Service Codes are required for all payable and billable items, such as Visits and Premiums. The Bill Code and Pay Code configurations on the Service Code will determine how the item is paid or billed.
Pay Codes and Service Codes
Since the purpose of the Pay Code is to determine how to pay for a Service Code in three possible situations (regular, holiday, and overtime), a Service Code can have up to three Pay Codes associated with it: a regular Pay Code, one for holidays, and one for overtime.
In the example below, three different Pay Codes are configured for Service Code 1 to handle all three scenarios. But Pay Code 3 is serving both as the Overtime Pay Code for Service Code 1, and the Regular Pay Code for Service Code 2.
Bill Codes and Funders
A Bill Code must have one and only one Funder.
A Funder can have numerous Bill Codes.
In this example, while Funder 3 has only one Bill Code, Funder 4 has two different ones. Each Bill Code is only associated with one Funder.
Bill Codes and Service Codes
Since the purpose of the Bill Code is to establish how a given Funder will be billed for the Service Code, there can be only one Bill Code per Funder on a Service Code. There can be many Bill Codes on the same Service Code, as multiple Funders may be paying for the same kind of Service.
In the example below, Service Code 1 has three Bill Codes and therefore three Funders configured to it. Funder 4 has no Bill Code for Service Code 1, and therefore cannot be billed for any Service Code 1 Services.
Funder 3 can be billed for both Service Code 1 and Service Code 2, and will be billed according to the same Bill Code Rate.
Funder 4 has separate Bill Codes relating it to Service Code 2 and Service Code 3, so will be billed accordingly for each when applicable.