[ Help Main ] > [Main Navigation Bar] > [Misc] > [Customize] > Fee Schedule (must have appropriate persmissions)

Overall function, use & design:
Fee schedules are used to set billing charges and expected reimbursements from carriers. This is a powerful tool that can expedite payment posting when the fee schedules are set up.

Standard Fees
In-network reimbursement rate
Bill out at in-network rate

Standard Fees
To bill out your charges at your standard rate per CPT code.

New Fee Schedule from Scratch

1. Click Fee Schedules Management (Brings you to maintain Fee Schedules)

2. Click on [New] near the bottom of the page

3. Name the fee schedule (free text in the box provided)

4. Highlight all the doctors that this fee schedule will apply to (to highlight more than one item hold down the “ctrl” and click your mouse)

5. Highlight all the facilities it will apply to

6. Do not highlight any claim offices or carriers.

7. Click the "Search and Add CPTs" button to set up specific fees per CPT

8. Enter the CPTs you want in the Search CPTs box (it is helpful to enter only the first 3 or 4 digits this will return a greater number of choices)

9. Highlight the codes that you want to add to your fee schedule

10. With the ▼ move those codes to the Selected CPTs box

11. Click "Close and Add" when finished and these codes will be added to your Fee Schedule

12. Input the charge per CPT that you want to bill for those doctors and facilities specified.

13. Click Save

Create a new schedule via Copy & Modify an existing fee Schedule
Note: Synabill comes with the Standard Medicare Fee schedule, see “System Fee Schedules” on maintain Fee Schedules page.
To Copy or Copy and modify from these

1. Highlight the desired fee schedule and click ▼ button to move a copy to the Group Fee Schedule box.

2. A box appears in which you may enter a multiplier for the Medicare fee schedule

3. Enter the multiplier and click OK. The copy is moved to GROUP FEE SCHEDULES

4. To rename this new fee schedule highlight it from the Group Fee Schedule box & click[view/edit].

5. Enter a new name in the Name box and click save at the bottom of the screen.

To copy and modify from an existing Group Fee Schedule

1. From Group Fee Schedules box highlight the fee schedule to Copy and Modify.

2. Click View/Edit

3. Modify any changes

4. Click "Save As New" (make sure to change the name of your new report by typing in a new name prior to clicking Save as New)

Multiplier of a Medicare Fee Schedule

1. Highlight the fee schedule from System Fee Schedules

2. Click on the ? button, a window pops up asking for the multiplier you wish to use

3. After entering your multiplier eg: 3.5, click OK

4. The new fee schedule appears in the System Fee Schedule Box

5. Highlight that Fee Schedule and click View/Edit to rename it for your own use

6. Type in the New name of the report in Name box

7. Click "Save" at the bottom of the page

Edit a Fee Schedule

1. Highlight the Fee Schedule that you want to edit from the Group Fee Schedule box

2. From here you can modify Doctors, Facilities, Claim Offices or Carriers that are affiliated with that fee schedule.

3. You can add or remover CPT codes

4. You can adjust fees

5. You can change the name of the fee schedule.

6. When you are finished editing click Save at the bottom of the page

To look for a particular code to edit

1. Enter the code (or part of code) or phrase in the [Filter View by CPT Code/Description]

2. This will retrieve all associated items enabling you to edit.

In-Network Reimbursement Fee Schedule

1. From Maintain Fee Schedules click the [New] button

2. Name the fee schedule ie., Aetna fee/reimbursement schedule

3. Highlight all the doctors that this fee schedule will apply to

4. Highlight all the facilities it will apply to

5. Highlight any claim offices or carriers that these fees/reimbursements apply to.

6. Click "Search and Add CPTs" to set up specific fees per CPT

7. Enter the CPTs you want in the Search CPTs box

8. With the ? move those codes to the Selected CPTs box

9. Click Close and Add when finished. These codes will be added to your Fee Schedule

10. Input the ALLOWED amount per CPT for that carrier/claim office for those doctors and facilities specified.

11. Click "Save"

To quickly create another fee schedule for the SAME set of CPT codes (Save as)Instead of creating another fee schedule from scratch, edit one schedule and "Save as"

1. Highlight the fee schedule that you want to use as your base

2. Click on [View/Edit]

3. Enter a new name in the Name box

4. Make any changes needed

   • Change fees per CPT code
   • Change claim office and/or carrier this is associated with
   • Change doctor or facility (if applicable)

5. Click "Save as New" at the bottom of the page

6. You will be able to see the name of your new fee schedule in the "Group Fee Schedules" box

“Bill Out” at in-network rate (instead of standard rate)
Allows the user to submit as a charge the in-network fee schedule rate instead of the standard billing rate.

1. From Edit Insurances (Misc > Customize > Edit Insurances)

2. Highlight claim offices from the Edit drop down box

3. Highlight the applicable claim office

4. Click in the box “Bill out at in-network fee schedule”

5. This will then charge the in-network rate instead of the standard billing rate for charges associated with that claim office.

Grid Matrix of CPT per Fee Schedule [Misc > Customize>Fee Schedule (Procedure Code)]
Shows the fee schedule rates per CPT code, per fee schedule

1. Click on Fee Schedule (Procedure Code)

2. Enter code(s) desire to review or modify

3. Modify any fee

4. Click Save

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