Insurers, care homes and other funders

Setting up funders

A funder is anyone other than the patient who pays for visits: an insurer, a care home, an NHS contract, a solicitor or an employer. The owner adds them in Settings → Funders: name, contact, billing email (invoices are emailed there), payment terms in days, and what each invoice line shows (the patient's name, their reference, or both: some insurers don't want names). If a funder's authorisation numbers always look the same, give the reference format (# a digit, @ a letter, * either, e.g. BU-######) and Hally checks each case's number against it. Under Warnings and bank details set when to warn about a case running out (80% to begin with) or expiring (14 days before), and the bank details printed on invoices.

Adding a case

On the patient's record, Cases → Add a case: the funder, the authorisation or policy number (insurers need one), how many sessions and/or how much money it covers, the dates, and which services (tick none for all). If the patient pays something each visit (an insurer's excess), put it in Patient pays each visit; if the funder pays a fixed rate a session, put that in Funder's rate, and the patient pays any difference.

Who pays at checkout

The diary shows the funder on each visit a case covers, in red once the case is used up. When a visit is completed or checked out it's charged to the case: the funder's share comes off the patient's bill (shown as "Paid by …"), so the patient only pays any excess. Who pays at the top of checkout shows the split and lets you bill the visit to the patient instead, or to another case. Once a case's authorised sessions or budget are used up, it stops: the patient pays, checkout says so, and a task goes to admin to ask the funder for more. Tasks are also raised when a case is nearly used up and before it expires. Cancelling a visit gives its session back.

Home visits under a case

A home visit's callout and mileage are paid by the patient unless the case says otherwise: tick Also pays home-visit callout and mileage on the case and the funder pays them too, on top of its rate a session and any excess, as long as there's budget left (the patient pays whatever the budget can't). When the case has stopped paying for visits (sessions or budget used up), the patient pays the visit and its travel. The funder's invoice shows the visit as "(home visit)" with the travel included.

Invoicing funders

Reports → Funders → To invoice lists every charged visit not on an invoice yet. Choose the dates (last month to begin with) and press Raise invoices: each funder gets one invoice listing its visits in that period, so a care home gets one monthly invoice for all its residents. Open the invoice to Email to funder or Print or save as PDF; it's due after the funder's payment terms. Invoice numbers come from the same sequence as patients' invoices.

Payments and credit notes

When the money arrives in the bank, open the invoice and Record a payment (bank transfer, cheque or card, with their reference). For a correction, Issue a credit note: it takes that much off what's owed. If an invoice went to the wrong funder or listed the wrong visits, credit the whole of it with put its visits back ticked: the invoice is voided and its visits can be invoiced again.

Reports and Xero

Aged debtors shows what each funder owes, by days since the invoice (0–30, 31–60, 61–90, over 90) and how much is overdue; Funder statement lists one funder's invoices, payments and credit notes for a period with a running balance, to send with a reminder. If Xero is connected (Settings → Integrations), funder invoices go across to a Xero contact for each funder, with their payments (into the bank account Stripe pays into) and credit notes.

Healthcode

Electronic claims to insurers through Healthcode aren't connected yet. You can save each insurer's Healthcode payer ID now; until then, insurers are invoiced by email like any other funder.