This is an overview of all fields in the billing import sheet. The Billing Import Sheet is attached at the bottom of this article. Please retain a copy for your records and any future updates.
Contract – Services and CPT codes are separated by contracts in the system. Private Pay services will have “Private Pay” as the contract name. Internal services will have “Internal” as the contract name.
Service Name – Services (referred to as Parent Services) in AccuPoint house the billing information for a specific service type or CPT Code.
Recommended Format: Contract-Certification Level-Service Type
Authorization Bank – Also referred to as “Hour banks” is the pool of approved hours per CPTcode for scheduling purposes. The Authorization bank column in the spreadsheet will be the name of this bank of hours.
Recommended: Name the hour bank similar to the service type
Example: the Hour bank for “Tricare-RBT-Direct” will be “Direct” or “RBT Direct”
Note: two services that have the same Authorization bank name will share however many hours that are entered into that bank.
Sub-service Name – This will be the name listed in the services drop down while scheduling. This will allow you to schedule billable services, non-billable services, services with modifiers.
Parent Service Name-Billable
Parent Service Name-NonBillable
Parent Service Name-Modifier-Billable
Please Note: Sub-services that share a parent service will share hour banks
Payroll Rate – Each sub-service can be assigned a payroll rate. In this column you will identify the name of this rate field. This is the hourly rate at which your staff member will be paid. After your site is complete, it is strongly recommended to have a payroll setup meeting.
Certification – Services can be sorted and reported on based on certification level. In this column list all certifications that can perform this service.
Payer/Payer ID – All payers that will be billed electronically through AccuPoint must be given a 5 digit payer ID associated with that payer by MD On-Line. MDon-line is the clearing house AccuPoint sends electronic claims to, they have provided a searchable list of payers and their payer ID using this link. https://abilitynetwork.com/payer-list/
Please search for the payer in the link above, and find the correct Payer ID next to it.
Group NPI – This should be the NPI for your company recognized by your payer.
TaxID – Your company Tax ID number.
Legal Name – The full legal name for your company
Address – Enter the billing addresses for your company as recognized by each payer.
How is this Billed?
Electronically – Claims will be submitted to, and routed by the clearing house to the payer, it is expected that an Electronic Remittance Advice will be provided by the payer into the clearing house, which is picked up by AccuPoint to automatically update your claims with the paid amount, or patient responsibility amount.
*On Paper*- Claims that cannot be submitted through the clearing house, or must be submitted directly through the payer would be considered “On Paper,” these items would have invoices generated for them from within accupoint, and their payments would be posted manually into the system when received.
Nonbillable – Claims will not be generated for items completed for this specific service. This would be for nonbillable or internal services that will not be billed by any means.
CPT Code 1 – Each service (not subservice) should have the CPT Code associated with this service in this column. Every subservice submitted with this CPT Code will be merged together per day, per client, to avoid duplicate claims by the system.
CPT Code 1 Hourly Bill Rate – This column will contain the hourly rate that you will bill for this service. This is not a per-unit rate. If you are billing a flat rate for your services, you should enter the flat rate here instead.
Contractual Rate 1 – This column contains the hourly rate that is specified in your contract by the payer. Any differences between your bill rate and your contract rate will be adjusted by the system automatically after your payment is received.
Units Per Hour – This should be a numbered field, 1 unit per hour if you are using 60 minute units, 2 units per hour if your units are for 30 minute duration, or 4 if you are using 15-minute units.
Modifier – Your modifier will be a 2-digit code provided by the payer for your codes, please contact your payer if you are unsure if your codes utilize 2-digit modifiers for your service. AccuPoint allows up to two modifiers to be entered.
Modifier 2 – Secondary Modifiers should be entered here,
*Bill One Unit*– Each service that is billed a flat rate for the day regardless of the hours served must have a “Yes” in the bill one unit column, this will tell the system that this is not a timed code.
These settings will determine the types of overlaps allowed while scheduling in the calendar.
Client Overlap – This allows multiple clients to be schedule with the same employee, such as in a Group or Classroom setting. Services with this overlap setting enabled will only allow client overlap other services that have Client overlap enabled.
Employee Overlap – This allows multiple employees to be schedule with the same client, such as in an RBT direct session that has a supervising BCBA present. Services with this overlap setting enabled will only allow employee overlap other services that have employee overlap enabled.
All Overlap – Often utilized for supervision services, this setting ignores any overlap configuration and allows this service to overlap with anything currently on the calendar. This allows Supervision services to overlap with Direct 1-on-1 therapy, where the Direct service normally would have Overlaps disabled.
- Rendering Provider* – This will be the name of the lead rendering provider in charge of services sent to this payer. AccuPoint will send claims based on the client’s individual rendering provider, but in the absence of an assigned rendering provider, claims will be submitted under this employee’s name.
- Rendering Provider NPI* – The NPI of the above-mentioned rendering provider. Claims will be sent under this NPI If the client has not been assigned a rendering Provider.
Is there an Authorization number? – Does this service need an authorization number to be submitted to insurance? If yes enter “Yes” into this field if no enter “No” into this field
*Place of Service (Bill Type)*- List all possible place-of-service codes, each 2-digit code can be separated by a comma.
Institutional or Professional – Identify the type of claim that needs to be submitted. Institutional Claims- UB-04 Forms Professional Claims- CMS-1500 Forms