PPO Fee Schedules Setup Go to Lists Fee Schedules New. Select Create Fee Schedule By: Individually Setting Up Service Codes. Manually add the code and then add the allowable fee, matching the fee schedule provided to you by the insurance company. Once the first fee schedule is complete you can select Utilizing an Existing Fee Schedule to build the rest, simply changing the name of the fee schedule and the allowable fees associated with that plan. Hint: Updating fees on existing treatment plans and appointments requires exclusive use. To update fees during a working day simply uncheck the top two boxes to save the plan. Later, when you can gain exclusive use simply edit the fee schedule, leaving these boxes checked and select OK to update these fees. Printed copies of this document are considered uncontrolled. 1
Another Hint: Only codes that you have a discounted fee for should be included in this list. If the insurance company has not provided a fee for a particular service, delete that code from the list. You do not want any zero (0.00) fees listed here as the fee listed in the allowable fee column is the fee that will be charged to the patient. If the code is not on the list, Eaglesoft will post your standard fee. Using Fee Schedules Now that the fee schedules have been created, it s time to put them to use! Attach Fee Schedules to specific employers using the blue hyper-link. Printed copies of this document are considered uncontrolled. 2
Be sure to select Bill Standard Fee on Insurance Claim when utilizing Fee Schedules. This preference is Employer specific and should be marked whenever you attach a Fee Schedule to an Employer. Hint: If you already have fee schedules attached to employers but are not sure if this box is checked, there is a utility to mark this preference for every employer in your system. Go to Utilities Mass Updates Global Employer Preferences. Printed copies of this document are considered uncontrolled. 3
Check Update Bill Standard Fee on Claim then click OK to save and update your employers. Fee Schedule Preferences Go to File Preferences Accounting. Check the preference Display Standard Fee and Adjust on Walkout and Tx Plan. This will show the fee schedule amount and adjustments made on the account window. Printed copies of this document are considered uncontrolled. 4
Printed copies of this document are considered uncontrolled. 5
Go to File Preferences Insurance. Check the preference Show Standard Fee and Adjust on Walkout Statements and Treatment Plans. This will show for the patient. Printed copies of this document are considered uncontrolled. 6
Productivity Reports when Using Fee Schedules Eaglesoft calculates production as the fee charged. Therefore, when using fee schedules your production numbers on the Day Sheet and Provider Productivity reports will reflect the PPO fee, not your full standard fee. The following reports should be utilized when using fee schedules: Printed copies of this document are considered uncontrolled. 7
Daily Fee Exception Managed Care Analysis Printed copies of this document are considered uncontrolled. 8
-or- Managed Care Utilization *This report does not include the RVU information. Printed copies of this document are considered uncontrolled. 9
Trends Go to Activities Practice Management Trends (or add Trends to your toolbar). Total Office Production = All production calculated using the office standard fee (full fee) Adjusted Production = All production calculated using Fee Schedules and adjustments (if they were set to impact production) To generate your Trends report, select the Import button to import totals from Eaglesoft. It is recommended to run Trends monthly but you can import totals for any time period, based on the needs of your practice. Additional information regarding reports: The Day Sheet or Production Reconciliation will always give you net production. Another way to see or reconcile gross production is to use the Managed Care reports to obtain the total from the difference column (standard fee minus fee charged). You could manually add the difference number to the total production from the Day Sheet/Production Reconciliation to get the gross production. Printed copies of this document are considered uncontrolled. 10