Pricing Groups can be a powerful tool when you want to consolidate your Price Options and simplify your billing process. Pricing Groups allow you to assign a group to both payers and price options, making it easier to manage multiple pricing structures across various accounts.

Using pricing groups enables you to create a single price option and link it to multiple payers, eliminating the need to create separate price options for each individual payer. This consolidation can save time and reduce complexity in managing your pricing.

To create a new Pricing Group that will be associated with your payers and price options, navigate to:

Management > Billing Setup > Pricing Group

This will take you to the Pricing Group queue where you can view a list of your current Pricing Groups.

Click the NikoHealth Blue Plus Sign in the upper right-hand corner of the screen. An "Add Pricing Group" window will appear.

Give the new Pricing Group a name and description (this is what will appear in the Pricing Group queue.

Be sure to Save!

After creating your Pricing Group, you’ll need to assign it to a payer or plan. Navigate to:

Management > Billing Setup > Payers

This will take you to the list of Payers you've added to NikoHealth.

Select the Payer you wish to associate with this Pricing Group. The Payer details page will open for the selected Payer. Here, you can click on the Pricing Group data field to select the Pricing Group you just created.

Be sure to Save!

Once the Payer is linked to a Pricing Group, it’s time to associate the Pricing Group with a Price Option. Navigate to:

Management > Billing Setup > Pricing

This will take you to the Pricing queue where you can see all the Price Options you've created.

You can see that some of the Price Options listed are already associated with a Pricing Group.

Select the Price Option you wish to associate with the Pricing Group (or click the NikoHealth Blue Plus Sign to create a new Price Option).

In the Price Option details, there is a Pricing Group data field. Choose the Pricing Group you created to associate that Pricing Group with this Price Option.

Once a Pricing Group is linked to a price option, that price option will be used for invoicing whenever the assigned Payer is relevant. You can also make this the default Price Option for this Payer. For example, imagine you create a price option called "Commercial." If the Commercial pricing group is assigned to one or more payers, the system will automatically select this price option under the following conditions:

When a Pricing Group is linked to a price option, the system evaluates all the attributes in the price option configuration to determine the appropriate option to apply. These attributes include:

The system will search for a price option that aligns with the relevant criteria, ensuring the correct price option is selected according to your predefined rules.

Pricing Groups are an essential feature for streamlining your pricing and payer management process. By linking Payers and price options under a single Pricing Group, you can simplify your workflow and avoid creating individual price options for each payer. Once set up, the system will automatically apply the appropriate price option based on the criteria you define, saving time and reducing errors in billing.