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Add Fee Schedule

Under the Fee Schedule tab of the New Contract window, you can add a fee schedule as set forth by the contract, or edit existing procedures in the schedule. You can also import a fee schedule or copy one from another contract (see Import Fee Schedule).

 

To add a fee schedule

  1. Click Settings > Contracts.

  2. Click New to create a new contract or double-click on an existing contract to open and edit.

  3. Select the Fee Schedule tab.

  4. If adding to an existing schedule, search the database first to make sure the procedure is not already in the schedule; enter all or part of a word in the Look for field.

  5. Add a procedure:

  • Click New on the lower right of the window; this clears the Procedure field.

  • Click Procedure to display the master list of procedures. Enter all or part of a word or number in the Look for field; when you find the procedure, double-click it. It will now show in the Procedure field.

  1. Complete the fields related to the procedure. See below.

  2. Repeat the steps for each procedure.

  3. When finished, choose one of the following:

    • Select the Providers tab. See Add Providers to Contract.

    • Click Save to save the contract and exit out of the New Contract window.

 

Fee Schedule Tab

Note that some of the fields below will be disabled depending on whether the contract is "practice standard" or "insurance-specific.

  1. Modifier: If applicable, enter the procedure modifier. Click the Modifier button to open the master list. Once found, double-click on it to select it.

  2. Diagnosis: If applicable, enter the diagnosis code. Click the Diagnosis button to open the master list. Once found, double-click it to select it.

  3. Gender: Default is Both; to change it, select Female or Male from the drop-down list.

  4. Standard Fee: Enter the standard fee for the procedure.

  5. Allowed: Enter the amount allowed by the payer as defined by the contract between the medical practice and the payer.

  6. Expected Reimbursement: Enter the amount of the expected reimbursement.

  7. RVU:Relative Value Unit (e.g., 4.55, 4.60, etc. ). If desired, enter the RVU for Work, Practice Expense and/or Malpractice. The RVU is the industry standard factor used in pricing of medical services and is meant to serve as a metric that compares the relative cost of different types of procedures.

  8. Anesthesia Base Units: If applicable, enter the number allowable for the procedure. Anesthesia Base Units are a value used to compute allowable amounts for anesthesia services.

  9. ClickSaveon therightof the window to add it to the fee schedule. It will then appear in the upper section.

  10. ClickCancelto clear the fields and start over. To remove a procedure, click once on it to highlight and click Remove.

 

 

To edit a procedure on the fee schedule

  1. Search for the procedure using the Look for field.

  2. When you find it, click once on the procedure to highlight it. This populates the fields with the procedure information.

  3. Make the changes and click Save on the right of the window to update the procedure.

  4. Click Save at the bottom.

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