- Click the Billing tab.
- Click Rate List.
- Select the Payor. Payors added to the system for your facility are available in the dropdown menu.
- Select the rate list file from the computer.
Upload the file. An orange hyperlink for the file displays after uploading.
Note: An orange hyperlink for the file displays after uploading.
- Click Add Rate.
Enter Rate Information
- Treatment Type
- Activity Type
Activity Sub Type
- Sub Types are created in the system by the organization. For example - Initial 97151.
- CPT Code
- Modifiers required by the payor.
- 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.
- This is how much insurance will pay for the CPT code.
- 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.
- Click the Add to Auth checkbox to integrate rate with the authorization.
- 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.
- 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.
- Enter amount of 0.00 in the Contracted Rate field.
- Click Save.
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