|In This Section|
'Fee', 'procedure fee' or 'procedure' all refer to the specific units you will be billing for, either through EMR-Bear's Superbill system, or through your own billing system via billing reports generated by EMR-Bear.
For a charge to be generated within the system, a procedure fee defining that charge must be defined within the system.
- All fees are associated with a Fee Schedule. To view the fees associated with a Fee Schedule, navigate to the Fee Schedules tab and click on the name of the schedule you wish to view.
- All of the fees associated with this schedule will be listed.
Creating a Fee
- To add a fee inside the Fee Schedule, click on the Add Fee link.
- A screen will open with fields that allow you to add a fee. Remember that this fee only exists for the Fee Schedule that it was created in.
- The form has several fields, many of which are mandatory.
- Service type: an organizational tool used to group fees by a given service type, allowing the ability to view all fees by that service type. There are two fields for the service types. The drop-down list shows all the existing service types in the system. The field next to it named "Or New Service Type" provides a way to enter a new service type that does not yet appear in the system. Once the new service type has been entered the first time, it will then appear in the drop-down list.
- Billing Level: helps the system determine whether the fee can be used by a certain type of provider or by any provider. This definition can be used to bill the same procedure at different amounts depending on the credentials of the provider (i.e., services rendered by an MD rather than a Nurse Practitioner).
- Proc Code: enter the procedure code itself (e.g., 90801).
- Mod1 / Mod2: allows addition of modifiers for that fee. If you have one procedure code that can be used with one modifier, then you need two fee entries in the system; one for the procedure code without the modifier and another for the procedure code with the modifier.
- Description: the detailed description of the procedure.
- Rate: the dollar amount for this fee.
- Units / Type: defines the individual unit that comprises that fee (i.e., 15 minutes = 1 unit).
- Place of Service: a list of codes under which the services can be rendered. The list has to be separated by commas, and the values are those accepted by the billing standards (e.g., 11,5).
- Billable: if you do not want the system to generate a charge for a given service, or if services are bundled and you will track those services outside of the system, choose 'No' from the drop down.
- Authorization Required: if you know the insurance company requires prior authorization for a given procedure, you can flag that fee as such. When that service appears in a billing report and/or Superbill, it will be identified as requiring a prior-auth in order to get billed properly.
- Authorization Number Required:/Insured or Medicaid ID Required: some companies will also require that a number or ID is entered for that prior-auth.
- Dx Code Required: most procedures must be associated with a client's diagnosis, use this check-box to enforce that.
- Once all fields have been entered, click on the blue Create Fee button
Editing a Fee
- To add a fee, when inside the Fee Schedule, click on the Proc Code for the fee you want to edit.
- An Editing Fee screen will open and all the options are the same as the New Fee screen.
- To delete the Fee, click the blue Delete this fee button at the bottom of the screen.