National Billing Provider Setup

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Therap Services, LLC.

562 Watertown Avenue, Suite 3, Waterbury, CT-06708 Ph: (203) 596-7553, Fax: (203) 757-5116

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Create Funding Source

A Funding Source is a person or entity paying the Claims or Invoices for one or more individuals. Funding sources are used when creating Service Authorizations for an individual.

Electronic payers such as: Florida Medicaid, KMAP, eMedNY

Manual payers may be: Boards of Education, DVR, County Funding, Grants or individuals

Enter all the information regarding the Funding

Source as appropriate

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Funding Source List

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Create Billing Provider

Therap’s Billing module allows for setting up of the Billing Provider with detailed information which includes Provider NPI Number, Medicaid

Provider number, Provider Commercial Code, Taxonomy Code, Provider

address, contact details etc.

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Billing Providers for the set-up will be created for each State Medicaid

Provider numbers and or each National Provider Identification (NPI) number assigned to the provider agency.

We have found that the use of NPI, State Medicaid numbers varies from state to state.

• In Florida the NPI number is required for all Billing Providers except HCBS Waiver Providers, which continue to use just the State

Medicaid Provider number for the agency and copy that number in the Provider Commercial Number box.

• In Delaware on the NPI number or Provider Commercial Number is used, along with the related Taxonomy number.

• In Colorado only the NPI number is used.

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• Claims will be rejected if P.O.Box number is entered in the

address fields.

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Service Description Code

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Create Attendance Type

Day Habilitation Sample for 15 min Unit Calculations with Time in and Time Out required

Click on the

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Sample is for Residential Services -Daily Unit Calculation

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Attendance Type for calculation of Billable Monthly Unit for Residential Services. Sample is Florida’s 25 day requirement.

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Custom Invoice

The Billing system will create a HCFA-CMS 1500 Invoice, setting up details for a

customized invoice, users are also be able to enter printing

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Service Authorization for Residential Services, with Daily Unit Rate Method.

Attendance Type selected, not Time In or Time Out.

The Attendance Type selected for Monthly Unit Calculation would need to have the bundling formula detailed in the Attendance Type set-up.

Method of Data

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Once the Service is saved it is shown under the ‘Service’ section of the Service Authorization form.

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Service Authorization for ISP Billing Method, with a Link to ISP Program, using Time In and Time Out to create either 15 min Unit or a single monthly Unit for Services

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Clicking on the ‘Add’ link opens a ‘Select ISP Program’ pop-up

On clicking the ‘Save’ button, the ISP Program is added to the Service.

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When creating ISP Program, the following should be marked to link to ISP Billing Section:

Select Non-Grid for ‘Input Method’

Select Yes

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Generate Billing Data from ISP

Individual List

Select appropriate Date Range

Click here to view Individual List

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Attendance Tracking to Create Billing Data

Select Attendance Option and Time In/Out time for the Individuals

Already submitted data

Click here to record attendance data

Already approved data

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Success messages will be shown for the respective Billing data.

Attendance Report and Statistics Report can be acquired from the Attendance module.

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Creating 837P, ASC X-12 Professional Claims

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Sending Claims

Search the claims that are to be sent

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