Users should reach out to their payor before setting up their account, to find out what is required for Telehealth, in terms of claims. Users should then set up their accounts based on what the payor requires. 

The following steps are suggestions for organizations. Click here to watch the “Telehealth Set Up: Create New Codes” webinar.

To create new service codes:

1. Create a service code.
2. Add service code properties:
   • Code: the service code being duplicated.
   • Description: it is recommended to add the word “TELEHEALTH” in all caps before the start of the description, to make it clear to use this code for Telehealth services only.
   • Default Service Location: Selecting 02: Telehealth will pull the location into all timesheets for employees using this code. Only add a location here if all payors linked to this code are asking for this specific location. If they are not, leave this as none and set the location by payor in the fee schedule.
   • Procedure Info: if providers ask for modifiers, select Optional. This will pull modifiers into the timesheet.
3. Add any note templates needed and click Save.
4. In the Service Codes grid, add or create any service code labels to the new code. 
5. Select the number under the “Default” column to add Default Rates.
6. Click the Actions drop-down and select Set Default Rate.
7. In the “Fee Schedule Default Rate” pop-up, select a fee schedule and enter the rates for this service.
   • Agreed Rate: if there is no agreed rate, make it the same as the billed rate in the “Rate” field.
8. Click Add.
9. If the payor requires a modifier or if rates differ by credentials, click the gear icon under the “Options” column on the right-hand side and select Add Modifier Group.
10. In the “Add Modifier Group” pop-up:
    • Name: it is recommended to add “Telehealth”
      • If rates are different by credentials, create a Modifier Group with each credential and state in the name. For example, Telehealth- BCBA.
    • Location: users can add the “02: Telehealth” location if the payor requires this and it is not set in the service code Properties.
    • Enter the rates that for this payor.
      • Agreed Rate: if there is no agreed rate, make it the same as the billed rate in the “Rate” field.
11. Click Add.
12. To set employee rates, select Custom Rates in the Service Codes grid.
13. Click the Actions drop-down and select Add custom rate.
14. In the “Add Custom Rate for:” pop-up:
    • Employee: add the employee.
    • Rate: users should not enter a client rate. Leave this blank if it is not needed.
      • Entering Client Rates will override what is set for the payor in “Default Rates.” Any modifiers added for the payor will not pull in.
15. Click Add Rates.
16. Users can also add employees by pay codes if they are subscribed to the Human Resources module. 
17. If the payor does not provide a new separate authorization with new authorized amounts for Telehealth services and the client must use the current authorization and the remaining amounts they have, put the service code(s) in the existing authorization. The new code should be put in with the group of codes they must share the remaining utilization with. 
    • Navigate to the Billing module and select Authorizations.
    • Find the service code they must share the amounts with and select the paper icon on the right-hand side to open the authorization and to that specific group of code(s). 
    • Select the Service Codes tab and add the new Telehealth service code. 
18. When scheduling new appointments, the employee creating the appointments should pick the code with the word “TELEHEALTH” for the Telehealth services. Both codes will be provided in the authorization, so it is very important to take your time when selecting these codes. 
19. To update existing appointments without the Telehealth code to the new Telehealth code, use the View as Grid screen to filter for any appointments with the old code and open the appointment details to change to the new code. Users can create a new appointment type for Telehealth or add “Telehealth” to the appointment name.
    • Add the Telehealth authorization.
    • Click Update Appointment.
    • Convert the appointment, review the timesheet, and click Save.
20. If the payor provides a new separate authorization, create a new authorization.
    • This means that there will be two authorizations valid for one client if they had one already on file.
    • It is not recommended to delete anything involving authorizations. Once deleted, it cannot be brought back.
    • It is recommended to expire the non-Telehealth authorization to the day those services stopped. Please note, users have to go into each group of codes in the authorization and expire each one. The Global Settings cannot just be expired, as it will not apply to each individual group of codes. 
      • The new Telehealth authorization will start the day after the other authorization ended. This will not provide the employee with the option to select the wrong authorization and nothing will be deleted that could be used in the future.
    • After Telehealth Services are no longer being provided to the client, bring back the old authorization if the new authorized amounts are not being provided. This has to be done for each group of codes in the authorization. Editing the Global Settings for the date range does not apply to each group of codes.
21. Delete the service code that was just created, but keep the authorization.
    • Deleting the code and keeping the authorization(s) intact will prevent employees from using the code. This keeps the utilization of those services up to date and untouched.
    • Anything that is deleted from an authorization cannot be brought back, but, deleted service codes can be.
22. Update any existing and unconverted appointments from when Telehealth services will no longer be provided back to the original code from the original authorization. Or, if a new authorization is provided, update the appointment(s) with that new one.

Click here to learn how to set up modifiers for Telehealth.

To add interest payments to a billing entry: 

1. Create a service code to use for a billing entry.
2. Navigate to the Billing module and select Service Codes.
3. Click +Add New and name the service code (e.g., Interest Payment).  
4. In the Service Code Properties: 
   • Type: Non-Billable 
   • Code: Interest Payment 
   • Enforce Rate: Default rate can be used 
   • Calculation Type: Bill by units/ Pay by time 
   • Default Units: 1

5. In the “Validation” section, all fields should be set to Optional or Not Needed. 

6. For the “Restrictions” section: 

• • Requires Authorization: Optional 
  • Do NOT select Enforce Single Timesheet Conversion, Requires Schedule Conversion, and Restrict Early Timesheet Conversion. 
  • Lock Grace Period: leave empty 

7. Click Save.

8. Add a fee schedule to the service code.

• • Add all of the payors an interest payment will be added for. 
  • Set the Rate and Agreed Rate to $0, so a custom amount can be added to the billing entry. 

9. Create a billing entry.

• • If creating the billing entry from an admin account, select I am the provider or enter the organization’s name. 
  • Add a date of service, this can be the date the payment was received, today’s date, etc. 
  • Click Service Codes and select the newly created service code. 

10. Click Submit.

11. Add an interest payment to the billing entry: 

• • Navigate to the Billing module and select Billing.
  • Identify the newly created entry and click the + icon to add a payment.
  • Select the client payor in the “Payor” field.
  • Select the “Payment Type,” usually electronic.
  • In the “Reference” field, if the interest payment is from an ERA, type the ERA reference number here. 
  • Add a note if needed. 
  • Add the interest payment in the “Amount” field.
  • Click Add.

12. Once added to the billing entry, the additional income will be reflected in the RCM report.  

The Reconcile Payments report contains all of the information about reconciled payments posted to billing entries and bank deposits in the Billing module.

To export the Reconcile Payments report:

1. Navigate to the Billing module and select Reconcile Payments.
2. Select any desired filters and a date range, by clicking the All Dates drop-down.
3. Click the cloud  icon on the right-hand side and select CSV or Text file.
4. Click  Download in the “Export” pop up to download the report to your computer, or Go To Files to be directed to the Files module. The file will also be located in the Files module.

Click here to learn how to reconcile payments.

Users should reach out to their payor before setting up their account, to find out what is required for Telehealth, in terms of claims. Users should then set up their accounts based on what the payor requires.

The following steps are suggestions for organizations. Click here to watch the “Telehealth Set Up: Modifier Groups” webinar.

To add a modifier to a service code:

1. Navigate to the Billing module and select Service Codes.
2. Select a service code that will be used for Telehealth and click the number under the “Default” column to open the fee schedules associated with that code.
3. Create a modifier for every location the service code will be used at and/or for the different credentials that are paid at different rates. Click the gear icon in the “Options” column on the right-hand side and select Add Modifier Group.
   • Please note, if there is only one Modifier Group linked to the fee schedule, any client with that payor using the service code will have that one Modifier Group automatically applied to the timesheet. If not all services for that payor/service code are provided with Telehealth, create another Modifier Group for those standard services.
4. In the “Add Modifier Group” pop-up:
   • Name: add a name, such as “Telehealth.”
   • Location: select 02: Telehealth IF required by the payor, or add another location that is required. This can be left blank if they are not requiring a location. The Modifier Group does not need to be saved.
   • Modifiers: reach out to the payor to see if they take modifiers and if they require a specific order, and set this up based on their requirements. This can be left blank if none were provided. The Modifier Group does not need to be saved.
   • Rate: add the rates that you as an organization bill for the service.
   • Agreed rate: add the rates that were agreed upon with the payor. If there is no agreed rate, make it the same as the billed rate in the “Rate” field.
5. Click Add.
6. Users can add “Telehealth” to appointment names or create an appointment type for employees converting these appointments. Or, users can create Scheduling labels to track which appointments are for Telehealth. 
   • These are recommendations to help with the tracking and auditing process if services are being provided with and without Telehealth.
7. During conversion, the modifier groups linked to the fee schedule will be listed for the employee to choose, depending on where/how the service is being provided.
   • Please note, if there is only one Modifier Group linked to the fee schedule, it will automatically default to that Modifier Group and the employee will not have to choose.
   • This setup will require warning and training employees filling out these timesheets if they have to choose between more than one linked Modifier Group.
8. Complete the timesheet according to the organization’s requirements and workflows. Click Save or Save and Return.
9. To audit the timesheets, navigate to the Billing module and select Billing. 
10. Select the correct date range and any necessary filters, such as Service Code Labels and Billing Labels. It is recommended to filter down by payor/service code and audit for what is required, such as the Location and/or Modifier(s).
11. To audit for modifiers, select all of the billing entries in your search. Click the Actions drop-down and select Bulk-merge claims, but do not generate the claim yet. In the bulk generation screen, open each claim by selecting the >  arrow to view if any modifiers are attached to those entries. Add or remove any modifiers as needed and required by the payor.
12. To audit for the location, look for the “Location” column and select the hamburger icon on the right-hand side of the blue word “Location”. This shows all of the locations that are applied to the billing entries with the current filters. Users can also click Locations on that same column to filter for any billing entries that do not have a location set. There are two ways to add or edit the location:
    • To add/remove Telehealth to the location, select the gear icon under the “Options” column on the right-hand side and select Edit Timesheet. Select the service line and edit the Place of Service. Click Save or Save and Return.
      • After refreshing the Billing screen, the entry will be updated.
      • Please note, this action is for billing admins.
    • Or, users can generate the claim(s). When the claim is generated, click the Actions drop-down on the right-hand side in the “Claim Manager” and select edit the claim. When the claim is open, click the Services tab and select each service line to edit the location. Click Save Claim.

13. Once auditing is completed, generate the claim(s).

When the Telehealth modifier is no longer needed, remove the Modifier Group from the default rate. Billing entries created before the Modifier Group is deleted will remain as is, because billing entries keep historical data.

Click here to learn how to delete a modifier linked to a default rate.

Click here to learn how to create new service codes for Telehealth.

Users cannot delete a payor that is no longer being used. However, the organization account can make payors inactive, to prevent employees from using them.

To make a payor inactive:

1. Navigate to the Home module
2. Click My Profile and select the Settings tab
3. Click Accepted Insurances and click the x to the right of the payor no longer being used.
   • Please note, this affects the future use of the payor. As long as timesheets are already created and saved with that payor, making a payor inactive should not affect the rebilling of claims.

CentralReach does not offer a standard integration with QuickBooks. However, we can support with the building of an .iif (Intuit Interchange Format) file, which will be useful if the version you have allows uploads. Importing and exporting .iif files created by QuickBooks is rather simple, because QuickBooks formats the file for you. It may be easier to manually enter the data directly into QuickBooks, unless you have large amounts of data to input.

• Please note, that .iif files are irreversible, and it is recommended to back up your company files before trying to import any .iif files into QuickBooks. This way, if any errors should occur while importing the file you can restore a backup of your company files

Creating a .IIF file:

To start off, determine what information you want to pull from CentralReach and have appear in your .iif file. CentralReach allows you to download various information, which you can export to a .CSV (Excel) file, that you can then convert to an .iif file. The initial steps you take to download the information from our system will depend on what data you are trying to collect and import into QuickBooks.

To download billing information from our billing screen and convert that data into an .iif file:

1. Navigate to the Billing module and select Billing
2. Select the date range you want to download and pull from our system, then download the billing screen
3. After following those instructions, you should have an open Excel file populated with information from your billing screen
4. Once you have this document created, you can modify it
   • You can delete any columns/fields within the document that you do not want or need
5. After you have edited the document and removed all unwanted information, you will need to modify the column names. QuickBooks column names are very specific. In order for your file to properly import into QuickBooks, you will need to use the appropriate column names

• For Example, If you look at the image above, the date column is labeled “DateOfService.” That would need to be changed to read “DATE” because that is the column name that QuickBooks will recognize as a date field. If it were to be left as “DateOfService,” when you went to import your file into QuickBooks, it would not read/upload the file properly
• The column names you will need to use will be specific to what area of QuickBooks you are trying to upload your .iif file to and what information is contained within that file.

6. Once you have your document fully edited and ready to be uploaded into Quickbooks, you will need to save it as an .iif file. To do this within Excel you will need to click File, and then Save As

7. A new window will pop-up. In the Save as type drop-down menu, select the option that allows you to save your document with an .iif file extension. Some older versions of Excel may not give you the option to save the document as an .iif file. In this situation, you will need to save it as a Text(Tab delimited).TXT file

8. If you are able to save the file as an .iif file, it is ready to be imported into QuickBooks. If you have to save it as a .txt file you will then need to:

• Close your file
• Open windows explorer and locate your file
• Left click on the file and select rename

9. All you will need to change in the name is the file extension. So simply change .txt to .iif

10. Once you have completed this step, your file will be ready to be imported into QuickBooks

We understand that this process is a bit lengthy and slightly confusing if you are not familiar with formatting delimited text files. If you have any questions or need assistance in creating a specific template do not hesitate to open a support ticket.