Single payor billing

AlayaCare’s new single payor billing methodology allows you to use the new billing module to bill a client's services and premiums to a single bill-to party using the new billing periods.

To use this methodology, you must select single payor as the funding methodology on the client’s services and premiums and choose a billing frequency. When you are ready to bill for the services and premiums, you will create a billing period for the frequency and generate the invoices for all billable items that fall within the dates billing period for the client and payor. Any recently approved billable items that have not yet been included in a billing period will also be invoiced.

Selecting single payor as the funding methodology for services and premiums

When creating a service for a client, select single payor as the funding methodology.  

Next, select a billing frequency (1 week, 2 weeks, 4 weeks, calendar month, daily [available by request]), funder (client individual or funder individual), and service code.  

When adding a new client billing premium, select single payor as the funding methodology. Then select a billing frequency and funder. 

Note that you will not be able to edit the funding methodology on a service or client billing premium that is currently included on active invoices. To edit the funding methodology, you would need to first delete or void the invoices the service or premium is included on. 

Creating billing periods and generating invoices

Services and premiums using single payor will be invoiced through billing periods rather than billing cycles just like services and premiums funded by payor programs.

To generate invoices for single payor services and client billing premiums, you must first create a billing period for the frequency you wish to bill for by going to Accounting>Billing>Billing Period for Payor Program and selecting Create Billing Period.

In the dialogue, select the Branch and Billing Frequency (1 Week, 2 Weeks, 4 Weeks, Calendar Month, daily [available by request]) and enter a Start and End Date along with an Invoice Date. Note that the Start Date can only be set on the first period created for the Billing Frequency (of the same branch).  

When you have finished, click save.  

Click view to open the billing period. Note that if your organization is multi-office, the application will switch to the branch that the billing period belongs to and filter the content accordingly.  

Clicking View will open the Visits tab within the billing period. From here, you can approve all visits and premiums included in the billing period and resolve any unscheduled visits as you would before generating invoices using the old billing methodology in AlayaCare.  

When you have finished approving source items, click on the Master Invoices tab and select Generate Invoices. This action will queue a background job to generate invoices. 

Once you click to generate the invoices for the approved source items during the billing process, the system will check each billable item in the billing period to see if it has single payor or a payor program selected as its funding methodology. If the funding methodology is single payor, the item will be included on an invoice and billed to the funder selected on the service or billing premium. 

Click View to review an invoice generated for any single payor funded client services and premiums. 

This action will open a screen that displays the billing details along with a list of all billable items included on the invoice. 

Depending on the status of the invoice, different action buttons will be available (+Add Misc. Charge, Delete, Send, and Regenerate if draft and Void if sent). Export will be available for invoices of all statuses.  

For invoices in draft status, you will also be able to add miscellaneous charges by clicking the Add Misc. Charge button.  

In the Invoice Details section, you will see the Invoice Number and Payor Name, Invoice Amount, Amount Due along with any Payments and Adjustments for the payor. If the invoice has been regenerated to account for any changes to the source items, the version number will be indicated in the invoice numbers (53 v.0, 53 v.1, etc.). 

In the Billed Items section, you will see details about the visits and premiums included on the invoice. The Type, Reference ID, Service Date, Scheduled Time, Employee, Quantity, Rate, Description, Amount and Total cost charged will be listed for each item. You will also be able to click on a hyperlink for the billable item in the Ref ID field to view more details about the visit or premium.  

If any additional charges have been added to the invoices, the Invoice Billable Items section will also contain a Miscellaneous Charges list. 

When you are ready to finalize the invoice and mark it as Sent, click Send.  

Once an invoice has been marked as sent, you can add transactions to the invoice as necessary.