Fee Schedules

A fee schedule is the set of service codes and prices which overrides the price in the CDM - Charge Description Master. When a fee schedule is in place, the charge post function will check for a fee schedule on the primary third party of the account. When the fee schedule exists, the fee schedule override price is applied either at the time of the charge posting or at the time the billing event occurs.

Each third party controls which method of pricing will occur. The Fee Schedule Code is entered in the third party profile, and an indicator is set which determines if the pricing override occurs at "Bill Time" or "Charge Post". If it is at bill time, an adjustment for the difference between the CDM price and the Fee Schedule price is tracked on the claim and in A/R. You will need to define a transaction code for the contractual adjustment.  If Charge Post is selected, then the pricing override occurs when the charge is posted to the account.

Each third party has one fee schedule, a fee schedule can belong to many third parties. Each fee schedule has one or more service codes.

• Identify which third parties require a fee schedule for override pricing.
• Assign an eight (8) character code for each fee schedule.
  
• For each fee schedule, Identify the service codes that require override prices. The service code must be added to CDM  prior to adding to a fee schedule.
  

Add a Fee Schedule

Open Fee Schedule

1. Select Fee Schedule from the File menu, Select Open Fee Schedule.
2. The first detail screen displays. Enter a Fee Schedule code, description and effective dates. Press enter or click OK.
   
3. The second detail screen displays. Enter the service code.
   
4. Tab to the Scheme field, enter your scheme.
   
5. If required, enter the percentage or amount whichever is appropriate for the scheme.
   
6. Press enter or click OK. The Booked price and the billed price fields are now populated.
7. Enter as many service codes as you need in the fee schedule. A service code can only be entered one time for each fee schedule.
8. Press enter or click OK. This completes adding a fee schedule and service code.
   

Activate Fee Schedule

A fee schedule must always be active or your fee schedule rates will not be posted to an account, otherwise the charge amounts will be the price amounts in the CDM service code.

1. Select Fee Schedule from the File menu
2. Select Activate Fee Schedule.
3. Enter you Fee Schedule code.
4. Press enter or click OK.
5. A list of all inactive fee schedules is displays. Select your Fee Schedule from the list of and press enter or click OK.
6. The fee schedule detail screen displays. Press enter or click OK to activate the fee schedule.
   

Add Fee Schedule Code to Third Party

After you have defined the Fee Schedule code, you will need to add the code to each third party ID that requires the override pricing. You will also need a transaction code for the contract adjustment if you select fee schedule type at "Bill Time".  

Model a Fee Schedule

Modeling a fee schedule duplicates one fee schedule to another . This function simplifies the task to open fee schedules if you have several fee schedules that contain the same service codes and each has numerous service codes.

You will need to enter a fee schedule name, description and effective dates. The description is defaulted from the fee schedule you have chosen to model from. You do not need to add any service codes to the new fee schedule, they were copied from the fee schedule you selected to model from.

Update, View, and Delete Fee Schedules

Once you have added the fee schedule, you can use the additional Fee Schedule functions to update, view and delete them.

Deactivate and Activate Fee Schedules

If a fee schedule is no longer valid, you can deactivate it.  Note: A fee schedule must always be active or your fee schedule rates will not be posted to an account, otherwise the charge amounts will be the price amounts in the CDM service code.

Add, Update, View, and Delete FS Service Codes

Once you have added the fee schedule, you can use the additional Fee Schedule Service Code functions to add, update, view and delete service codes for a fee schedule.