Level of Care services in the Kipu EMR are referred to as UR-Required Services in the Kipu RCM (Avea). When creating a new Level of Care service, there are a few crucial steps that need to be completed in order for the services to map properly across the systems.
Required Permissions: Users must be Super Admins in the EMR and at minimum an Organization Admin in the RCM to complete the following steps.
At a high-level, this process includes:
- Creating Codes in the EMR
- Building the Level of Care in the EMR
- Create the matching UR-Required Service in the RCM.
- Set up the associated Billing Service Profile in the RCM.
- Add the Service Facility Reference in RCM.
Process Walkthrough
You can click through the process for adding a Level of Service in the simulation exercise below. Please use the fullscreen button (lower-right) if you have a hard time seeing the steps.
Here's an interactive tutorial
** Best experienced in Full Screen (click the icon in the top right corner before you begin) **
Here's an interactive tutorial
** Best experienced in Full Screen (click the icon in the top right corner before you begin) **
1. Create Billing Codes
In this example, we'll show how to create a new PHP Level of Care that we intend to bill institutionally with codes 0913 and S0201.
The first step is to set up the EMR codes we want to include in the Level of Care. The Kipu EMR supports three types of codes:
- CCodes for professional claims
- RCodes (required to bill) and HCodes (optional) for institutional claims
Because we are creating a level of care that will bill on an institutional claim form, we'll create the 0913 as a Revenue Code (RCode) and S0201 as an HCPCS Code (HCode). | |
Click here for step-by-step instructions on creating Codes.
2. Build the Level of Care
Next, create a new Level of Care for the PHP per-diem service. Levels of Care are configured under Settings > Patients.
You'll notice that we selected the RCode and HCode we previously built and entered in the desired Place of Service, Claim Format, and Type of Bill. It's important that these details match between systems to ensure the service transmits from the Billing Report successfully.
Click here for step-by-step instructions on creating Levels of Care.
3. Create the RCM UR-Required Service
Next, build the Service in the RCM Practice Admin under the Services tab.
When creating the service, it's important to:
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Click here for step-by-step instructions on creating a Service.
4. Create the Service Billing Profile
Next, create the Service Billing Profile for the service to set the billing standards.
When building the Service Billing Profile:
*When building a Professional Service Billing Profile be sure to select the same Professional Place of Service field on the Service in the RCM and on the EMR Level of Care. Additionally, please follow the instructions for setting up Professional Services to add the HCPCS/CPT Code which should match the CCode in the EMR Level of Care. |
Click here for step-by-step instructions for building Service Billing Profiles.
5. Add Facility Service Reference
The last step is to reference the service and set a service rate at each of the facilities that should be able to bill this service. This occurs under Practice Admin > Facilities > Facility Services.
When adding a facility rate, select the correct Service and related Billing Profile. For Professional Services, you'll have another line to add in the Professional Unit Rate in addition to the institutional/Patient Billing Unit Rate. |
Click here for step-by-step instructions for setting Facility Rates.
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