a specific date, click Create Scheduled Change Set.
     
  5. Enter the desired effective date and click Save.
     
  6. Next, click the pencil icon next to the effective date.
     
  7. Make the necessary changes before clicking Save to complete the process.
     

Walkthrough

Feel free to click through the interactive walkthrough below!