Special Note: Split billing is being progressively replaced by the upcoming Payor Programs feature. For this reason, it may not be enabled in your environment. If you are currently using split billing, your client relationship manager will contact you soon about transitioning to Payor Programs.
The Funding Methodology of a Service is Single Source by default. In other words, only one Funder will be billed when Invoices are generated for Visits.
However, there is another Funder Methodology option available when creating a Service called Split Billing, which allows you to select more than one Funder for the Service. To use Split Billing, select Split from the Funder Methodology dropdown in the Create Service dialogue.
When Split is selected, the Funder dropdown is replaced by the Funder Breakdown table. In the Funder column, select a Funder in each dropdown. Note that the following rules apply:
- You cannot select the same Funder more than once.
- If you select a Funder of type Client Individual, you will obtain an additional Billing Contact dropdown in which you can select from the Client's Contacts.
- Another Funder can be added by clicking + Add Funder in the bottom right.
In the 100% column, enter the percentage billed to each Funder.
- The total of percentage amounts you have entered will appear in parentheses at the top of the column (see 55% below). The total must equal 100% before you can save the Service.
Every Funder of the split-billed Service must have a Bill Code for the Service's Service Code. As a result, once Funders are selected, only matching Service Codes can be added. Once a Service Code is selected, only matching Funders can be added. For instance in the example below, only the Service Code BRV has associated Bill Codes for both MOHLTC and Private Stest - Cash.
Once a Service Code has been selected, the Use Rate column of the Funder Breakdown will populate with the rates of each Funder for the Service Code. You must select one of the rates to be the billable rate for all Funders on the Service.
In this example, the rate 10.00/visit is selected, which is MOHLTC's rate for the Service Code.
Therefore, when Invoices are generated for Visits, MOHLTC will be billed 5$ per Visit, and Jane's parents will be billed $5 per Visit, as they are splitting the fee 50/50.
The Funder Breakdown appears also in the Accounting tab of the Visit dialogue.
The user can edit the breakdown:
- The percentage split can be altered.
- The effective rate can be changed from one Funder's Bill Code to the other.
- A different Bill Code can be entered for either Funder. Note that unless the Bill Code is the effective Bill Code (chosen in the Use Rate column), this will have no effect on billing.
Premiums are also split between Funders. See the Premiums tab of the Visit dialogue.
Here again, the percentage split can be edited, though the selected rate will always be the rate of the primary Funder on the Visit.
When the Visit is approved for billing, it is approved for all Funders of the Visit. If a Visit. If a billing cycle does not exclude any of the Funders of the Service, all the Invoices for the Visit will be generated for all Funders. Otherwise, it is up to the user to ensure that they create Billing Periods for each Funder of the Service so that all portions of the Visit will be billed.