Procedures

Updated June 08, 2026 16:41

Procedures are configured in the Procedures feature in AccuBill. There, you'll maintain the list of procedures that can be billed to payers. Procedures can also be known as a listing of service codes, with billing/claim requirements and rates defined.

Permissions Needed

To use the Procedures feature, you need the following permissions:

Configuration Mgmt. > Procedures > CREATE or UPDATE or DELETE, and/or;
Configuration Mgmt. > Procedures > Billing Rates > CREATE or UPDATE or DELETE

Configuring Procedures

Follow the guide below to configure procedures in AccuBill.

Creating a New Procedure

To begin creating a new Procedure, follow the steps below:

Click the green Create button.
Within the form, fill out the following sections:
1. General Information
  1. Name - Required
    1. This is the name for the procedure
  2. Start Date - Required
    1. This is the start date in which events can be billed using the procedure. This is event (service) date sensitive.
  3. Active
    1. Defaults to Yes, but can be switched to no to make the procedure Inactive. Note: Inactive procedures will not be considered for billing, even if all billing requirements are met.
  4. + Add More Settings - Situational/Optional
    1. Click this to open the right navigation bar, Additional Settings. Note: If additional settings are added to the form, they must be filled out.
      1. End Date
        This is the end date in which events can be billed using the procedure. This is event (service) date sensitive.
      2. Procedure Group
        Associated a procedure group with the procedure. This allows procedures to be better organized and is also a filter when creating charges. Note: This list comes from Account Mgmt. > List Creator > Procedure Groups.
2. Billing Requirements
  1. Payers - Required
    1. Select the payers that this procedure can be billed to
  2. Programs - Required
    1. Select the programs that can have their services bill this procedure
  3. Billing Frequency (once per) - Required
    1. Select how often the procedure can be billed
      1. Day
      2. Event
      3. Month
      4. Week
  4. Event Types - Required
    1. Select the event types that can be used to bill the procedure
      1. Attendance - Includes: Program Attendance (Reception Desk > Program Attendance) & Group Attendance (Services - Group > Group Activities AND Reception Desk > Group Activities)
      2. Charting Timetable - Includes: Charting Timetable (Services - Individual > Charting Timetable)
      3. Housing - Includes: Nightly Absences (Housing > Nightly Absences)
      4. Service - Includes: Contacts Log, Group Notes, Progress Notes, Transportation (All found within Services - Individual)
  5. + Add More Settings - Situational
    1. Click this to open the right navigation bar, Additional Settings. Note: If additional settings are added to the form, they must be filled out. Also, the list of additional settings will vary based on the selection(s) made from the Event Types setting.
      1. Additional Eligibilities
        Availability: Housing & Service Event Types
        Use: Requires an additional eligibility record to be assigned to the consumer within Certified Entitlements
      2. Additional Procedure Consideration
        Availability: Housing & Service Event Types
        Use: Requires that another procedure is billable or not billable
      3. Consumer Age Minimum/Maximum
        Availability: Service Event Types
        Use: Requires the consumer's age on the date of service to meet the age/range entered
      4. Nightly Absence Event Types
        Availability: Housing Event Types
        Use: Requires that a specific nightly absence record is saved for a consumer within the Nightly Absence module
      5. Program Status
        Availability: Housing & Service Event Types
        Use: Requires that the consumer has a program status record active on the date of service in the Program Status module
      6. Require Plan Effective date within XX days prior to Event Date
        Availability: Housing & Service Event Types
        Use: Requires that the consumer has a plan with an effective date within XX days of the service in the Plans and Reviews module
      7. Service Event Types
        Activity Types
        Availability: Service Event Types
        Use: Requires that a specific activity type is selected on a group note in Services - Group
        Bill Pre-Admission Service Dates
        Availability: Service Event Types
        Use: Allows services prior to program admission (provided during intake) to be billable
        Contact Methods
        Availability: Service Event Types
        Use: Requires that a specific contact method is selected on a contacts log or progress note in Services - Individual
        County
        Availability: Service Event Types
        Use: Requires that a specific county is selected on a progress note in Services - Individual and/or a group note in Services - Group
        Crisis/Routine
        Availability: Service Event Types
        Use: Requires that Crisis or Routine is selected on a progress note in Services - Individual
        Electronic Signature Required
        Availability: Service Event Types
        Use: Requires that a note is e-signed for progress notes in Services - Individual and/or a group notes in Services - Group
        Face to Face
        Availability: Service Event Types
        Use: Requires that a Face to Face Yes or No selection is made on a progress note in Services - Individual
        Forms - Note: Options are displayed based on programs selected.
        Availability: Service Event Types
        Use: Requires that a specific answer is selected from a form question that is flagged as Can be used as an AccuBill billing requirement = Yes within a FormBuilder form that is included in a progress note
        Group Attendee Count Minimum/Maximum
        Availability: Service Event Types
        Use: Requires that a group note contains a specific number of consumers in Services - Group
        Interactive Complexity
        Availability: Service Event Types
        Use: Requires that a Interactive Complexity Yes or No selection is made on a progress note in Services - Individual
        Languages
        Availability: Service Event Types
        Use: Requires that a specific language selection is made on a progress note in Services - Individual and/or a group note in Services - Group
        Note Writer Credentials
        Availability: Service Event Types
        Use: Requires that the note writer has a specific credential assigned to them in Human Resources > Staff Information > Credentials tab > Authorization Credentials section
        Note Writer NPI
        Availability: Service Event Types
        Use: Requires that the note writer has an NPI entered for them in Human Resources > Staff Information > Credentials tab > National Provider Identifier field
        Note/Log Locations - Note: Options are displayed based on programs selected.
        Availability: Service Event Types
        Use: Requires that a specific location selection is made on a progress note in Services - Individual and/or a group note in Services - Group
        Program Division Enrollment
        Availability: Housing & Service Event Types
        Use: Requires that the consumer has a program division record active on the date of service in Individual Client Schedule within Services - Group
        Progress Note Configurable Dropdown (Ratio) - Note: This settling will only display if a program was selected that uses this progress note setting in AWARDS. Additionally, the AWARDS setting labels and values will also be displayed for each program that has them set.
        Availability: Service Event Types
        Use: Requires that a specific "ratio" selection is made on a progress note in Services - Individual
        Progress Note Types - Note: Options are displayed based on programs selected.
        Availability: Service Event Types
        Use: Requires that a specific note type selection is made on a progress note in Services - Individual
        Service Event Days Count Minimum/Maximum
        Availability: Service Event Types
        Use: Requires that a specific number of service days are documented in Services - Individual and/or in Services - Group
        Service Event Duration Minimum/Maximum - Note: Exceptions can be set for this by payer.
        Availability: Service Event Types
        Use: Requires that a specific number of minutes are documented in Services - Individual and/or in Services - Group
        Service Event Start Time Start/End
        Availability: Service Event Types
        Use: Requires that a specific start time is documented in Services - Individual and/or in Services - Group
        Service Events Count Minimum/Maximum
        Availability: Service Event Types
        Use: Requires that a specific number of services is documented in Services - Individual and/or in Services - Group
        Service Plan Linked
        Availability: Service Event Types
        Use: Requires that a progress note in Services - Individual is linked to a consumer's plan in Plans and Reviews
        Service Types - Note: Options are displayed based on programs selected.
        Availability: Service Event Types
        Use: Requires that a specific service type selection is made on a progress note in Services - Individual and/or group notes in Services - Group
        Telehealth
        Availability: Service Event Types
        Use: Requires that the Telehealth checkbox is selected for a consumer in their group note in Services - Group
      8. Weekdays
        Availability: Housing & Service Event Types
        Use: Requires that service date occurs on a certain day or days of the week
3. Claim Requirements
4. Billing Rates - Required
  1. Click Create Billing Rates
    1. Within the modal, fill out the following sections:
      1. Name - Optional
      2. Billing Rate - Required
      3. Start Date - Required
      4. End Date - Optional
      5. Payers - Optional
      6. Programs - Optional
      7. Note Writer Credentials - Optional
      8. Note/Log Locations - Optional
      9. Consumer Age Minimum - Optional
      10. Consumer Age Maximum - Optional
  2. Created billing rates will appear on the main screen and can be edited, duplicated, or deleted by clicking the actions icon Action Menu
5. Claim Amount Multiplier Calculation - Required
  1. From the dropdown select:
    1. 1 Unit - 1 claim unit will be billed for the procedure
    2. Duration - Claim units are calculated and billed based on the duration of the service using the additional settings provided:
      1. 1 unit of measure = ______ minute(s) AND ______ unit(s) of measure = 1 claim unit - enter the unit of measure values (eg: If 1 and 15 were entered, a claim unit would be calculated for each 15 minutes of service)
      2. No rounding, require full units of measure to calculate claim units - selecting this will not using rounding to calculate claim units
      3. Apply natural rounding to units of measure remainder - selecting this will round down or up based on the number of partial units
      4. Count _____ or more remaining minutes as whole units of measure - selecting this will round up based on the number entered in the field provided
      5. Apply natural rounding to claim units remainder - selecting this will round down or up based on the number of partial units
      6. Count _____ or more claim units as whole claim units - selecting this will round up based on the number entered in the field provided
      7. First calculate individual event units and then sum all event units together - Select this to first calculate units at the event level and then add the individual unit together
      8. Deduct _____ event minute(s) from claim unit calculation - enter a value to deduct from the claim unit calculation (eg: enter 5 to deduct 5 minutes duration from the unit calculation)
      9. Round partial claim units to nearest - Claim units are rounded further based on the three options below
      10. Don't Round - Selecting this will allow claim units to calculate past the hundredth place
      11. Tenth - Selecting this will not allow claim units to calculate past the tenth place
      12. Hundredth - Selecting this will not allow claim units to calculate past the hundredth place
    3. Custom Unit Type - Claim units are calculated and billed based on the options within the Select One dropdown and the additional settings provided: Note: This settling will only display if a program was selected that uses this progress note setting in AWARDS.
      1. 1 unit = ______ - enter the value associated with the selection from the Select One dropdown
      2. Select One dropdown - select the type to calculate units from
      3. Apply rounding down - selecting this will always round down based on the number of partial units
      4. Apply rounding up - selecting this will always round up based on the number of partial units
      5. Apply natural rounding - selecting this will round down or up based on the number of partial units
      6. Count ______ remaining number of units as whole claim units - selecting this will round up based on the number entered in the field provided
      7. Billable unit count maximum - enter a value here to cap the number of units that can be billed for this procedure when using the Custom Unit Type
  2. Note: Exceptions can be set for this by payer and/or program.
6. + Add More Settings - Situational
  1. Click this to open the right navigation bar, Additional Settings. Note: If additional settings are added to the form, they must be filled out.
    1. File/Form Type
    2. Both Types - includes settings that can be used for both file/form types
      1. Measurement Code - 837 Usage: SV1-03 (837P) / SV2-04 (837I)
      2. Procedure Code - 837 Usage: SV1-01 (837P) / SV2-02 (837I)
        Procedure Code Modifiers - 837 Usage: SV1-01 (837P) / SV2-02 (837I)
      3. Procedure Description - 837 Usage: SV1-01-07 (837P) / SV2-02-07 (837I)
      4. Referring Provider - 837 Usage: NM1*DN (837P & 837I)
      5. Third Part Org. Note - 837 Usage: NTE-01 & NTE-02 (837P & 837I)
      6. Valid ICD-10 Categories - 837 Usage: HI*ABK (837P & 837I)
    3. 837P/CMS 1500 (HCFA) - includes settings just for this file/form type
      1. Last Seen Date Required - 837 Usage: DTP*304 (837P)
      2. Line Note - 837 Usage: NTE-01 & NTE-02 (837P)
      3. POS Code - 837 Usage: CLM05-01 (837P)
      4. Rendering Provider - 837 Usage: NM1*82 (837P)
    4. 837I/CMS 1450 (UB-04) - includes settings just for this file/form type
      1. Admission Date Required - 837 Usage: DTP*435 (837I)
        Admission Hour Required - 837 Usage: DTP*435 (837I)
      2. Admitting ICD-10 Code Required - 837 Usage: HI*ABJ (837I)
      3. Attending Provider - 837 Usage: NM1*71 (837I)
      4. Discharge Hour Required - 837 Usage: DTP*096 (837I)
      5. Facility Type - 837 Usage: CLM05-01 (837I)
      6. Patient's Reason for Visit ICD-10 Code Required - 837I Usage: HI*APR (837I)
      7. Patient Status Code - 837 Usage: CL1-03 (837I)
      8. Revenue Code - 837 Usage: SV2-01 (837I)
      9. Value Information - 837 Usage: HI*BE (837I)
7. Miscellaneous
  1. Notes - Optional
8. Review
  1. Review the contents of the procedure and click Create the save the new procedure record.
    1. Note: If the checkbox called Reprocess All Billing Events is selected prior to clicking the Create button, all billing events will be reprocessed that haven’t been used to create a Charge record.

Procedures Table

Within the Procedures table, you’ll see the following tabs/columns:

Tabs

Active - Lists all procedures that are set to Active status. Note: This tab is selected by default.
Inactive - Lists all procedures that are set to Inactive status.
All - Lists all procedures, both Active and Inactive status'.

Columns

Name - Name for the procedure record
Procedure Group - Procedure group assigned to the procedure record
Start Date - Start date assigned to the procedure record
Status - Current status for the procedure record (Active or Inactive)
Payers - Payers assigned to the procedure record
Programs - Programs assigned to the procedure record
Active Billing Rates - List if billing rates that are active as of today
Last Modified - The date and time the procedure record last updated
ID - ID number assigned to the procedure record by AccuBill
Actions
- View Record - Click to view and edit the procedure record
- Change History - Lists all updates made to the procedure record
- Delete Record - Click to delete the procedure record

Bulk Actions

By selecting at least one procedure record checkbox, a footer will appear with the following:

Cancel - Deselects records and hides footer
Export - Exports selected records from AccuBill
- All exports created by users will be maintained within the Exports modal (click Exports button in table header). Within the Exports modal, the following data is listed for each export:
  - Status - this will either report Pending, Complete, or Error
  - Exported - this is the date/time that the export was created
  - Expiration - this is the date/time when the export will be deleted by AccuBill
    - Note: This is 30 days from the date the export was created
  - User - this is the user who created the export
  - Download - this is a link to download the export file from AccuBill to the users computer
  - Delete - this will delete the export record in AccuBill
Compare - Compares multiple records side-by-side
- Note: At least 2 records must be selected to activate this button
Duplicate - Creates a new record with the same data, just the name is different
Delete - Deletes the selected records