Teams: Billing Set up in MyTherapyWizard

Teams: Billing Set Up

Teams Billing Set Up - MyTherapyWizard help article card

You must have a Teams account with the billing feature enabled + your ClaimMD plan integrated.

⚠️ Important

It is strongly suggested that you set up at least 2 clients and mark them as "test clients" (in profile) so you can test billing on "dummy" clients. 

Insurers

🔗Go to Practice Settings > Payer &Codes

⚠️ Important

You need to have your ClaimMD integration set up before you add Insurers.

Go to Insurers>Add insurer.  Once your ClaimMD is integrated, you can search your payer (best to search the payer ID) in the search box.  This integrates with ClaimMD and shows you the matches.   

Label: This is for your records only and is not passed to insurance.   For times when multiple insurance plans have the same payer and payer ID, a payer label helps differentiate.  

ℹ️ Note

Once you add the payers, the services code will tell you if that payer offers Eligibility, Claims, ERA and if enrollment is required.  You can enroll with a payer by logging in and enrolling in ClaimMD.  Note that enrolling is different than credentialing.  Credentialing process is outlined by each specific payer and MyTherapyWizard nor ClaimMD offers credentialing services. 

💡 Tip

💡 Tip

If the payer doesn't support eligibility, this means that you must go to that payer portal to look up client eligibility.  A tip is to edit any insurance labels to "Name n/e" to help your team remember that they don't offer eligibility (no elig, n/e). That helps to remember not to run eligibility checks in MTW .

Direct Pay

Add any non insurance here.  It can be agencies that you contract with, private pay, private pay: camps, etc.  

Direct Pay Rates

⚠️ Important

Add your Procedure codes  (next step) and Non-Procedure Codes before adding direct pay rates. 

These are the rates that you charge to direct payers.  Note this is not insurance rates. You could add in camp rates, supplies, tutoring, and charges that insurance cannot be billed for. Once you have activated your procedure codes, those codes will populate when you add a rate. If you don't see the procedure code that you need, activate it or add it to procedure codes first.  

⚠️ Important

For private pay, you want to add normal procedure codes here so that the rates and codes will display properly on superbills and invoices. 

Procedure Codes

You can search codes in the magnifier line, or search by discipline.  193 + codes have been loaded but you will need to activate and check for accuracy.   You may add a procedure code as well.  If the procedure code, default unit ,or discipline is entered wrong, it will result in claim denials.  Consult with your payers clinical coverage or claims and billing policies as needed. 

Bundles

I love the bundles feature !  When several procedure codes are allowed to be billed on the same visit, there are often rules, including max units modifiers etc.  Create the correct bundle, name it as you want (short is better), and your therapists will see it as a choice for billing a session note. When chosen it will add the bundle components so nothing is ever forgotten.  

                               

Rates

These are the negotiated rates /fee schedule from your insurance payers.  Add a rate, then use "copy from insurance" to add same or similar rates from other insurances. Edit to make revisions. Be sure to add the discipline that the rate is for.  When a rate changes, go into the rate, edit , and end date the rate to keep a copy for historical reasons.  

⚠️ Important

You must add in negotiated rates for accounting to work properly.  If a rate ends, be sure to add a new rate for the insurance.  

Pay Rates

Pay rates are rates that you pay your clinicians for particular procedure codes.  You may have different rates per insurance and per direct payers.   

Pay rates pay in the manner of the unit as previously set up in procedure code.  If you set up 97530 to as per unit, then the pay rate will pay per unit.  

Non Procedure Codes

Non-procedure codes are custom codes that are charged to direct pay methods (non-insurance) only.  Examples are screenings, camps, tutoring.  This area just sets up the name and codes of the codes.  The rates are set up in direct pay rates.

Modifiers

Set up your needed modifier codes.  You can multi-select disciplines that use the same modifiers.  

See other articles in Billing Set Up here.