Fee Schedules

Information about Fee Schedules

Billing / Fee Schedules Assign a Fee Schedule Based on Date

To assign a fee schedule based on the service date on a timesheet:

  1. Navigate to the  Billing module and select Service Codes
  2. Click the Fee Schedule Rates button
  3. Search for the fee schedule you want to edit and click the Settings  button to the far right of it
  4. Select Add Range
  5. Add your Rate and Agreed rate and choose the Start Date and End Date
  6. When you are done, click Add

Billing / Fee Schedules Assign a Fee Schedule Based on Location

To assign a fee schedule based on the service location on a timesheet:

  1. Navigate to the  Billing module and select Service Codes
  2. Click the Fee Schedule Rates button
  3. Search for the fee schedule you want to edit and click the Settings  button to the far right of it
  4. Select Add Modifier Group
  5. Give this modifier group a Name, choose a Location, optionally add Modifiers, and add your Rate and Agreed rate
  6. When you are done, click Add

Billing / Fee Schedules Create a Fee Schedule

To create a new Fee Schedule:

  1. Navigate to the Billing module and select Fee Schedules
  2. Click + Add New on the top right corner
  3. Complete the form:
    • Name: enter the name of the Fee Schedule (E.g. United Healthcare)
    • Description: enter a brief description. (E.g. All United Healthcare services)
    • Click the checkbox Is Active, to activate the code
  4. Click Save
  5. Now that you have created a Fee Schedule you will most likely want to start linking it to payors and eventually attach this fee schedule to the desired service codes

Billing / Fee Schedules Link a Fee Schedule to Payor’s Insurance Plans

Once you have created a Fee Schedule, you will need to link it to the payor’s insurance plan.

To link your Fee Schedule to an insurance plans:

  1. Navigate to the  Billing module and select Fee Schedules
  2. Click the By Payor tab
  3. Next to each payor insurance plan, click the No fee schedules  drop-down and select the Fee Schedule you want to associate each payor plan to
    • If an insurance plan is not displayed on the list, click the link add a new one displayed within the sentence on top of the payors list: Manage existing fee schedule/insurance associations, or add a new one
      • Click the Select a company  drop-down, to select the insurance company name
      • Click the Select an insurance company  drop-down, to select the plan name
      • Click the Select a fee schedule  drop-down, to select the fee schedule you want to link this payor plan to
  4. Once you have created your Fee Schedules, you can begin assigning them to your service codes. This will ensure that the default fee schedule rate will automatically pull over when a timesheet is created with that particular authorized code
    • If you do not see the payor you are looking for, please contact your organization account to ensure the plan is approved by your organization

Billing / Fee Schedules / Billing / Service Codes Add a Fee Schedule and Rate to a Service Code

Service Codes can be assigned to multiple Fee Schedules, based on the agreed payor rates. Service Codes must have at least one fee schedule attached, otherwise, you will see a yellow warning  to the left of the code. The default rate associated with the Fee Schedule is the rate an insurance company or private client will be billed for such service.

To assign Fee Schedule and a rate to a Service Code:

  1. Navigate to the Billing module and select Service Codes
  2. Click the gear   icon on the right of the code, under the Options column, and select Add Default Rate
  3. Click the Fee Schedule  drop-down and select the Fee Schedule you are associating to the code
  4. Enter the Rate, which is the amount you are charging for a specific service
  5. Enter the Agreed Rate, which is the rate negotiated with the insurance payor for the service. If you do not have agreed rates you can enter the Rate used above
  6. Click Add