SETTING UP PAYER INFORMATION

Requirements: All field users, case managers and clinical administrators can post information and instructions and make changes to this form if they have a HHC Ultra user’s account and have access to these sections.

Payer Information needs to be set up first before posting visits in the calendar. This is essential especially if insurance requires TAR / TAC.

This feature sets a limit to the number of visits that can be posted and billed based on the TAR. Make sure to select the correct insurance to bill for certain visit dates in the episode.

You may add Payer information for this episode by clicking the “Add” button under the Payer Information section. A dropdown list of the previously defined Insurance Agencies and HMOs from your library, select the “Insurance” and fill out the start and end dates of the reimbursement period as well as added notes and click “Save”.

To add new TAC information to the newly saved insurance detail, click on the insurance first to enable the loading of the TAC listing below the insurance section. 

When the Treatment Authorization Code window appears, the information may now be added or updated. To add TAC, click on the “Add” button on the TAC Information box. To edit the previously saved values, click on the “TAR” entry and the fields will automatically be enabled. The user will be requested to fill out the boxes including the Care Staff Type, Visit Type, Unit and Limit as this will set the maximum value characterized by a particular discipline and visit setting.

Always remember to fill out and save the TAC details. Once saved, highlight the TAC to populate TAC details where the user will fill out the discipline and visit types for covered by this TAC and Save. Once done, the visits can now be posted under the specified Payer.