How does private pay work, and do private-pay clients need an authorization?

Private pay and prior authorizations: set Preferred Billing Method to Private pay; no authorization or insurance needed, invoice the family directly. Private pay skilled nursing works the same way.

Quick answer1 min readUpdated for AveeCare
Short answer

Set the client's Preferred Billing Method to Private pay, on the add-client form or later from the client's profile. A private-pay client needs no prior authorization and AveeCare does not ask for insurance details. You invoice the client or their family directly, and they can pay online when your agency has connected Stripe, Square or PayPal. Skilled nursing works the same way for private pay: set the Service Type to Skilled Nursing. Prior authorizations are only for a payer that approves hours, and when a client has one, hours beyond it bill as private pay.

Good to know

  • Insurance and private pay together Choose Both (insurance + client) when a payer covers part of the care and the family pays the rest.
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Founding Partner, AveeCare

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