Jump to Section:

Add Rate

1. Click the Billing tab.
2. Click Rate List.
   
    
3. Select the Payor. Payors added to the system for your facility are available in the dropdown menu.
4. Select the rate list file from the computer.
5. Upload the file. An orange hyperlink for the file displays after uploading.

   NOTE: An orange hyperlink for the file displays after uploading.

   
6. Click Add Rate.
   
   

Enter Rate Information

1. Treatment Type
2. Activity Type
3. Activity Sub Type
   • Sub Types are created in the system by the organization. For example - Initial 97151.
4. CPT Code
5. Modifiers required by the payor.
6. Rate Per
   • If rate is per unit, enter the time amount. This is typically 15 mins, but each payor will list the time unit on their rate list.
7. Contracted Rate 
   • This is how much insurance will pay for the CPT code.
8. Billing Rate
   • This is the rate the organization wants to charge. When reimbursed, this will be the contracted rate.
   • A billing rate is not required. If you use a billing rate, please contact the support team so it can be added on the backend. 
9. Click the Add to Auth checkbox to integrate rate with the authorization.
10. Click Save.

Hide Payor Contracted Rates from Staff

Create a duplicate CPT code for the original code in the amount of 0.00. Click the Add to Auth checkbox for the the 0.00 contracted rate entry. 

1. Click the Add to Auth box. Uncheck the Add to Auth box on the CPT code page with a rate if hiding contracted rates from staff. 
2. Enter amount of 0.00 in the Contracted Rate field. 
3. Click Save.
   
    

[Back to Top]