The Codes/Rates tab in each User file is for setup of the pay rates when using the payroll feature in PIMSY.
Billing Code – The billing code giving the user ability to access this code through PIMSY
User Pay Rate as % - will pay employee a percentage of what is paid for the service
User Pay Rate/Unit – will pay employee this rate per unit depending how the code is set up on billing code set up under the financial tab
User Pay Rate Flat/Session – will pay employee one flat per session. Will not pay for secondary.
Alt. Billing Rate/Unit – If the employee needs to charge a different amount for the billing code to payer sources, you can enter that amount here
Expected Amount/Unit – If reimbursement is expected to be different for this particular provider (than other areas in the system such as Insurance set up, billing code set up), you can add that here
Start Date – the first day this code is available to be used by this user in the system
End Date – the last day this code is available to be used by this user in the system
Requires Dual Sign Off – when checked, this code will require the supervisor’s approval for release and attach both clinician’s signatures to the note
User Modifier – If there is a user modifier on the User Detail page, it will auto populate from the here on all codes. This will go out on the claims.
Default – If they have a code that is a default code to be used, check this box.
Taxonomy - Taxonomy code is not auto populated. It will need to be filled based on what NPI is being used for each Billing code.
Rendering NPI (Pri. #) – This is auto populated from the User Detail page. This will go out as the Rendering Provider NPI on claims. If it should not be the User’s NPI, you can manually enter a different NPI in this box.
Billing NPI (Sec. #) – The Billing NPI will automatically pull from the organization management. If the user has a different Billing NPI that needs to be utilized for a specific code, you can enter that here and the code will go out with that specific billing NPI.
Tertiary Provider #- if the provider has a Medicaid Number that must go out on claims, you can enter it here and it will be submitted on the electronic claims.
User Codes & Rates
On the PIMSY main screen, go to Users
Select a user and go to the Codes/Rates tab.
- User Pay Rate as %
Example: If you pay an employee 55% of what the payer pays, for the code 90846 put 55.00 in the first column. Do that for each of the codes for which you pay a percentage.
- User Pay Rate/Unit
For every time they use a code, such as 90838, put $10 per unit in the second column. This means for every 4 units they use, you pay them $40.
- User Pay Rate Flat/Session
Every time a code is used you pay them the amount specified in the third column.
Now you need to set up the user profile. Go to Administration > Profile Management.
Choose the profile you need in the Profile box. Select an item on the left (Unassigned Rules) and double-click to move the item to the right window (Assigned Rules). This assigns that rule to the user’s profile.
There are three types of rules for a User Profile:
- Staff to view/change/process payroll
- Clinicians who need to view/approve their own payroll
- Clinicians or others who need to view/approve payroll for users
There are three rules you will need to consider for the profile.
Scroll down on the left to the “F” section to find:
- Financial Menu View
Scroll down to the “P” section to find:
- Payroll View (Approve Only)
- Payroll Modify (Approve Only)
When you are finished, click Save in the center of the two windows. Click Yes to modify the profile. Once saved, select another profile if needed and go through the steps above.
Bobby Harris is a clinician at the ABC Therapeutic Group. Bobby is a supervisor over other therapists in the company and is required to review their payroll before it is processed. The PIMSY administrator creates a user profile that allows Bobby to approve payroll for the therapists under his supervision.