Psychological Behavioral Health
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Payments are issued twice a month by ACH, on the 15th and at month end. Deposits usually arrive 1 to 3 business days after they are sent.
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Only the sheets uploaded here. Every figure on this tab comes from one of three files: the appointment status report, the payments export, or a rate sheet below.
Settled claims the payer did not pay at the contracted rate, grouped by payer, code and the exact difference. A group of one is usually that member or that claim. A group that repeats the same difference is usually the schedule.
Staff working area. Providers never see this screen.
Run against the raw file before anything reaches a provider.
Payback is the rule paying more: 1% of gross, automatically, once gross clears $2,500.
Adj is a person deciding something: a lump sum you add on the row, with a reason the provider reads.
Nothing in the file ever creates one.
Open any row to read the full ledger and every claim before you publish.
Add a payment or an adjustment on any row. Every entry records who made it and when.
| Provider | Match | Paid to | Sess | Collected | Gross | Payback1% over $2,500 | Adjadded by hand | Fees | Net |
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Every report PBH has issued this provider, published and staged. Open one to read the ledger and claims, or update it.
Every period PBH has published. Open one to see all providers paid in it.
Internal analysis. Nothing here is visible to providers.