Set Sail with SETWorks - Departments, Funders, Services, Authorizations
Set Sail with SETWorks!
Welcome aboard the ship of SETWorks! Let's set sail on the ocean of digital documentation and head towards a new horizon. Our destination: the port of authorizations - where we can create a ticket for each client so that they may embark on a voyage of their own.
Please, climb aboard and take a look at the "engines" that power the ship of SETWorks as we chug along towards authorization port!
Engine 1: Department:
Our first stop is the Department Utility.
Departments might be physical or conceptual locations.
We recommend creating a unique department for each physical location or office at your agency.
We also recommend creating a department for each different program you provide.
Creating at least one department is required before proceeding to the next stop.
Engine 2: Funding Source and Contract:
Our next destination is the Contract / Funding Source / Funding Source Contact Utility.
Funding Source is any entity that provides reimbursement for services rendered.
Common examples of funding sources include: your states' Medicaid program, a health insurance company, MCO, or private-pay/self-funded.
Contract is a sub-division under Funding Source that allows you to break out the Funding Source into different subsections. It is common to have multiple Funding Sources each with only one Contract.
In order to create an authorization in SETWorks, you must first create at least one funding source and one contract.
Engine 3: Service and Service Type:
Our third destination is the Service / Phase Utility and the accompanying Service Type Utility.
Each service that you provide must be entered into the Service / Phase Utility.
Any service that has a unique billing code or a defined rate for reimbursement must be its own entry in the Utility. If the same service is billed at two different rates, create an entry for each rate.
Services can be grouped into categories that we refer to as Service Types. Create at least one Service Type and Service to continue.
Destination: Authorization:
Congratulations! You've created a Department, Funding Source, Contract, and Service! Now that those three engines are running we can create Authorizations.
Authorizations are what link a department to a funder and contact to a service. With the authorization created you'll be able to create billable records in SETWorks.
Now that you've visited the three engines that power the ship of SETWorks we're ready to engage the final piece of the puzzle - authorizations.
In order to climb onboard the ship, each client will need their own authorization. Think of an authorization like a ticket - without one, you won't be able to add that client to a billable record.
Connecting the Dots:
The authorization connects a funding source & contract to the service the client is receiving.
The authorization points to a department, a contract, and a service.
Each authorization must be associated with one and only one department.
A client can have more than one authorization, but each authorization must be tied to one department, contract, and service.
Each billable record is associated with one and only one authorization.
Webinar
Make sure to check out the webinar below for more information!
Printable PDF Available as an Attachment!
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