Skilled Nursing Facilities

Contents

Mapping Schedule/Status by Payer 

To bill correct rates, you must associate Payer Rate Schedules and Census Status codes for each Primary in-house Payer. Rate Schedules populate rates in residents' census. Status Codes determine the rate schedule used in census based on Schedule Status by Payer. Use Schedule/Status by Payer to define the rate schedules available for each Payer in Payer Rules & Rate Schedules and in Census. You must complete setup for each Payer.

Important

Before mapping Schedule/Status by Payer, Payers must be setup in the database.

Note

Only the selected rate schedules appear in Payer Rules & Rates Schedules to setup rates. Only Status codes selected for the Payer and Schedule appear in census entries. 

  1. Do one of the following: 

    • Single facility: Admin > Setup > Schedule/Status by Payer 

    • Multi-facility: Management Console > Standards > Financial Management > Schedule/Status by Payer

  2. In Show Relationship for select the Payer. 

  3. Select each schedule the Payer covers.

  4. Under each Schedule, select Status Code(s) the Payer covers. For example, the Payer covers in-house days and Therapeutic Leave. Select the In-House schedule, and select the Active or In-House Status Code. Select the Therapeutic Leave Schedule, and select the Leave Status Code. 

  5. Select Not Applicable for Status Codes not associated to a schedule.

  • Status Codes are not applicable if they are not selected in a Schedule, even if they are not marked Not Applicable.