Bill by Program

Bill by Program allows users to route billable items based on the patient’s assigned program. This enables organizations to bill different CMD Facilities or RCM Practices from a single EMR Location. Additionally, for CMD, BBP allows users to define reports and track revenue by program

Important: Bill by Program and Bill by Building cannot be enabled for the same EMR Location at the same time. You must choose one or the other for each location.

Create Programs

Ensure that each EMR Location has the correct programs configured. Follow the instructions here: Patient Programs Setup.

Enable Bill by Program

The Billing by Program setting must be enabled by Kipu staff. If it is not already enabled for your instance, please contact Billing Support.

Once enabled for your instance, you’ll turn it on for each Location.

1. To begin, click on your initials and then click Settings. 
   
2. Then click the Billing Audit Tool tab.

3. Click Location Settings.
4. Click the Edit / Pencil icon for the location.
5. Select Enable Billing by Program or Show (depending on interface), then click Submit.
6. Repeat for additional locations as needed.

CMD-Specific Requirements

Create a Facility in CMD

Bill by Program in CMD requires a separate CMD Facility for each program you intend to report on. If a facility does not already exist, follow: Add Facilities in CMD. If the facility already exists, follow: Modify CMD Facility.

Important: The CMD Facility Reference # must match the Program name in Kipu EMR.

CMD Konnector Setup 

For CMD billing, each CMD Facility must be configured to a Konnector in the EMR to create the integration between the platforms.

To request a new CMD Konnector, please complete the CMD Add Konnector Request form. If you need to modify an existing CMD Konnector (for example, to point to a different CMD Facility or update credentials), click here. 

RCM-Specific Requirements

For RCM billing, a Konnector in the EMR must be configured for each RCM Facility that needs to be integrated with the EMR. Click here for instructions on configuring RCM Konnectors.

Note: If you need additional Konnectors created to support Bill by Building, please contact Support.

Example Configuration

I need to integrate 2 EMR Locations with 4 RCM Facilities. Program structure:

• Treatment Center: PHP, Detox, Residential
• Outpatient Center: Telehealth, IOP

Billing requirements:

• Bill Residential, Telehealth, and IOP separately
• Bill PHP + Detox together

Click image to expand

Tips for Using Bill by Program

Bill by Program allows billing from a single EMR Location to different CMD Facilities or RCM Practices, supporting unique billing addresses, Tax IDs, NPIs, or credentials as needed.

1. The patient must always be assigned a program.
2. If two programs have the same start date, the system uses the most recently assigned program.
3. The system uses the Konnector assigned to the patient's program and location on the date of service.
4. For retroactive chart changes (such as building/bed assignment), wait 5 minutes before making additional updates.
5. RCM Only: For per-diem billing, you must add a new UR plan and ensure service dates match program assignment dates.

Note: If services were already generated on the billing audit tool with incorrect data, please contact Support to correct them.