Payroll
Sign in through the Hub
Fiscal opens from your Hub, so your password only ever goes to the Hub. Sign in there and choose Fiscal.
Go to the HubPay settings for this provider
Turning this on sends each trip's start and end addresses to Google Maps. Google's health-privacy agreement does not cover Maps, so leave it off for real children: providers then type the miles for each trip. Safe to use with made-up data.
Held for review
Sessions a provider flagged as wrong. They stay out of payroll, with their fee line, until you clear them here.
| Date | Provider | Child | What the provider said |
|---|
MSO invoice
An invoice for the MSO fee on what this provider was paid, using the dates above. It is separate from payroll. Each payment can be on only one invoice.
| Invoice | Issued | Period | Fee |
|---|
Import a provider sheet
Brings a provider's existing billing sheet into this system, read the same way the Management tool reads it (CONT, the payer tabs, Travel and Ongoing). In Google Sheets choose File → Download → Microsoft Excel (.xlsx), then pick that file here. It is read in your browser and loaded for the provider selected above. Always check first: nothing is saved until you import, and importing the same sheet again updates instead of duplicating.
Payments from ESDS and the plans
The ESDS claim report, the plans' payment reports and the travel report are all loaded on the ESDS tab (steps 5 to 8), where you see what will change before anything is saved. Once loaded, the amounts show here in payroll.
Ready to pay
Payment Statement
| Service date | Child | Payer | Service | Status | Charged | You owe |
|---|
Recent payments
| Date | Amount | Method | Lines |
|---|
My sessions
Confirm the sessions that are right. If one is wrong, flag it and say what is wrong. A flagged session is held until your agency looks at it.
| Date | Child | Start and stop | Status |
|---|
Travel voucher
Built from the sessions you logged for the dates above: home to the child and, after the day's last visit, back home. Each trip is rounded down to a whole mile and paid at $0.445 a mile. Nothing is sent to ESDS. You key each trip into ESDS from the voucher below, then mark it entered.
Add one trip by hand
| Date | Miles | From | To |
|---|
My caseload
The children assigned to you. A child's COS is due on their third birthday and is done once the exit scores date is entered.
| Child | Early Steps # | Payer | Frequency | Auth expires | Periodic review due | COS |
|---|
Files downloaded this session
Upload each file where the last column says.
| Time | File | Items | Upload it to |
|---|
1. ESDS contact notes (file 1 of 2 for ESDS)
ESDS needs a contact note for each visit before it will take a claim. The file this step downloads is the one you upload to ESDS as the contact-note (EMR) upload. Then bring the ESDS Results back in step 2 so each visit gets its Service Log ID.
2. ESDS Results
Choose the EMR Results file ESDS sends back. Nothing is changed except adding each visit's Service Log ID.
3. Claims for ESDS (837) (file 2 of 2 for ESDS)
This step is for billing sessions to Part C for children who do not have Medicaid or private insurance. Upload the file it downloads to ESDS as the 837 claim upload.
4. Plan claims for children on Medicaid (Availity 837) (a different file, for Availity, not ESDS)
A child on a Medicaid plan is billed to the plan only, through Availity. The file this step downloads is the one you upload to Availity, not to ESDS, for the same provider and dates chosen above. These visits do not go to Part C.
5. Payments back from ESDS
Choose the ESDS claim report (the Claim Detail export, .xlsx or .csv). It is matched to your visits by Service Log ID, or by exact name and date when it has none. Nothing is saved until you click Apply. Travel rows are matched to your saved travel trips by child and date.
6. Payments back from the plans
Choose the plan's payment report: the Availity remittance (Humana and others), the Sunshine claim report, or the Aetna claim report (.xlsx or .csv). It is matched to your visits by our claim ID when the plan gives it back, otherwise by member ID and service date. Nothing is saved until you click Apply. A claim the plan paid $0 is noted, not recorded as a payment.
7. Travel: the ESDS travel report
Choose the ESDS Travel report (.xlsx or .csv). Each line is matched to a saved travel trip by the child (the name, or the Early Steps number in the ESDS ID column) and the session date, which the report has to carry: add a Service Date column when you pull it. It brings back ESDS's status, id, voucher number and calculated amount. What ESDS paid comes from step 5. Nothing is saved until you click Apply.
8. Availity: the batch report
After you upload a plan claim file, Availity sends back a batch report (a .ebt file). Choose it here to see which claims were rejected and why. A rejected visit is marked "Rejected by plan" with the reasons beside it; fix the cause and download it again from step 4 (tick "Include visits already sent"). Nothing is saved until you click Apply.
Private insurance (for licensed providers: SLP, OT, PT)
The child's private insurer is billed first. Part C is billed second, after the insurer has paid or denied. The charge on each claim is the rate you entered for that insurer under Team, Insurers and rates, and a visit with no rate cannot be added. Travel is billed to Part C only. A child on Medicaid is billed to the plan, never to a private insurer. The file this page makes is for Availity, not ESDS. A visit in private insurance goes to ESDS with its contact note naming that insurance (not Part C): if a note was already sent before you added the visit here, send it again as an update on the contact notes step. Each insurer needs its ESDS code, and each child's insurance needs its coverage start date and, for a parent's policy, the policyholder's birth date, to match what the service coordinator entered.
1. A child's private insurance
| Insurer | Member ID | Who holds the policy |
|---|
Add or change their insurance
2. Add visits to private insurance
| Child | Date | Length | Code (CPT) | Modifiers | Units |
|---|
3. Visits in private insurance
When a session is logged for a child whose insurance and rate are on file, a claim is prepared here by itself (status PROPOSED) with the code, modifiers and units filled in. Nothing prepared goes in any file until you approve it. A visit that needs a choice (two possible codes, no times, two insurers) is not prepared; it waits in step 2.
| Child | Date | Insurer | Code | Units | Charge | Status |
|---|
4. Claim file for the insurer (Availity 837) (for Availity, not ESDS)
Uses the provider and dates in step 2. The file this step downloads is the one you upload to Availity, then pull the insurer's EOB back when it arrives.
5. The insurer's EOB (Aetna)
Choose the EOB you downloaded from Availity (the PDF, or its text). Nothing is saved until you press Apply. A claim the insurer called a duplicate is never billed to Part C; a payment is recorded; anything the tool does not recognise is left for you to read. Part C must be billed within 60 days of the EOB date.
6. Denials and what needs doing (worklist)
| Child | Date | Insurer | What to do | Deadline | Decision (and the insurer's denial code) |
|---|
7. Bill Part C second (ESDS 837) (for ESDS, not Availity)
For visits you marked Bill Part C in step 6. Uses the provider and dates in step 2. The file carries the insurer's result (what it paid, what the member owes, what it denied) as ESDS requires. Needs the visit's ESDS Service Log ID. The file this step downloads is the one you upload to ESDS.
Team
Who can sign in to this agency's billing, and as what. People sign in through the Hub as always; billing recognizes them by the email on their Hub account, so use that email. Owners and admins manage the team and see everything. Staff run billing but cannot manage the team. Providers see only their own sessions, travel and caseload. Only an owner can add, change or remove an owner or an admin.
| Role | Provider |
|---|
Add a person
Add a provider
A provider is who sessions and pay belong to. Add them here first, then give them a login above if they will sign in.
Add many providers at once
Copy the rows from your spreadsheet and paste them here, one provider per line, columns in this order: Name, Discipline, NPI, Taxonomy, ESDS email, Login email. Everything after the name is optional. A first line that starts with "Name" is ignored. Pasting the same list again updates providers by name instead of adding them twice, and a blank cell keeps what is already there. Up to 200 at a time.
Provider profiles
Contact details, license and an emergency contact for each provider. Only owners and admins can see or change these.
| Provider | Discipline |
|---|
ESDS claim setup
The facts the state's claim file needs. Test (T) sends to the state's practice system; only switch to Production (P) when the owner says so. On this test system use made-up values only.
Rendering providers
| Provider | NPI | Taxonomy | ESDS email |
|---|
Insurers and rates
The insurers you bill and what each one pays. Private insurers and their rates are entered by you; nothing is filled in for them. A visit with no rate entered cannot be billed. This only stores the information for now: it does not build or send any claim.
| Insurer | Type | Availity ID | ESDS code | Filing limit (days) | Rates |
|---|
Add a private insurer
Copy the payer ID from Availity’s payer list. It tells Availity where to send the claim, so it is never guessed. You can add it later, but no claim can be made for this insurer until it is there. The ESDS insurer code is the one on ESDS's insurance list (the one your service coordinator picks at eligibility); Part C's second bill needs it.
Rates
Rate in dollars, per unit billed or per visit, whichever that insurer pays. A rate is never edited or deleted: end it on its last day, then add the new one.
| Discipline | Code | Modifiers | Rate | From | To |
|---|
Add a rate
Children
| Child | Date of birth | Early Steps # | Payer | Provider | Periodic due | Auth expires |
|---|
Start from an IFSP
Choose the child's IFSP PDF from the Early Steps data system. It is read in this browser and is not uploaded. You will see what it says in the child's form, can fix anything, and nothing is saved until you press Save.