Configuring Program Billing Groups

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Program billing groups are the next item to be configured in the setup process.  They enable you to combine programs that share the same payer, billing type, procedures, and rates into one group and to bill for that group with a single invoice batch.  Once you create a program billing group, you will be able to add programs to the group in the next step of the setup process. 

IMPORTANT! Invoice batches are always created for program groups rather than for individual programs.  As a result, even if there is only one program that does a particular type of billing, a program billing group must still be created for it.

To configure a new program billing group, complete the following steps:

    1. From the AWARDS Home screen, click Administration from the left-hand menu, and then click Fiscal.  The Fiscal fly-out menu is displayed.
    2. Click BillingBuilderThe BillingBuilder Menu page is displayed. 

    1. Click Program Billing Groups.  The SELECT PAYER page is displayed.
    2. Click the Payer drop-down arrow and select the appropriate payer.
    3. Click Select.  The Billing Program Groups page is displayed.

    1. Click Create.  The program billing group configuration page is displayed. 

    1. In the Program BIlling Group field type the name of the program billing group.
    2. In the Description field, type a brief description for the group.
    3. Click the Billing Type drop-down arrow and select the appropriate type.  When a selection is made the page is refreshed and values for the selected billing type are automatically dropped into the following fields IF values were entered for them during the billing type configuration process:

  Payer Name

  Agency Sender ID/Submitter ID

  Agency Tax ID

  Taxonomy Code

  Sender Address

  Sender location code

  CMS place of service code (837P)/Uniform Bill Type Code (837I)

If values are missing from any of these fields after the billing type has been selected, configure them at this time.

    1. In the Sender Code (if different from sender ID) (GS02) field, type the code required to be reported in the GS segment of the 837 file's second position, if it is different from the Sender ID entered in the Agency Sender ID/Submitter ID field (referenced in step 9).
    2. In the Revenue code field, type the appropriate code.

  TIP: The Revenue code is used to classify the type of service being provided.

    1. In the Billing Provider NPI field, type the NPI of the billing provider.
    2. In the Billing Provider Secondary ID field, type an additional ID associated with the billing provider NPI if one is required by the payer.  This ID will be reported in box 33b of the HCFA-1500 claim form.  If you are billing 837P files to this payer, please also enter the associated ID qualifier for the billing provider secondary ID in the ID Qualifier text box.

  NOTE: This field is only shown if the program billing group is associated with a billing type where "837P" has been selected from the Whether to generate the 837I, 837P option. 

    1. Click Save.  The program billing group is created and the Billing Program Groups page is re-displayed.
    2. Repeat steps 1 through 13 until all program billing groups have been created.

The process of configuring new program billing groups is now complete.

  TIP: If it is later necessary to update or delete a program billing group, complete steps 1 through 5 above, select the program billing group in question, and then click Update or Delete as appropriate.  Keep in mind:

When updating - If changes are made, be sure to click Save on the program billing group configuration page to have those changes applied.

When deleting - A program billing group can only be deleted if there are no programs in it.  If you choose to delete an empty program billing group you will be asked to confirm your choice after clicking Delete.  Be sure to click OK at that time to complete the deletion process.  Once deleted, a program billing group cannot be restored.