Description: This article provides a reference to billing system elements and terminology. This article includes an overview of account types, billing units, and billing roll-ups.

Role Required: Superuser, Billing Team

Permission Required: N/A


Account Type

Name

Id (for imports)

Description

Key Characteristics

Examples

Hourly Services

1

Used for any type of individualized service where an employee is working with one client at a time in any capacity. Funding source pays based on service provided (hourly, daily, milestone, etc.).

·       Not site-based

·       Employee works with 1 client at a time

·       Behavior Consultation

·       Respite/Relief Care (Hourly or Daily)

·       Skills Training

·       Vocational Services where one employee works with one client at a time and is not at a site.

Residential Program

2

Client lives at a residential program and employees clock in and out at that program. Funding source pays based on client attendance.

·       Site based

·       Employees punch at the program, can work with 1+ clients at a time

·       Client attendance is generated

·       24 Hour Residential Programs

·       Service Codes would include: Residential, Rent

Day Program

3

Client attends a facility of some sort and employees clock in and out at that facility. Funding source pays based on client attendance.

·       Site-based

·       Employees punch at the program, can work with 1+ clients at a time

·       Client attendance is generated

·       Activity centers

·       Job sites

·       Rehab centers, etc.

Group Service

4

Client receives service in any location and is not tied directly to a site. Employees can work with one or more clients at a time in any capacity. Funding source pays based on service provided (hourly, daily, monthly, milestone, etc.)

·       Not site-based

·       Employee works with 1+ clients at a time

·       Oregon Supported Living

·       Oregon Day Services

·       Group Therapy

Parenting Program

13

Client lives at a foster home/professional parent home and employees clock in and out at that home. Funding source pays based on client attendance.

·       Site based

·       Employees punch at the program, can work with 1+ clients at a time

·       Client attendance is generated

·       Professional Parent Homes/tracking

Transportation

14

Client lives at a residential program/professional parent home and receives funding for transportation. Funding sources pays based on client attendance and transportation provided.

·       Site-based

·       Attendance based

·       MTP

Client Transportation

15

Client receives transportation services and the mileage is billable to the client’s funding source.

·       Not Site-based

·       Employee works 1:1 with client.

·       Transporting to the community for hourly services.



Billing Unit

Note: Billing Units are not tied to how an employee punches. Billing units can be provided in a variety of account types. Just because a billing unit is hourly, does not mean that it has to be tied to an Hourly Services Account. Similarly, just because a billing unit is Daily, does not mean that it has to be tied to a Day Program Account.

Name

Id (for imports)

Description

Hourly

2

Paid per hour worked. Is not tied to how the employee punches. Can be billed per hour, or can be rolled up into a daily, weekly, or monthly unit (see below).

Daily

3

Paid per day of service provided, regardless of the number of hours worked. Can be billed per day, or rolled up into a weekly or monthly unit (see below).

Monthly



Paid per month of service provided, regardless of the number of hours worked.

Miles

7

Paid per mile. Note: An hourly account type can have a billing unit of miles. Can be billed per mile, or can be rolled up into a daily, weekly, or monthly unit (see below).



Billing Rounding Increment

Note: Billing Rounding is available for service codes with hourly units. There are four type of rounding and four increments to select from.

Name

Id (for imports)

Description

None

0

Do not round - every minute is billed

15

25

Round to the 15 minute mark (quarter hour)

30

50

Round to the 30 minute mark (half hour)

60

100

Round to the hour mark (hour)



Billing Rounding Type

Note: Billing Rounding is available for service codes with hourly units. There are four type of rounding and four increments to select from.

Name

Id

Description

Round

1

Round up or down to the nearest increment

Truncate

2

Always round down

Increment

3

Always round up



Billing Rollup Type

Name

Id

Description

Examples

None

1

Every billable punch entry is itemized on the billing file.

For example, two employees each work a 2 hour respite shift for Johnny on the same day. Respite has a billing unit type of hourly. The billing file will show two billing entries for 2 units each.

Daily

2

The billing files shows one line per day per Service Code, with each line representing the number of billable units used that day under that Service Code.

For example, two employees each work a 2 hour respite shift for Johnny on the same day. Respite has a billing unit type of hourly. The billing file will show one line item for a total of 4 units consumed that day.

Weekly

3

The billing file shows one line per week per Service Code, with each line representing the number of billable units used that week under that Service Code.

For example, one employee works a 2 hour respite shift for Johnny on Monday, Wednesday, and Friday. Respite has a billing unit of hourly. The billing file will show one line item for a total of 6 units consumed that week.

Monthly

4

The billing file shows one line per month per Service Code, with each line representing the number of billable units used that month under that Service Code.

For example, Johnny receives services in a residential 24-hour program. Residential services has a billing unit of daily. If Johnny was present at the program for 28 out of 31 days in the month, the billing file will show one line item for a total of 28 units consumed that month.

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