Each center has specific ways in which rates and fees are set and charged, and may change the specific terminology to suit their users, but they share in common the following elements.
- Accounts and Projects: Groups or entities which use center services are sent bills to pay for their costs.
- Chargeable Items: There are items, procedures, and services to be paid for.
- Charge Rates: The amount charged for such items may be fixed, variable at the time of charge, or calculated in some manner.
- Tiers or Rate Categories: Amounts charged may be adjusted up or down based on the level of service or contracts. In other words, projects might be assigned to a rate category, which would act as a sort of multiplier on the standard charge rates.
- Exceptions: Sometimes exceptions to standard charges or miscellaneous charges will be necessary.
This topic outlines the basics; consult documentation on your client support portal for specifics for your center.
Accounts and Projects
The entities to be billed are the accounts and projects using the services provided. When accounts and projects are added to the billing system, you can customize how these projects are billed. For example, different projects might pay different rates for items. The specifics of invoicing systems vary by center.
Chargeable Items
A chargeable item is something that could appear as a line item on an invoice. It could represent a specific service, supply, use of staff time, or similar. At different centers, chargeable items may be divided into physical items, supplies, procedures, labor, or other types of things that would be billed to an account or project.
Chargeable items are generally assigned to categories for filtering and assignment of billing rates. At some centers, users can only enter charges for categories associated with their own group. This reduces the risk of errors and also streamlines entry when users only see items relevant to them when entering data.
Charge Rates
Setting the standard chargeable items or billing rates for specific items and services is done via links in the
Finance web part. Some centers also differentiate between rates charged for chargeable items and fees. Some centers allow the definition of variable charge rates, meaning the custom unit cost is specified at the time of charge. Each center may have different names for these tables and links, but the general procedure is the same.
Open the relevant grid, then use the
(Import) button in the header. You can select either the
Import Single or
Import Spreadsheet tab.
- Import Single: Enter a value for each column in the given table. Specific fields will vary by center.
- Import Spreadsheet: Copy and paste or upload from a file. Click Download Template to obtain a blank spreadsheet with the correct format.
Tier Rates or Rate Categories
Within an organization using electronic health records, different projects may be charged different rates for the same items. These
rate categories or tiers can be though of as multipliers on the standard rates set using the
steps above.
For example, a center within a university might charge different rates for collaborators based on whether they were also part of the same university umbrella (and thus paying into a shared overhead pool already). In such a scenario, outside collaborators might pay full rates, but in-university collaborators might pay 85% of those rates.
Each center differs in how such categories and tiers are defined and used. Understanding that the EHR system can apply a multiplier like this, and if needed, a more complex multiplier that involves varying rates depending on the type of service for a given tier or category of project.
Exceptions
Within most electronic health record system there will be exceptions, special case charges, and exemptions. Perhaps legacy charges need to be reissued or the rates for a specific service are charged differently for a given project during a billing cycle.
Further, in a system using rate categories or tiers for projects, some billable items or categories may be always charged at a different rate than the project’s rate category. For example, if the veterinarian’s time is already funded, the center could set up a rate exemption to not charge vet time.
To apply rate exemptions, an administrator makes an entry in the ehr_billing.chargeRateExemptions table and at the time of billing run, the exempted rate items are charged the adjusted rate while all other items are charged at the project's base rate.
Example: Project X: Inside University rate @ 70% except VET @ No Charge
- Project X would be assigned to the In-University (70%) primary rate category
- Project X would get a row in the exemption table for a "Research Support Services > Vet Time" chargeable item to set it to use the No Charge rate category for that item.
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