Pear Suite allows you to update your procedure codes, modifiers and reimbursement rates as needed. While many health plans follow the Medi-Cal FFS Doula Billing Codes Chart, some health plans may use different procedure codes or reimbursement rates, and you should refer to your specific contracts to determine how your claim configurations should be set up. 

To update your claim configurations, follow the steps below: 

1. Navigate to the Organization page using the left-hand main menu.
2. Click on the Claims tab at the top of the workspace.
3. Scroll down to the Claim Configurations section.
4. Select the specific insurance plan you wish to update, or click Add Configuration to create a fresh rule profile.
5. Define or adjust your billing rules, including your procedure codes, default modifiers, negotiated rates, or service unit billing limits.
6. Click Save.

⚠️ Important Administration Note: When modifying an existing claim configuration, Pear Suite may preserve previous layout iterations. If an older configuration ruleset is entirely obsolete, completely remove it by clicking the trash icon next to that version.

Once your organization-wide claim configurations are successfully updated, you can control which codes auto-populate for the specific activity by adjusting the activity templates.

Option A: Limiting to Specific Codes

If you want the activity template to prioritize a specific code automatically:

1. Go to the Templates page in your menu sidebar.
2. Select the specific activity you want to adjust (e.g., Postpartum Visit).
3. Locate the billing defaults section. If it is currently locked to code Z1034 (Standard Visit), but your contract layout requires Z1038, add or swap the code selections here.
4. Save your template changes.

Option B: Removing Restrictions for Full Manual Selection

If you want full access to all procedure codes and you prefer not to limit the options when completing the activity.

1. Simply delete the default procedure codes 
2. Leaving this area blank prevents the system from locking in a default code. Instead, it will allow the doula to freely search and select the exact proper code manually when they conclude the activity on the End Activity Details screen.