Staff/Client/Payer Management Overview

Staff/Client/Payer Management Overview


Setting up Payers

Pay close attention to this section, this will determine the methods and rates to bill each payer. You will have a few choices when adding a new payer and they are Insurance, Regional Center, School and other payers. Please make sure you have your contracts available since you will need to add your rates.

  1. From the navigation menu click the  icon.
  2. There are 2 ways you can add a new payer. After clicking the  icon you can select Add New or you can select the payer list and click the Add icon at the bottom right of your screen.
  3. After entering the Payer's name select the Payer Type (Insurance/Regional Center/School/Other) and add the payers basic information. 
  4. Once completed you will land on the Payer's profile.
  5. Select Services from the top.
  6. Select the Add icon on the bottom right corner to add a new service.
  7. Use the chart below to help you complete this section.
  8. Click Save.
  9. Repeat steps 5-8 until you have added all your services for this payer.






    Field Name
    Description
    Rate
    Dollar amount to charge for the unit size
    Unit Size
    Unit of measure (15 Min/30 Min/Appointment/Day/Flat)
    Rounding
    How would you like to round for fractional units? 
    AMA/Up/Down/Nearest/Not Allowed 
    **Note AMA - Round up if unit is > = 50%, otherwise round down (this rule is also known as the 8 minute rule).
    Required Credential
    The staff needs to have a minimum of this credential before services can be provided.
    DX Code
    Select your diagnosis code from the drop down list.
    Billing Code
    Select your billing code from the drop down list.
    **Note - If you select a T-Code a new section will appear allowing you to select the additional code.
    Add Modifier
    Select your modifier from the drop down list.


Setting up Staff

To add a new staff, user the following steps.
  1. From the navigation menu click the  icon.
  2. There are 2 ways you can add a staff. Either select Add new from the navigation menu or from the staff list click the Add button at the bottom right of the screen.
  3. Fill in the staff's basic information and click Save.
  4. You will land in the Staff's profile.

Profile

Personal Info

This section holds your staff's personal information such as name, phone and address.

Custom Fields

Custom fields can be customized to track any information that is staff related.

Clinical Teams

Clinical Teams are used to group staff and/or clients together. Many customers find it helpful to create clinical teams to view multiple schedules at once without typing in each individual name.  

How to Create a Clinical Team 
  1. 1. Select Staff> Manage Clinical Team 




  1. 2. On the left column are all created clinical teams. To add a new clinical team, select the Add button to the right of Clinical Teams.


    1. 3. Name your Clinical Team and click on the blue check to save 

    1. Tip: You can create a clinical team for all staff, all clients, break up staff/clients by region, etc.  

    1. 4. Add your staff/clients to the team in the “Add Staff/Client” section 

    1. 5. Click Save  

Supervisor

The staff's supervisor(s) can be added in this section. The staff will automatically be added to their Supervisor's caseload for easy access. This is how you can add a supervisor.

Adding a new Supervisor
  1. Select the Edit button on the top right of the card.
  2. Check to make sure the Status is Active.
  3. Select the Staff Name from the drop down.
  4. From date is required.
  5. Click Save.

Qualifications

Adding a new qualification
  1. Click the Add button on the bottom right had corner.
  2. Select the qualification from the drop down list.
  3. Fill in the general qualification information.
  4. Click Save.

Pay Rates

An organization may pay staff multiple rates based on the service they are providing such as drive time, direct service or meetings. This section is used to manage the staff's pay rate.

Adding a Hourly Pay Rate

  1. Click the Edit icon on the bottom right hand corner.
  2. Click the Add icon on the top right of the window.
  3. Select an Earning Code from the drop down list.
  4. The From Date is required, and the To Date is not required. Usually this is the start date and the date of the staff's next annual review.
    **Note - The appointment will throw a warning if the pay rate has expired.
  5. Enter the hourly Rate.
  6. Click Save.

Adding Salary Pay Rate

  1. Click the drop down on the top left hand corner, and select Salary Exempt. 
  2. Click the Add icon in the bottom right hand corner.
  3. Repeat steps 3-5 from above and enter the Monthly Salary Rate.  
  4.  Click Save.

Cabinet

This is your virtual filing cabinet to store confidential and non confidential information. Posts can be shared with an individual, a team or not shared at all. Comments can be added to an new or existing note for additional detail. 

Adding a new Post
  1. Click the blue Add icon on the bottom right hand corner.
  2. Enter your title, select a category and your note.
  3. If necessary add a file by clicking Choose File.
  4. Now, set your permissions. All other options besides Public and Only me will display an additional option for you to select who you want to share the note with.
  5. Lastly click Post.
Delete, edit or hide a Post
Notes can be deleted by clicking the "..." on the right of each note and select the Delete Note, Edit Note Hide Comments.

Adding Provider Identifiers (NPI/Tricare/Medicaid/Referring Provider)

A NPI (National Provider Identifier) & Tricare number is a unique ID for covered health care providers. These numbers are used on the CMS 1500 form as a way to identify the health care provider(s) for HIPPA standard transactions. 

Adding Provider Identifiers

  1. From the left navigation menu click the  icon and select Provider Identifier.
  2. On this screen you will notice General, Tricare ID, Medicaid ID, and Referring Provider tabs along the top.
  3. Select which tab you would like to add an ID for.
  4. Use the search at the top to locate the staff then add their identifier on the right. 
On the General tab you can select whether or not the the staff/office NPI is used as a render provider, billing provider and service facility. 

Setting up Clients

  1. From the navigation menu click the  icon.
  2. From here there are 2 ways to add a new Client. The first way is to select Add New from the navigation menu. The 2nd is to click Client List and hit the Add button on the bottom right of your screen.
  3. The Add Client window will appear. Complete this section with your client's general information.
  4. Click Save.

Profile


Personal Info

This section will hold your client's general information such as name, phone and address.

Custom Fields

Custom fields can be customized to track anything client related.

Contacts

One of the most important things you need to know about a client are who their contacts are. Lets add a contact.
  1. For new clients you will notice an Add Contact in the middle of the card and for clients who already have contacts, you can click the Add icon on the top right of the card.
  2. Complete the Contacts general information
    • Responsible Party - Generally this is the person who is responsible for the bill (only 1 contact can be marked as the Responsible Party at a time).
    • Client Portal - Allow this contact to access Client Portal to view their schedule and more.
Client Portal: An email address is required In order to allow contacts to access client portal.

Client Assignments

We use client assignments to track and assign caseload to staff/teams. From this section you can manage who this kid can work with. 

Adding a staff/team to client's caseload.
  1. For new clients you can click the Manage Client Assignments link in the middle of the card. For existing clients who already have staff/teams assigned you can click on the Edit button on the top right of the card.
  2. Enter the staff/team's name in the Add Staff / Team and select from the drop down.
  3. Depending on whether you add an individual staff or team, will determine where it will be placed within the Assigned Staff or Assigned teams section. 
  4. Click Save.

Authorizations

Authorizations are issued with the set of billing codes and service details approved to be provided to the client. AlohaABA uses these authorizations to schedule appointments and streamline your billing process. 

First we need to add the Payer and the client's insurance information.
  1. Click the Add button on the bottom right.
  2. Use the drop down and select the Payer.
  3. Fill out the client's insurance information.
    **Note: Normally this can be found on the client's medical card.
                                            

  4. Click Save.
Next lets add the clients authorization.
  1. Find the Payer's card and select Add Authorization the Add icon on the top right of the card.
  2. Enter the client's authorization information here.
    1. In this section you can enter the authorization as it appears on your contract or you can customize the hours that can be provided during a certain period. The limit section allows you to customize the authorization to fit your organization. 
      Examples: (Allowed Limits / Select Type / Per)
      • 40 Hours per Week
      • 20 appointments per month
      • 30 dollars per day
  3. Click Save.
To prevent over-billing make sure you are adding your authorizations in units. This prevents the possibility of over billing for appointments that have fractional units.

Cabinet

This is your virtual filing cabinet to store confidential and non confidential information. Posts can be shared with an individual, a team or not shared at all. Comments can be added to any new or existing Post for additional detail. 
 


    • Related Articles

    • Setting up Staff & Client Logins

      Creating a new staff login/account The staff's profile will need to be added before you can issue them an account. To add a staff Click Settings from the navigation bar Next click Security > User Accounts The User Accounts page will default to users ...
    • Settings Overview

      Settings Organizations Editing your Organization This is your Head Quarters (HQ) that we call your Organization. Your organization is used throughout the system from billing to payroll so its essential that the information you add is correct. Lets ...
    • Client Portal

      AlohaABA's client portal is a convenient way for the parent or any contact on the client’s contact list to access their child's schedule. Users can review, sign, and pay for appointments in the client portal at anytime from anywhere. How to Give ...
    • Billing Overview

      To access any of the features below simply click the icon on the left navigation menu. Accounts Receivable AR Manager This is your Accounts Receivable Mission Control. All transactions related to billing (post payment, adjustments, re-bill, denials, ...
    • Creating User Roles

      Creating User Roles Go to Settings > Security > User Roles Click the + icon to create a new user role Enter in the user role name. Click the check icon to create the new role. Select the permissions the permissions for the role. At the very bottom, ...