The electronic billing and all required progress notes (if applicable), attached to the billing calendar in the SETWorks software program, shall be submitted in its entirety by 5:00pm on the 5th of the month to be processed for payment the same month. If this is not met, payment will be processed the following month. If the 5th lands on the weekend or holiday in which our office is closed, we will honor payment for submissions received by 5:00pm the following business day.

You can view authorizations in future months, but remember the authorized individuals and units are never guaranteed. Services can be cancelled prior to the start of the month. You can submit your billing anytime during the month of service. You can only bill once for each month/service. If you are missing an individual, an increase is in process, or billing is not complete, DO NOT submit billing.

For providers who bill per session, semester or similar: You may bill on any date on the calendar for the month in which the service starts. Pay careful attention to the calculated billed amount in the usage information, as you may need to bill a “1” in some cases or a dollar amount in other cases.

Payments are sent on the 20^th of the same month of submission.

If the 20^th falls on a weekend or holiday of which BCFR is closed, payment will be sent the business day prior to the 20^th

Payment can be sent via check or Direct Deposit. To receive payment via Direct Deposit, please complete the Direct Deposit Election Form located above.

Fill out the form here.

If you billing is incomplete it will result in a delay of payment.

Reasons of which a billing may be deemed incomplete are: missing progress notes (if required), progress notes are attached however there are no units entered for each individual, etc.

If you receive paper checks: Please allow 10 business days for mail delivery, if you still have not received payment please email serviceprocurement@bcfr.org. Please be sure to include the month of service and type of service in your email.

If you receive direct deposit: Please wait until the next banking day before inquiring. If you still haven’t received your Direct Deposit, please email serviceprocurement@bcfr.org.

BCFR offers a 95 day grace period to submit for payment. For Example: For services that occurred in January, you have until May 5^th to submit the billing.

If you require more time to submit your billing, due to questions of authorizations, please contact serviceprocurement@bcfr.org to discuss.

SETWorks automatically locks billings after 95 days

For Services with session longer than 95 days – Upload your billing/units into SETWorks and email serviceprocurement@bcfr.org with the following details: Service, month of service, confirmation that billing is complete and accurate, and request that BCFR staff submit on your behalf

If the billing is over the 95 day grace period but not due to the session length, please email serviceprocurement@bcfr.org with a brief explanation of why billing is beyond 95 days and BCFR will determine if an exception is appropriate. We will provide you with instructions on how to proceed depending on the determination of an exception.

Once you have opened the billing, you can upload all notes for billing under the first individual. Once all notes are uploaded, you will proceed to enter units under each specific individual.

Note: Uploading the Process Notes is not sufficient for the completion of billing. You must enter units under each individual.

Instructions: Open billing, select ‘attach documentation’ at the bottom of the first individual, select the up arrow, push ‘select’ button, select all the desired progress notes, select ‘open’, add a brief description for each document (ex: Client Initials, October 2024), select ‘save’. Proceed with entering units under each individual.

Individuals should be ensuring that services are authorized prior to signing up. If you do not see an authorization, you should advise the individual to reach out to their BCFR Support Coordinator to request authorization.

You can call us at 573-874-1995 to speak with our front desk staff who can assist you.

When you view your billing in SETWorks, you will see a gray box with individual’s information on the left. In this box you will find the following information:

Individual’s name, DOB, DMH #, and their Support Coordinator

Authorization Details

Dates: This will tell you the dates you are authorized to service this individual.

Total Units Used: Total units already utilized on the entire authorization

It is important to note, the authorization may span for more than the month you are entering units for. The Total Units Used section is important to look at to ensure you are billing for the correct amount of units. If you are finding there are not enough units available, please contact the Individual’s Support Coordinator.

Total Units on Authorization: Total amount of units available to be used for the entire authorization.

Authorizations can span for any amount of time from one month to twelve months.

The ‘hard limit’ is the total units available to be used for whole authorization

If there are 14 Total Units on the Authorization – you will not be able to bill for more than 14 units during that time frame of the authorization without an increase by the BCFR Support Coordinator.

When you are in the billing, you can see the utilization (what has been used so far on authorization) using the bar below each individual.

The ‘soft limit’ is the total units allocated to each specific month

You can ‘borrow’ from other months on the authorization

Example: Authorization dates of 11/1/2024 – 6/30/2025, the individual was ill in November and could not attend the service so they did not utilize any units that month. You can schedule more sessions in the future (December – June) and bill for it ‘borrowing’ units from the unused units in November.

Note: Units must be ‘borrowed’ from a month that is covered in the authorization. You cannot add services to July because the authorization ends in June.

You can reach out to the individual’s Support Coordinator for additional information. When you are in the SETWorks billing you will be able to see the Support Coordinator assigned to the individual.

Please Note: It is important that you DO NOT submit your billing until all individuals are accounted for and all questions are resolved. Once you submit your billing, you are unable to edit it further. Once your billing is paid, you are unable to be paid out for additional individuals for that month.

Yes! When you are on your home billing page in SETWorks, change the ‘service dates’ filter at the top to includes the date you are wanting to look at and change the ‘Billing Status’ to ‘all items checked’.

You can look back at SETWorks to see what was most recently paid. You will see the paid date on the right of your submission that aligns with the month you receive payment.

TIP: To see a quick overview of who and what was billed, click the ‘>’ button to the left of the ‘service’ column

‘Used’ amount is the amount billed/paid which will match the amount of your payment.

No, you should not submit until everyone in attendance that has BCFR Funding is complete.

Once you submit your billing, you are unable to edit it further.

Once your billing is paid, you are unable to be paid out for additional individuals for that month.

Once you submit your billing, you are unable to edit it further.

EXAMPLE: September 2024 Occupational Therapy can only be submitted/billed for once.

If you run into a situation where BCFR has paid you for a month/service but you are needing to bill for additional individual’s please email serviceprocurement@bcfr.org and BCFR will determine if an exception is appropriate. We will provide you with instructions on how to proceed depending on the determination of an exception.

No, BCFR is unable to pay for a service unless the individual has attended at least one time during the duration of the session.

For example: If the session starts January 1, 2025 and ends March 31, 2025 and the individual attends in January but does not attend for the remainder of the session, you can submit billing to BCFR.

If the individual does not attend at all, BCFR is unable to pay for no attendance of BCFR individuals.

Yes! When you are on your home billing page in SETWorks, change the ‘service dates’ filter at the top to includes the date you are wanting to look at.

NOTE: Authorization can be canceled by BCFR up until the month of service so please check back once month of service has started to ensure no changes to the authorizations have occurred.

NOTE: You can view the future authorizations, but you are unable to enter units for the month until the month has started.

It is best to reference your provider contract with BCFR. Depending on how your contract is set up will determine what your unit rate is.

For example: Unit rates could be 1 unit = $1, 1 unit = full cost of service or 1 unit = 15 minutes @ $17.00.

If still unsure, you can enter a ‘1’ in one of the daily boxes with the month in the billing and look at the ‘usage this month’ box. The ‘Billing’ amount will show you what 1 unit equals.

Please reach out to Joanie Chenault (jchenault@bcfr.org) for a contract amendment.

If you are needing additional assistance with getting an authorization in place, please contact serviceprocurement@bcfr.org.

If you are unable to reach an individual’s Support Coordinator, you can reach out to Service Procurement. If the Support Coordinator is out of office, has changed, etc. we can assist you with getting you in touch with another staff member who can assist with your request.