A funding source in Motivity refers to the entity responsible for paying medical bills. Common sources include insurance companies, government programs like Medicaid, school districts, or direct payments from patients or their families. Adding a funding source is the first step to add an authorization. You can add more than one funding source for any patient.
These are the funding source contracts which you have added through the contracts module. Except for ‘Private pay’, for that ‘Private Pay’
Add A Funding Source
Funding Source type
When adding a new patient, the funding source section will initially be blank. Add a funding source by linking it to an existing contract from the contracts module. If a contract isn’t available, create one in the contracts module or wait for it to be added by your payor relations department.
Select the funding source type. In the next step you will be able to select the ‘contract’ which you have added under this funding source type from the contracts menu.
Note: Adding a contract through contracts module is a first step to be able to select the funding source type here.
Funding Source Details Form
The Funding Source Details Form is a crucial part of the patient profile setup, where you input and manage the necessary information regarding the patient's coverage and payors. Below are the details for completing this form:
Funding Source Field Conditions
- Mandatory Field: This field is required for processing and must be completed before moving forward.
- Dropdown Values: The options in this dropdown are derived from the contracts added in the contracts module. You can only select contracts under the chosen funding source type, such as commercial, regional center, etc.
- Service Location Applicability: The selected contract must be applicable to the service location where the patient is assigned.
- Active Contracts Only: Only active contracts will be displayed for selection.
Coverage and Insured Details
Insurance Payor ID: This ID is automatically inherited from the selected contract. If necessary, you can override the ID directly in this field.
Insured's ID: This is a critical piece of information that is included in your claims. The insured's ID is usually found on the insurance card.
Patient Relationship to Insured:
- Select "self" if the patient is covered under their own policy.
- Select "child" if they are covered under a parent's insurance.
Insured's Name and Address (Section on the Right):
- If you selected "self" for the patient's relationship to the insured, you can use the "same as patient" toggle to autofill these details from the patient details page.
Payor Patient ID:
- This ID is not used in claims but is applicable for California-based patients who require parental verification of receipt of behavioral services.
Vendor Number:
- This number is also not used in claims and is applicable only for California-based patients requiring parental verification of receipt of behavioral services.
Additional Considerations
Tracking Coverage Dates: Ensure that the coverage start and end dates are accurately tracked. This is essential for managing the validity of authorizations and claims processing. The authorization must be within the coverage dates.
Primary and Secondary Payers: When multiple funding sources are involved, appropriately set the primary and secondary payers to ensure accurate billing sequence and processing.
Claim Form
The details filled in the funding source details form will reflect on the claim form.
The grey label in front of the field name represents the fields in CMS 1500 form.
Example-
Edit Funding Source details form
Click on the pencil icon here to edit the funding details information.
Adding and Linking Secondary Funding Sources
Motivity Practice Management supports adding multiple funding sources for a patient, including both primary and secondary payers. While tertiary payers are not yet supported, the system allows for the seamless integration of primary and secondary funding sources, automating the sequence of billing to ensure accurate and efficient claims processing.
Steps to Add and Link a Secondary Funding Source:
Add a Secondary Funding Source:
- Begin by adding a secondary funding source in the same way you would add a primary funding source. Navigate to the funding source details page for the patient.
Link the Secondary to the Primary Funding Source:
- On the top of the funding source details page, you'll see a toggle labeled "secondary = yes." Turn this toggle on to indicate that the funding source you are adding is secondary.
- After activating the toggle, select the primary funding source you wish to link the secondary source with from the provided dropdown menu.
Automated Billing Sequence:
- Once linked, Motivity will automatically handle the sequence of billing, first billing the primary payor and then the secondary payor as needed. This ensures that all claims are processed correctly according to the established hierarchy.