AlayaCare's new billing module allows organizations to better manage how payors are invoiced for services within billing periods.
The new approach to billing was designed to address key challenges faced by many organizations using the old billing cycles in AlayaCare and improve the overall user experience. Highlights of the new billing module include:
- Billing periods that have set billing frequencies and branches and allow for automatic back billing.
- A refreshed, more intuitive user interface.
- Ability to create different types of payor programs for clients containing rules for determining how the cost of services and premiums will be split between bill-to parties.
- Improved single payor billing experience.
- Ability to add miscellaneous charges directly to draft invoices.
- Better error handling around invoice generation and regeneration background jobs.
- AlayaCare Standard invoice template that can be customized using system settings to include/exclude fields and incorporate different formats.
How it works
In the new billing module, all billable items are invoiced through billing periods that recur on a set frequency. A billable item refers to a source item (visit, visit premium, or client billing premium) that has been approved and has a bill rate.
Please note that equipment and supplies and income items are not currently supported.
Billable items can be invoiced to either a single bill-to party or multiple bill-to parties. If the cost of items is split between multiple parties, you must create a payor program for a client to determine how items will be split between payors and attach the program to the services and premiums to which it applies. If you need to invoice items to a single bill-to party, you must select single payor as the funding methodology on the client’s services and premiums.
The new billing periods follow a set frequency of 1 weeks, 2 weeks, 4 weeks, or per calendar month. You must select a billing period frequency when setting up a payor program for a client or selecting single payor as the funding methodology on a service or premium. Once you create a billing period for a specific frequency, you will not be able to choose the start date for the period because there can be no gaps between billing periods of the same frequency.
For payor programs in which the cost of billable items can be split between bill-to parties, at least two invoices will be generated, one for the payor on the policy or contract and one for the guarantor. For services and premiums funded by a single payor, only one invoice will be generated.
Transitioning to the new billing module
Before moving to the new version of billing, your organization will work closely with your AlayaCare representatives to go through the following steps before enabling the feature in production:
- Meet with your Client Success team to discuss the new billing module and determine which payor programs you need to satisfy your split billing scenarios.
- Request configuration of the new billing feature in a UAT environment.
- Request a copy of your production data to the UAT environment (optional).
- Test your organization's main billing use cases as well as any edge cases.
- Test the AlayaCare Standard invoice and invoice export.
- Test the billing aggregate export.
- Request for the new billing module to be enabled in production. Any existing services will need to be converted to the available funder methodology.
Customers who use client individual or funder individual funder types will be encouraged to transition to the new billing module beginning in early 2021. Improvements are currently underway to allow customers who rely on HCP, LHIN, or funder batched type funders to move all of their billing over to the new module as well.
Please reach out to your Client Success Manager or Client Relationship Manager to learn more about transitioning to new billing and the right next steps for your organization.
To learn more about key concepts in the new billing methodology, refer to the following articles:
You can also download the attached user guides for more details about individual payor programs and the various workflows available.