Managing billing profiles

billing profiles define how billing details, defaults, and cms 1500 information are applied to visits they help control which fees, payment providers, and billing information are used based on visit type, location, or provider w hat is a billing profile? a billing profile is a configuration that brings together billing identity information (tax id, npi, address) invoice and superbill behavior visit and location targeting provider assignment rules when a session is billed, eggmed evaluates active billing profiles and applies the one that best matches the visit based on priority and targeting a ccessing billing profiles to manage billing profiles go to settings → billing open the profiles tab here, you’ll see all existing billing profiles, their status, priority, and where they apply c reating a new billing profile to create a new profile click add profile choose the billing profile type organization used for practice level billing individual used for provider specific billing enter a profile name set a priority lower numbers mean higher priority enable active to make the profile usable mark it as the default profile (optional) only one default active profile is allowed t argeting and applicability billing profiles can be limited to specific scenarios using optional targeting rules visit types choose which visit types this profile applies to, such as in person visits or telehealth sessions locations limit the profile to one or more practice locations, or allow it to apply to all locations providers rendering provider who delivers the service assigning providers who can use this billing profile these filters help ensure the correct profile is applied automatically during billing cms 1500 billing fields each billing profile contains cms 1500 information required for insurance claims and superbills required fields tax id type (ein or ssn) tax id npi taxonomy code billing phone billing address city, state, zip these fields must be accurate to avoid claim rejections c ontact and invoicing details billing email invoice due days default payment terms you can also enable auto send invoices auto send superbills fee schedules and payment providers you can optionally assign a default fee schedule pin a payment provider to the billing profile if not set, eggmed will resolve these based on other billing rules p rofile priority and resolution when multiple billing profiles could apply eggmed checks which profiles match the visit, location, and provider among matching profiles, the one with the highest priority (lowest number) is used if no specific match is found, the default profile is applied this allows flexible billing setups without manual intervention m anaging existing profiles from the billing profiles list, you can edit profile details activate or deactivate profiles change priority set or remove the default profile inactive profiles are ignored during billing but remain available for future use b est practices use one default profile for general billing create additional profiles only when billing rules differ keep priorities simple and documented double check cms 1500 fields before submitting claims yes, it’s a lot of fields no, insurance does not care about your feelings