In Careswitch, a service is the type of care you deliver and a policy is what connects a payer to that care. This guide covers both halves: first adding a service to a client, then connecting a payer by creating the right kind of policy — private-pay (the client, a family contact, or an LTC / Guide organization) or a VA third-party authorization.

New to policies? Start with What is a Policy? for the concept overview.

How services and payers connect

A client in Careswitch is also called a recipient. The people or organizations who pay for their care are payers. Two building blocks link them:

A service (service line) is the type of care you deliver — e.g., Companion Care or Skilled Nursing. It carries bill rates and a care plan, but on its own it has no payer.
A policy is what actually connects a payer to care. Each policy belongs to the client, names a payer, and contains one or more service groups — where you list the specific service(s) the policy covers, along with any coverage limits.

So the rule of thumb is: assigning a service to a policy is what connects that service to its payer. A service that no policy covers can't be billed to a payer.

Because of this, every setup below follows the same two-stage shape: first add the service (Part 1), then create a policy, choose its payer, and assign the service(s) to it (Parts 2 and 3). The payer type decides which kind of policy you create:

Client, another contact, or an LTC / Guide organization → a private-pay policy (you choose the payer and add the services it covers).
VA (and similar electronic third-party payers) → a third-party policy, which you create from the authorization and the system builds out for you.

Before you start

Make sure the client profile exists.
If the payer is an organization (LTC, Guide) or a family contact, confirm it exists under Contacts so you can select it on the policy.
For a VA third-party policy, the client must have a date of birth on file, plus a Veteran ICN (or a Medicaid ID for Medicaid payers).

Part 1 — Add a service to the client

Start by adding the service line you'll later attach to a policy.

Open the client's profile from the Clients (Care Recipients) list.
Go to the Services tab and click Add Service (top right).
Choose the service from your templates — e.g., Companion Care (Hourly). The template carries the shift method (Hourly, Live-In, or Visit-Based), the default bill rates, and the care plan, so picking it seeds those for the client. (Templates are managed under Settings → Workspace Services.)
Optionally choose team members to Notify, then click Add Service.

Open the new service to finish setting it up:

Start date — set it before scheduling shifts (and an end date if known).
Bill rates — review them under the service's Rate Settings, and override the default for a client-specific rate or discount if needed.
Live-in policy — for a live-in service, choose the applicable live-in policy (this is the scheduling / clock-in policy, not the billing policy in Part 2).
Stage — new services start in an early pipeline stage; move the service to Active when care is ready to begin.

Tip: A client can have several services, and one policy can cover multiple services — or you can use a separate policy per payer. The quickest way to connect a payer is to create the policy right from inside the service (see Part 2): the Policies panel pre-attaches that service for you.

Part 2 — Connect a payer by creating a policy

This is the step that actually connects a payer: you create a policy, choose who pays, and assign the service(s) it covers. The three scenarios below are all private-pay policies — the only difference is who you pick as the payer (and, for LTC, the Assign Benefits to Payer checkbox).

First: set the client or contact up as a payer

Before anyone can be selected on a policy, they must be enabled as a payer on their own profile. If they aren't, they won't appear in the payer list when you build the policy — so do this first.

Make the client a payer (self-pay): open the client's profile, find Private Payer Information, and click Make Payer. Enter the billing and payment details — invoicing frequency, days until due, and payment method (Credit Card, ACH, Paper Check, or Wire Transfer). If you collect payments through Careswitch, add and verify the card or bank account so the payment method shows as Verified. Save.
Make a contact or organization a payer (family member, responsible party, LTC / Guide): open them under Contacts, or create them with Create → Individual (a person) or Create → Organization (e.g., an LTC / Guide payer). On their profile, open Private Payer Information → Make Payer and enter their billing and payment details. Save — they'll now appear in the payer list.

The common flow (all private-pay policies)

Open the policy builder. Easiest from inside the service: open the service and, in the Policies panel, click Create Policy — the service is pre-attached. (You can also open the client's Policies tab and click Create Policy there.)
Keep the Private Pay tab selected (the Third Party tab is for VA / Medicaid — see Part 3).
Select the Payer (they must already be set up as a payer — see above).
Confirm the Services the policy covers (pre-filled from the service; add more if needed) and set the Coverage Start Date. Assigning the service to the policy is the connection — those services now bill this payer.
Optional — toggle Advanced Controls to add service groups with limits, a Policy / Authorization / Claim number, documents, and the Assign Benefits to Payer option (see 2C).
Click Create Policy. The assigned services now invoice this payer. (Invoice frequency, email, and payment method come from the payer's profile.)

2A — Client as the payer (private / self-pay)

Use this when the client pays for their own care. Make sure the client is set up as a payer first.

In Create Policy, keep Private Pay and select the client as the Payer.
Confirm the Services and Coverage Start Date (use Advanced Controls only if you need limits or a policy number).
Click Create Policy. Invoices for the covered services bill the client; email, frequency, and payment method come from the client's payer profile.

2B — Another contact as the payer

Use this when a family member or responsible party pays on the client's behalf.

Make sure the contact is set up as a payer first — create them under Contacts and add their payer details if they don't exist yet.
In Create Policy (Private Pay tab), select that contact as the Payer.
Confirm the Services and Coverage Start Date, then click Create Policy. Invoices are addressed to that contact.

Note: Billing settings and saved payment methods live on the payer's contact record, so the same payer can be used across multiple clients and policies.

2C — LTC / Guide payer (organization) + reimbursement

Use this when a long-term care (LTC) insurer or Guide-type organization pays. It's still a private-pay policy, but with two important additions: the Assign Benefits to Payer toggle and the advanced policy controls.

Select the organization and assign services

Make sure the organization is set up as a payer. Then in Create Policy (Private Pay tab) select that organization (the LTC / Guide payer) as the Payer.
Confirm the covered Services, then toggle on Advanced Controls to configure the reimbursement option and limits.

Reimbursement: uncheck "Assign Benefits to Payer" (two invoices)

Under Advanced Controls, Assign Benefits to Payer is on by default (the agency bills the payer directly). For LTC reimbursement, uncheck it — the form notes this is for reimbursement-only policies and that "billing will route to a different primary policy." Because the client also has a primary (assign-benefits) policy, billing then produces two invoices: one the client pays out of pocket, and a separate reimbursement invoice for the LTC insurer.

Why two invoices? Two policies on the client create the two invoices: a primary policy (Assign Benefits to Payer = on) the client pays, and a reimbursement-only policy (Assign Benefits to Payer = off) that routes to the insurer. Unchecking the box is what makes a policy reimbursement-only.

Advanced controls

Policy Number, Authorization Number, and Claim Number — enter whatever the policy provides.
Service Groups — the services that share a limit; on each set Limit Value, Limit Type (hours, visits, or dollars), and Limit Period (week, month, year, or authorization), plus coverage dates.
Documents — optionally upload policy-related documents (drag and drop, max 50 MB per file).

Careswitch tracks utilization against the limits and warns you before a scheduled visit would exceed them or fall outside an allowed day / time window.

Part 3 — VA third-party policy (via the authorization)

For Veterans Affairs (VA) and similar electronic third-party payers, you don't build the service groups and rules by hand. You add a third-party policy and drive it from the authorization — the system does the rest.

Confirm the client's profile has a date of birth and a Veteran ICN. (The policy can't be created without a date of birth on file; the system also extracts these from the authorization, but they're required on the client in order to bill.)
In Create Policy, choose the Third Party tab. Set Payer Type to VA, then select the Payer — e.g., Veterans Affairs Community Care Network or Veterans Affairs Fee Basis Program.
Under Upload Authorization, drag and drop or browse to attach the VA SEOC (Standardized Episode of Care) or authorization letter (max 50 MB).
Click Create Policy. If the authorization isn't available yet, toggle "No current authorization (provisional policy)" to create a provisional shell. Either way the policy starts provisional / pending until the authorization is processed.

What happens next

Once the authorization is submitted, Careswitch takes over:

It validates the authorization and extracts the client's details (date of birth, Veteran ICN) from it.
It automatically builds the service groups and rules — covered services, procedure codes (e.g., G0162) with their constraints, authorization limits, and coverage dates — so you don't enter them by hand.
Once the authorization is approved, you're notified and the policy becomes active (Primary billing), so the assigned services can be billed against it.

In short: for VA, your job is to attach the right authorization (SEOC) plus the client's identifiers (DOB + Veteran ICN). Careswitch validates the auth, extracts the details, builds the service groups and rules automatically, and notifies you once it's approved — no manual rule entry.

For more detail, see How to submit a Third-Party (Insurance) Authorization and Why a VA client needs both a Home Health and a Homemaker service.

Quick reference

First enable the payer on their profile (Private Payer Information → Make Payer), or they won't appear in the policy's payer list. Then every payer is connected the same way: create a policy → choose the payer → assign the service(s). The differences:

Payer	How to connect it
Client (self-pay)	Create Policy → Private Pay → Payer = the client → confirm Services + Coverage → Create Policy. Billing details come from the client's payer profile.
Another contact	Set the contact up as a payer → Create Policy → Private Pay → Payer = that contact → confirm Services → Create Policy.
LTC / Guide	Create Policy → Private Pay → Payer = the organization → Advanced Controls → uncheck Assign Benefits to Payer (reimbursement-only → two invoices with the primary policy) → add policy number & limits.
VA (third-party)	Create Policy → Third Party → Payer Type VA → select Payer → Upload Authorization (SEOC) → Create Policy (provisional until processed). The system validates, extracts DOB / Veteran ICN, builds service groups & rules, and notifies you once approved.