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After the activity types are created, the next step is to create the rate schedule.
Create the rate schedule by going through the Admin tab > Rate Schedules sub-tab > +Rate Schedule button:
Fill out the name of the Rate Schedule and check the appropriate rate level (it should only be VRC for PGAP). Specify the Start Date.
Note: The Start Date should be earlier than the earliest Referral Date for PGAP cases you want to track and bill through EDI invoicing in Gardiant.
Leave the general rates blank since all billable PGAP activities are activity-based rates. If you want to be able to enter case notes with other activity types, those case notes must be marked as non-billable.
The next step is to enter rates for the different activities under the Activity Rates Differing from General Rates section on the right-hand side of the screen. The rates for the activities will be set up in one of two ways:
The activities that have multiple quarter hour “units” billed in one case note can be set up as Hourly Rates. In this case, the VRC will enter a multiple of .25 in the hours field of the case note according to how many 15-minute “units” were delivered. To calculate the correct Hourly Rate, multiply the non-facility rate by 4 (15 minute increments x 4 quarters in an hour).
If the hourly activities sometimes involve Travel/Wait and Mileage, you can enter the relevant rates for those, as well.
Note that all Mileage and Travel/Wait have the same billing codes for PGAP, but they are different than the standard L&I Travel/Wait and Mileage codes.
Be sure to enter the correct billing code for each activity and rate in the box below the rate.
The activities that bill only one unit in each case note are flat rate activities (Workbook/ebook/video or those with time increments in the name, e.g.1-10, 11-20, 21-30 minutes). These activities can be set up as Flat Rate using the non-facility rate. In this case, the VRC will select the activity corresponding to the length of the call. While hours will not have an effect on billing in these case notes, the actual hours for the call can be entered if necessary for payroll or time tracking purposes.
These flat rate activities don't involve travel so Travel/Wait and Mileage rates can be left empty.
Be sure to enter the correct billing code for each activity in the box below the flat rate.