Fee schedules

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This topic contains 1 reply, has 2 voices, and was last updated by  Dayna Johnson – founder and CEO of Novonee 5 months, 2 weeks ago.

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  • #2810

    Two years ago we created fee schedules for PPO fee schedule so that treatment plans would reflect what patients portion would be. However,
    when it works it works but the past few months has been difficult. Most of the issues have been related to either a primary/secondary issue or Medicare advantage plans. Is there any way to change all pts back to office fee schedule and update tx plans at one time? We have had some bizarre issues with insurance companies paying my fees then coming back months later and deducting from other vlaim checks because of them processing Medicare advantage plans wrong initially.

    #2811

    When you use fee schedules it is also important to make sure your claims are going out with your full fees, especially when a patient has dual insurance. This ensures that the insurance plans are paying at the highest fee just in case they have increased the fee schedule without you knowing. Also, with dual you are entitled to collect up to your full fee from the insurance plans.

    The medical advantage plans sounds like it is not your problem, sounds like they are processing the claims incorrect.

    To answer your question, there is no magic wand to change all the patients back to the full office fee. You can, however, override the PPO fee schedules with your full office fee and then you can update the treatment plans all at the same time. Go the the Fee Schedule Maintenance > Select your fee schedule and click on Auto Updates and then copy your full fee schedule back into your PPO fee schedule.

    Hope this helps,
    Dayna

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