In order to translate the calendar items that users create to something that can be billed to an insurance company, you need to have billable procedures.

The combination of codes used to map a procedure should be unique to the system.

In this example we will be setting up a new procedure  "Test Billable Procedure". To create a procedure, please read this article.

The easy way to have a unique combination of codes is to make your activity codes 1:1 to a procedure.

From the Procedure screen under List Maintenance, select the procedure to create a mapping for. From the Add/Edit dialog, look to the mappings tab.

Select the unique combination of activity, cost center, location, modifier, and expense. Leaving any one of these blank will indicate that any code can be used in the combination. For this example, we are going to select a specific activity, program and location.

Tick the checkbox next to the code and click the Save Procedure button.

Now that you have codes linked to a procedure, you can test the mappings to make sure there are no other procedures that have the same mappings. If there are, the system can not determine what procedure to pick for billing.

On the procedure dialog click the Test Mappings button.

You will get back all combinations of the selected codes, and what procedure it maps to. If you do not see any red text, everything is set up correctly.

Next will be to set up the rates. If the customer can be charged for this procedure (Self Pay), click on the Self Pay Rates tab on this dialog

Click the Add button to add a new rate.

For this example, we will create a rate that is 4 units per hour, with an unlimited max units. This can be indicated by 999. It just has to be a number over the max units in a day.

Click the Edit in the grid row to add the rate details. Click the Add New button.

We will add a duration of 1 (hour), and a rate of 25.00 dollars. This means that all services up to 1 hour will be charged a flat rate of 25.00. Save the Procedure when finished.

Now we can go to the proofing screen to try this out. Use the quick add to create a service using the codes selected in the mapping

If a Procedure, CPT Code, and Charge is there in the grid the mapping worked.

Maybe different durations will get charged different amounts. We can change this by adding more rate details.

Instead of having a single row with 1 hour, we can change it to fractions of the hour.

The contact will be charged different amounts depending on how long the appointment is.

If the client has insurance set up in the system, and the service can be charged to the insurance company, the rate will need to be set up under the insurance. This is done under Payment Sources in List Maintenance. Load up the insurance company, and scroll down to the rates

Click the Add button to add a new rate.

For the insurance rate we will select Units instead of flat fee.

Click the Save button when finished.

From the Rate grid Edit the procedure we added.

Just like the self pay rates we will add a new rate detail.

1 hour duration with a rate of $100.00

Since we selected units at 15 minute billing increments, the charge will calculate based on the service duration.

You will notice that a payer is now listed. This is the payer we added the rate to for the procedure.

If the client has a co-pay that will show as well