Adding billable items

When you onboard with Effra, we’ll work with you to configure your existing billable items so that we know how they should be submitted to each insurer. In this article, we’ll cover how you can add new billable items if you start billing for new services. Please note, Effra currently only allows users to add billable items using a service code that they already have in use for another item. If you need to add a completely new treatment type, you will need to liaise with us via support@effra.io.

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Adding a billable item from an invoice

If Effra receives an invoice containing a line item that we don’t yet have a billable item configured for, we’ll let you know with an Action Required message on the invoice. You can select the appropriate procedure directly from the form in the invoice. Once you’ve done this, we’ll save it as a new billable item so that Effra recognises it for future invoices. If you’re unsure which procedure to select, please get in touch with us and we’ll be happy to help.

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Adding a billable item from your settings

You can also add new billable items at any time from your settings.

1. Go to Settings → Billable Items.
2. Select Add billable item.
3. Enter the Description exactly as the corresponding line item appears in your PMS.
4. Under Find procedure, search for the relevant procedure and select it from the dropdown.
5. Select Create billable item.

Where you have different billable items for different insurers, make sure the description you enter exactly matches the relevant insurer-specific billable item in your PMS.

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Choosing the correct service code

Under Find procedure, search using a general description of the service, such as ‘initial physio appointment’. This will help you find and select the correct service code for the billable item from the dropdown. The service code is used when Effra submits an invoice to the insurer, so it’s important to select the correct one. If you’re unsure which procedure to choose, please get in touch with us. Insurer service codes can sometimes be confusing, and we’re happy to help you make sure the billable item is configured correctly.

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Editing or disabling a billable item

Billable items can’t currently be edited or deactivated from your Effra settings. If you’ve added a billable item incorrectly, need to change its configuration, or no longer want Effra to use it, please get in touch with us and we can make the change for you.

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Billing for Shockwave treatments

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Bupa

Bupa shockwave treatments are now billed per session, rather than as an upfront package. Use the following codes and fees:

• AB129 — Initial physiotherapy session with Shockwave
• AB130 — Follow-up physiotherapy session with Shockwave

Create an invoice for each appointment as it takes place. If you previously billed Shockwave packages, update your billable items and Bupa codes in Effra to reflect this change. The old surgical Shockwave codes should no longer be used. If you need help updating your setup, please get in touch.

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Other insurers

All other insurers are billed via standalone shockwave sessions. These should be added to Effra using the service code T7419. If you would like to bill shockwave treatments for specific conditions, please get in touch with us at support@effra.io.