Setup New Facility

Each of your locations, programs, or facilities need set-up in the Facility Master. During the implementation process, we make sure all facilities are set-up. As new areas are added or closed, the Facility Master would need updated.

The information in the Facility Master drives various features in the system. If the information is not completed properly, system processes may not work properly. Work with your Horizon representative during implementation to make sure you understand what information you need to maintain for each of your locations. Submit a Help Desk ticket if you need assistance with master table set-up as new facilities are added.

 If you download 835 files, make sure you complete the PROMISe ERA Enrollment. New facility 835 files will not pull into the system until the PROMISe ERA Enrollment is completed.

NAVIGATION: MAINTAIN menu > Master Tables > Facility Tables > Facility Master

Facility Master Header

1. In the FACILITY field, click the BROWSE button to view the existing facilities that are set-up. Look at the last facility number. The new facility should be the next number. Click CANCEL.
2. In the FACILITY field, type the next facility number. 
   1. Typically, the facility number matches the last four digits of the provider number.
   2. The facility field is a key field that cannot be changed.
3. DESCRIPTION field: type the name of the facility.
   NOTE: two different facilities can not have the same facility name.
4. In the PROGRAM field, if you are using programs to group your facilities, click the browse button to view the existing programs. 
   1. Review Setup Programs
5. The STATUS field will automatically default to active. If you are closing a facility, mark the status as inactive.
6. The REVALIDATION DATE field can be used to track licensing dates for the facility.
7. The STATUS DATE field would be used to track the date the facility was opened. If you are closing a facility, enter the close date in the END DATE field.
8. AUTHORIZATION REQUIRED checkbox: If the services at the facility need an authorization, check this box. With this box checked, when staff enter services the system will look at the consumer service plan to make sure there are enough available units.  If there are not enough units, the staff will get an error when trying to save the entry.
9. AUTHORIZATION COUNT BY DOLLARS checkbox: If the services at the facility are authorized by a dollar amount (instead of number of units), check this box.

General Tab

This tab contains the basic information about the facility.  This information must match the facility information in PROMISe.

1. Type the address, city, state, and zip code.
2. PROVIDER #: the facility provider number is required for billing purposes.  If you plan on billing, this field must be completed.
3. NPI and Taxonomy numbers are optional.

Fee for Service Tab

This tab lists the service codes and approved rates the location provides to your consumers.

1. For billing to process properly, all services provided at the facility need added to this tab. The billing process will not work properly if this information is not entered.

1. SERVICE
   1. Click the BROWSE icon to see the list of services. 
   2. Select the service to be added.
   3. Click OK.
2. DESCRIPTION: once you select the service, the description will appear
3. RATE: type the reimbursement rate for this service. This is the amount that will be billed.
4. UNIT TYPE: typically this would be OCCURRENCE.  
5. STATUS: the dropdown options are ACTIVE or INACTIVE
6. BEGIN DATE: enter the date the service is to start at the facility
7. END DATE: if the service is no longer being provided, enter an end date
   1. If you add an end date, the line will be removed from the grid.  Click SHOW EXPIRED LINES to see all service codes.
8. PROCEDURE: type the procedure code
9. PROVIDER #: type the facility provider number
10. NPI: Optional
11. DEFAULT PAYOR: Optional
12. Tab to the next, blank line to save the entry.

To delete a service from the grid, click the DELETE at the end of the line.

AR Groups Tab

This tab lists the insurance companies that are billed for the services provided at the location.

1. INSURANCE GROUP: click the BROWSE icon to see the list of payors.  Select the payor. Click OK.
2. AR GROUP: click the BROWSE icon to see the AR Groups.  Select the group. Click OK.
3. DESCRIPTION: when you select the AR Group, the description will appear
4. ACCOUNT BUILDING: If you have account building setup on the consumer service plans or procedure codes, select the correct option in the ACCOUNT BUILDING column. Options are Consumer or Procedure Code.

To delete a service from the grid, click the DELETE at the end of the line.

Defaults Tab

The Defaults tab shows various options to set-up default information for the services provided at the location.

1. DEFAULT SERVICE INSURANCE
2. NOTE DEFAULTS
3. DEFAULT PROVIDER/EMPLOYEE
4. CHECK FOR MULTIPLE ATTENDANCE CODE
5. ATTENDANCE CONSTRAINTS
6. DEFAULT POS: default place of service; options are Office, Patient's Home, Mobile Unit, Other Unlisted Facility 
7. APPROVAL
8. ADDITIONAL OPTIONS: Check the various options that apply to this facility.
   1. Default Today in Service Entry
   2. Community Participation Facility: if the location is a community participation facility
   3. Reauthorize by Number of Days
   4. Auto Email Case Manager
   5. Employee ADP Time Tracking

TOC Tab 

lists the types of contacts/services provided at the location.

As staff enter notes for the facility and select the type of contact, the service code linked in this grid will populate in the service entry.

Notes Tab

NOTES tab: open text area that you can keep general information about the location.

If you use the automatic alerts feature in the system, the ALERTS/RIGHTS button on the top right of the dialog box shows all staff who are set-up to receive an e-mail alert.

Submit a Help Desk ticket to have a Horizon representative help set-up your alerts properly.

Click SAVE to save all information entered in the various tabs.

To ensure you have the facility setup properly, run the EDI Billing Edit List and Error Check. If any required information is missing, the report will show what is needed.

When setting up a new facility, use the Copy Facility Fee File process to copy the fee for service information from an existing facility to a new facility that is being set-up.  You would want to use this process when the new facility has the same/similar service codes as an existing facility to save time in the set-up.

Alerts/Rights

Review Existing Facility

NAVIGATION: MAINTAIN menu > Master Tables > Facility Tables > Facility Master

1. In the FACILITY field, click the BROWSE button to view the existing facilities that are set-up. Select the facility you want to edit and click OK.
2. Change any of the information in the screen/any tabs.
3. Click SAVE.
4. If you are closing a facility, change the STATUS field to inactive. Enter the close date in the END DATE field.
5. The FEE FOR SERVICE tab is a listing of the service codes and approved rates the location provides to your consumers.  As services change, make sure to update this information.
   1. Remember, for billing to process properly, all services provided at the facility need added to this tab.  
   2. Be sure to include the approved rates as listed on the service authorization, active status, begin date, procedure code, and provider number. 
   3. The billing process will not work properly if this information is not entered.
   4. To add a new service, go to the last line in the grid.  Click TAB to move to the next available line and enter the new service.
6. Click SAVE to save all information entered in the various tabs.

Close A Facility

Make sure all billing is processed before you close a facility.

1. In the FACILITY field, click the BROWSE button to select the facility to close.
2. STATUS field: use the dropdown to select INACTIVE.
3. END DATE: enter the close date.
4. Click SAVE.

VIDEO: How to Enter and Work with Facilities

5/2023

NEED MORE HELP?  Submit a ticket to the Help Desk or call (814) 535-7810 or (800) 889-3388