Runnel One is a billing management platform designed for behavioral health providers. It helps organizations:
Think of it as the central hub that connects what therapists do (visits) with what insurance companies pay (EOBs), and ensures everything adds up correctly.
Before using Runnel One, the system must be configured in a specific order. Each step depends on the previous one.
| Step | What to Configure | Why It's Needed |
|---|---|---|
| 1 | Company Settings | Sets your organization name, and billing period type |
| 2 | Insurance Providers | Defines which insurance companies you work with and their CPT code rates |
| 3 | Clients | Adds your clients with their insurance information and specific billing rates |
| 4 | Therapists/Contractors | Registers therapists with their credentials, rates, and system access |
| 5 | User Roles | Defines who can access what features in the system |
| 6 | Billing Periods | Sets up your pay period schedule (biweekly or monthly) |
When first logging in, you'll be directed to set up your company:
Insurance providers are the companies that pay for therapy services. Each provider has specific CPT codes (service codes) and payment rates.
For each insurance provider:
The system can automatically read payment PDFs from these insurance companies:
| Insurance Provider | Supported Formats |
|---|---|
| Aetna Better Health | Direct, Availity, MeriTain |
| Carelon | Direct |
| CCP (Community Care Plan) | Direct |
| Cigna | Direct |
| Florida Blue | Via Availity |
| Humana | Direct, PaySpan |
| Medicaid | Direct |
| Molina | Direct |
| Sunshine | CMS format |
| United Healthcare | Optum, Availity |
Clients are the individuals receiving therapy services. Each client must be linked to their insurance and have billing rates configured.
| Field | Description | Why It Matters |
|---|---|---|
| Client Name | Full name (must match exactly in all imports) | Used to match visits with insurance claims |
| Medicaid Member ID | Insurance member number | Required for insurance claim matching |
| Alternative Insurance ID | Secondary insurance identifier | For clients with multiple insurances |
| Assigned Insurances | Which insurance covers this client | Determines billing rates |
| CPT Rate Configuration | Per-CPT code rates | Controls billing amounts |
Each client can have customized rates per insurance and CPT code:
| Rate Type | Description |
|---|---|
| Company Rate | What your company pay to the contractor per unit |
| Forced Rate (CMS 80%) | Override rate for specific programs (like Medicaid CMS at 80%) |
Example:
Client: Maria Garcia
Insurance: Aetna Better Health
CPT 97153 → Company Rate: $7/unit, Insurance Rate: $12/unit
CPT 97151 → Company Rate: $12/unit, Insurance Rate: $15/unit
Therapists and staff members who provide services are registered as contractors.
| Field | Description |
|---|---|
| Name | Full legal name |
| Used for system login access | |
| Role | THERAPIST or STAFF |
| Therapist Type | RBT, BCBA, LBA, etc. |
| Provider NPI | National Provider Identifier number |
| Hourly Rate | Base pay rate for payroll calculation |
Contractors can be assigned system roles that control what they can see and do in Runnel One. For example, a therapist might only see their own clients and visits, while a billing manager can access all financial reports.
Visits represent therapy sessions - the core of your billing data.
| Field | Example |
|---|---|
| Client Name | John Smith |
| Therapist | Jane Doe |
| Service Date | January 15, 2025 |
| Start Time | 9:00 AM |
| End Time | 10:00 AM |
| CPT Code | 97153 |
| Units | 4 (1 hour x 4) |
| Period | PP01-2026 |
Each visit has two important statuses:
| Status | Meaning |
|---|---|
| ACTIVATED | Active, valid visit |
| DELETED | Removed (soft-deleted) |
| DUPLICATED | Flagged as a duplicate of another visit |
| Status | Meaning |
|---|---|
| PENDING | Waiting for insurance payment |
| RECONCILED | Insurance payment matches the visit |
| MISMATCH | Insurance paid a different amount than expected |
| DENIED | Insurance denied the claim |
| SKIPPED | Manually marked to skip reconciliation |
When importing visits, the system checks:
If any check fails, the visit goes to the "Not Imported" list with the reason.
Billing periods define time windows for grouping visits and generating payroll.
| Type | Duration | Example |
|---|---|---|
| Biweekly | 14 days | P2501: Jan 1-14, P2502: Jan 15-28 |
| Monthly | Calendar month | P2501: Jan 1-31, P2502: Feb 1-28 |
Always verify the correct period:
An EOB (Explanation of Benefits) is a document from an insurance company that shows what they paid for specific therapy claims.
| Problem | Cause | Solution |
|---|---|---|
| "Client not found" | Client name on EOB doesn't match exactly | Update client name to match insurance records |
| "CPT code not configured" | CPT code exists on EOB but not in system | Add the CPT code to the insurance provider |
| "Medicaid ID missing" | Client's insurance ID not entered | Update client profile with member ID |
| "Duplicate check" | Same EOB already imported | Skip - it's already in the system |
Reconciliation is the process of matching therapy visits with insurance payments. This is the core value of Runnel One.
The system matches a visit to an EOB claim when ALL of these match:
| Scenario | Result |
|---|---|
| Visit amount = EOB payment | RECONCILED - Everything matches |
| Visit amount ≠ EOB payment | MISMATCH - Amounts differ, needs review |
| EOB shows denial | DENIED - Insurance denied the claim |
| No matching EOB found | PENDING - Still waiting for insurance payment |
When a visit and EOB don't match perfectly, you have options:
The dashboard gives you a real-time snapshot of your billing status for any period.
| Card | Shows |
|---|---|
| Total Visits | Number of visits imported for the period |
| Reconciled | Visits matched to insurance payments |
| Pending | Visits waiting for insurance payment |
| Denied | Visits where insurance denied the claim |
| Mismatched | Visits where payment doesn't match expected amount |
| Payment Issues | Visits with incorrect company payment calculations |
| Total EOB Claims | Number of insurance claims processed |
| Per Insurance | Breakdown by insurance provider |
Runnel One provides several reports for different business needs.
| Report | Who Uses It | What It Shows |
|---|---|---|
| Client Summary | Billing Team | All visits per client, grouped by insurance and CPT code, with payment totals |
| Client Profitability | Billing Team | All visits per client, profit calculation, and reconciliation status |
| EOB Summary | Billing Team | All insurance payments by check number and period |
| Payroll Period | HR / Payroll | Therapist hours, rates, and gross pay per period |
| Therapist Rate | Operations | All configured rates per therapist per client (for verification before payroll) |
All reports can be exported to Excel (.xlsx) for further analysis or sharing with external systems.
The system uses role-based access control - different users see and can do different things.
| Role | Can Do |
|---|---|
| Admin | Everything - full access to all features |
| Billing Manager | Manage visits, EOBs, clients, reports; cannot change settings or roles |
| Analyst | View visits, generate reports; cannot modify data |
| Therapist | View their own clients, submit timesheets, view payroll |
Before importing visits or EOBs, verify:
| Symptom | Likely Cause | Fix |
|---|---|---|
| Visits showing $0 payment | Missing rate configuration | Configure CPT rates for the client |
| Many PENDING visits after EOB import | Client name mismatch | Ensure names match exactly |
| EOB claims not matching | Missing alternative insurance ID | Add it to client profile |
| Dashboard shows "Payment Issues" | Rate misconfiguration or XP code issue | Review affected visits, check rates |
| Cannot access a feature | Missing permission | Contact admin to update your role |
| Import shows "not imported" items | Validation failures | Review the error messages and fix data |
| Term | Definition |
|---|---|
| CPT Code | Current Procedural Terminology - a 5-digit code identifying a specific medical service (e.g., 97153 = Adaptive Behavior Treatment) |
| EOB | Explanation of Benefits - a document from an insurance company showing what they paid for specific claims |
| Reconciliation | The process of matching a therapy visit to the corresponding insurance payment |
| Period | A billing time window (e.g., biweekly: Jan 1-14) used to group visits and generate payroll |
| Tenant | An organization using the system; each tenant's data is completely isolated |
| NPI | National Provider Identifier - a unique 10-digit number for healthcare providers |
| Unit | A billing unit; typically 4 units = 1 hour of service |
| Mismatch | When the amount billed for a visit differs from what insurance paid |
| Soft Delete | Marking a record as deleted without physically removing it |
| RBT | Registered Behavior Technician - a type of therapist |
| BCBA | Board Certified Behavior Analyst - a senior therapist type |
| Medicaid Member ID | The client's unique identifier with their insurance provider |
| Check Number | The reference number on an insurance payment |
| Company Rate | What the therapy company charges per unit |
| Insurance Rate | What the insurance company pays per unit |
| Forced Rate | An override rate applied for specific programs (e.g., CMS 80%) |
| Split Visit | Dividing a visit into two records when insurance pays a different amount than billed |
| Recalculate | Re-running the matching algorithm to update reconciliation status |
| Dashboard | The main overview screen showing billing status at a glance |
| Payroll | The calculated payment for therapists based on their visits and hours |