Placement/Attendance Service Payment Rate

Last updated
Save as PDF

Placement Services can be bed days, administrative charges, clothing charges, and so on. Payment rates entered here are typically used to pay foster homes; however, they can also be used to pay outside organizations who also provide placement services such as group homes.

Attendance Services are days a client is marked as present in an attendance facility schedule of sessions. Payment rates entered here are typically used to pay family day care providers.These are configured is the same area.

Menu path

Finance Setup > Payment Rates (A/P) > Placement/Attendance > History

Create a Placement/Attendance Service Payment Rate

Navigate to the following path: Finance Setup > Payment Rates (A/P) > Placement/Attendance > History.
In the toolbar, click Select a Rate. Search for and select a rate.
In the toolbar, click New > Placement Rate - Placement Based.
Complete the following fields:

Description - Enter the name of the rate. In many cases, rates are changed every year. Consider using description like FY17 Rates (FY - Fiscal Year)..
Associated Plans - Choose all plan/contracts under the selected payer where this rate will be used. This area allows you to share a rate. For example, you may send bills to multiple counties, and most counties pay you the same amounts. Add the plan/contracts here instead of creating the rate many times.
Effective Date - Start date of the plan.
End Date (Included) - Enter the date when the rate ends. Included means the date entered is last date the rate is effective.
Rate Method - Only the rate methods available for the rate type (manual, placement, occurrence, vacant bed) are available. Note: These are defined by Netsmart.

Rates tab

Here, you can add as many lines in the details as necessary, but the variables cannot overlap to determine the rate. Note: The system validates that you do not attempt to save logic with overlap, meaning more than one line can be found for a single service provided.

From Age (Incl) - Required. Enter the age of the client at the time of the service. Enter 0 if N/A.
To Age (Not Incl) - Required. Enter the age of the client at the time of the service. Enter 99 if N/A.
Min Time - If applicable, enter the minimum amount of time/duration on a service the client needs in order to use the listed rate.
Max Time - If applicable, enter the maximum amount of time/duration on a service the client needs in order to use the listed rate.
Payment Amount - Enter the amount of the payment to be made to the vendor.
Procedure Code - Select the code that describes the service being provided. The code is used as a way of translating Agency services to Funder specific codes.
DOC Additional Rate - The amount in addition to the defined rate based upon how many DOC points are entered on a client's program modifier.

Rate Rules tab

Consolidated Services are grouped together as a Period (Week, Month, etc) to product a single line on a claim. Unconsolidated means that each service will produce individual line on a claim.

Consolidate Services - Select this check box to consolidate services for a time period. For example, you may want the system to create one claim for an entire day's services provided under this rate.
Consolidate for a Period - If you select Consolidate Services, select how the claim should be consolidated, for example day, week, year, and so on.
Rate Applies to a Full Period - Select this check box if the rate will apply to full period. If selected, the next four fields become active allowing you to set specific options and rules.
- % Services To Qualify for Full Period - If Rate Applies to a Full Period is selected, enter the percentage of services required in order to qualify for a full period. For example, if you enter 75, the client must have been enrolled in the program/facility for 3/4 of the month in order to charge for the full period. These percentages are provided to you by your billing provider.
- If not Full Period, Apply Rule - Select the rule used if the amount of services is less than the percentage entered in the % Services to Qualify for Full Period field. These rules are defined by Netsmart.
- If fixed Number, Divisor Value - Use this field only if you selected the Fixed Amount rule in the If not Full Period, Apply Rule field. The number entered here is the divisor number used in the calculation for a period length less than the percentage entered in the % Services To Qualify for Full Period field.

For example: A client is enrolled 13 days of the period (July). % to Qualify is 90% and Divisor Value = 30.424. Rate is $1,000 for the month. The calculation is 1000/30.424 * 13 = $427.2942 ($427.29) for that month.

Create One Unit per Period - When you select this option, the system creates only one unit. For example, if a client is in the Program/Facility for 25 out of 31 days, instead of creating 25 units and consolidating for a period, myEvolv creates One unit for the time period (for example, 25 days = 1 unit).
Include Discharge Date - Select this option if the Discharge from the Agency Date (if applicable) should be included in the unit calculation.

Period Break Rules for Consolidated Services

Break When Rate Amount Changes - Flag if you wish to break the claims separately when the rate changes. This depends on many factors of the client's placement such as rate change due to birthday, placement disruption, and more.
Apply Period End Rate - Otherwise - Period Start - Select this option to determine which rate to use when a rate is to change. If this option is selected, the system uses the original rate, and if deselected, it will use the new rate. Used only if the previous flag is not checked.
Break When Vendor Changes - Tells the system to create separate claims in event of a facility transfer during the consolidation period.
Use Vendor from the End of the Period - This option denotes who to pay. If selected, the vendor paid (Invoice The entity the system produces (automatically or manually) used for paying Vendors.) is the original vendor.