> ## Documentation Index
> Fetch the complete documentation index at: https://support.effra.io/llms.txt
> Use this file to discover all available pages before exploring further.

# 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.

## 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.

## 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.

## 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.

## 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.

## Adding Shockwave packages

Setting up Shockwave packages can sometimes be a little confusing, as they are typically charged upfront, with subsequent treatment sessions then claimed against that initial payment.

Billing for **Bupa Shockwave packages** works slightly differently from most other services. To ensure the full package can be submitted to Bupa upfront, you'll need to set up and invoice the package in your PMS in a particular way.

1. Create the invoice for the **initial appointment at the full price of the Shockwave package**.
2. Create invoices for each of the **subsequent appointments at £0**.

Effra will submit the initial invoice for the full package amount to Bupa. We'll then ignore the £0 invoices for the subsequent appointments, so these won't be submitted to the insurer.

This means you can **receive payment for the full package upfront**, rather than waiting for each individual Shockwave session to take place before it can be billed.

If you're unsure how to set up your Bupa Shockwave package, please get in touch with us and we'll be happy to help.