Bundled Services is an option available for programs that include more than one service within a day for a client. For example, a child sees a therapist, psychiatrist, and receives BMS in one day. There are many other combinations that might apply, depending on the program being offered to the client. Bundling services prevents billing separate charges for each service provided to one client within the day and combines all services into a bundled amount. Many insurance companies will not pay separate services provided to one client within a 24-hour period, but will reimburse for the bundled service amount. This has to be set up in EMR-Bear in order for services to bundle for billing.
Enabling Bundled Billing Services requires certain components to be in place.
- Fees that are defined as "Facility" billing level.
- At least one program defining one or more "Enrollment Level"
- At least one "Bundle Services" definition using a Facility Fee, and pointing to the Enrollment Level of the program.
To begin, go to the Dashboard and under the Billing section, click on Bundled Services.
A screen will open and if no programs are enabled for Bundled Services, it will notify you to enable those (see below).
To begin the process of enabling Bundled Services for a particular Program, click on the blue “program” link.
This will open another window that appears similar to this:
Notice the section at the bottom of the window
This opens two fields to the right of that section: Label and Position.
Enter the Level of service according to priority and give it a position (e.g., Level 1 / Position 10, Level 2 / Position 20, Level 3 / Position 30), then click . This brings you back to the specific Program’s screen where the Enrollment Levels will be listed at the bottom of this screen.
Once this has been set up, go back to the Dashboard and click on Bundled Services. Notice that the programs information has disappeared. Next, you have to create a “Facility” fee for these services. At least one fee must be defined with the billing level of “Facility” with a “Place of Service” code of 53. To begin this process, click on the blue “Fee” link.
This opens a window that lists a “Self Pay” link.
Click on “Self Pay” to open the Self Pay Fee Schedule window where all Service Types are listed.
It is best practice to create a new fee for service instead of amending an existing service. This leaves a service available to be billed separately. To do this, click on the blue "Add Fee" link at the top of the window.
The following screen will pop up.
Complete each field according to the type of service being bundled. It is CRITICAL that you assign the Billing Level field as “Facility” and the Place of Service field as “53” in order for that service to bundle when billing. Once all fields have been completed, click on the blue button “Create Fee”.
Once this fee has been created, it will appear in the list of services. To edit a service, click on the Procedure Code to open the screen for that service. Once changes have been made, click on the blue “Update Fee” button. Once all Fees have been added, click on the “Close” button. This brings back the main Fee Schedule window. Now that the “program” and “Fee” have been assigned, you will need to assign the Bundled Service to the Program and Level, which should have already been established (as mentioned earlier). To do this, click on the Bundled Services tab and you will see that Bundled Services Setup has a green plus sign next to it. Click on that.
This opens a window to allow assignment of the Program, Level, Payor, Procedure Code, Trigger Type. It is not necessary to complete the “Default Form to Launch” to properly assign for bundling.
Once you click on the blue button “Create Bundled Service”, you will see this listed under Current Bundled Services. To edit any of the listed services, hover to the right of that service and a pencil will appear. Click on that to open the window to make changes.
Once at least one Bundled Service has been created, it can be tracked by clicking on the Tracking tab. If there is more than one Program assigned for bundling, use the dropdown arrow to select the preferred program to track along with a specific week, then click the blue “Track” button.
This will open a working chart for the week by provider.
Notice the pink fields listed under each day for each provider. As you hover the over the icons within the field, a popup will appear that describes what it is for.
The last icon is a number within a colored field. This icon reflects the Superbill status. A green icon means the Superbill has been paid. A yellow icon means the Superbill has been created but not collected. A red icon means there is no Superbill.