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HealthFeeScheduleDataService:getProviderFees
Use this service to retrieve data from the given provider fee schedule and use the supplied date to determine the appropriate base fee schedule version.
Class: HealthFeeScheduleDataService
Method: getProviderFees
How It Works
-
The service takes a
providerFeeSchedId, determines whichFeeSchedule__cit is associated with, and what the currently active version of thatFeeSchedule__cis for a given date. -
Services uses the
executionDateTimet option as the given date. IfexecutionDateTimehas no value, the service uses the current date. -
The service then retrieves the list of base fees from the
FeeSchedule__c. If offset has value, the next 2,000 rows after the specified offset will be returned. Otherwise, the first 2,000 rows will be returned. -
The list of
ProviderFeeScheduleEntry__cfor the givenproviderFeeSchedIdis retrieved. -
Service then computes the provider fees in one of two ways:
-
If the base fee has a matching entry in the
ProviderFeeScheduleEntry__c, the service looks atFeeType_calong with Additional Amount and Rate Factor. The value ofAdditionalAmount__cis added to the base fee. The value ofRateFactor__cis multiplied to the base fee and divided by 100. -
If the base fee has no matching entry in the
ProviderFeeScheduleEntry__c, the provider fee is the same as the base fee.
-
Remote Options
Option |
Description |
|---|---|
|
Required Id of the provider fee schedule. |
|
Optional Date specified determines which enabled version of the schedule is selected. Format:
|
|
Optional Key value pair. offset: <value> where value = fee schedule column that has the procedure code column mapping type applied to it. Used to determine where the returned rows of procedure codes will start. With no value, service returns the first 2,000 values from the base fee schedule. If a value is provided, the next 2,000 rows after the procedure code value (that is to say, below it) are returned. The rows before/above the value are not returned. In any case, only 2,000 rows are returned. Important Returned data sorting order is presently based on ascending procedure code hash values, not by procedure code. For example, procedure code ABC with hash value 789 would come after procedure code DEF with hash value 456. |
Input JSON
The following sample input JSON shows the inputs the service uses:
{
"providerFeeSchedId":"a444P000001H44GQAS",
"executionDateTime":11/25/2019,
"retrieveOptions":{
"offset":"99215"
}
}Output JSON
The service returns an output JSON of base fee schedule data, based on the
providerFeeSchedId and options provided:
{
"providerFees":[
{
"Provider-Non-Facility Price":0.05,
"Provider-Facility Price":0.05,
"Description":"99215",
"Facility Price":1,
"Non-Facility Price":1,
"Procedure Code":"99215",
"deleted":false,
"versionEnabled":true,
"versionId":"a1I6F00000nM7LxUAK",
"Name":"9952ac9010c8edba8ee0f2b4e80793e0",
"vLineItemId":"a1H6F000006SvT8UAK"
},
{
"Provider-Non-Facility Price":2,
"Provider-Facility Price":2,
"Description":"99214",
"Facility Price":1,
"Non-Facility Price":1,
"Procedure Code":"99214",
"deleted":false,
"versionEnabled":true,
"versionId":"a1I6F00000nM7LxUAK",
"Name":"f88f1140bdd063cfc2ce8652abb6f581",
"vLineItemId":"a1H6F000006SvT9UAK"
}
],
"error":"OK"
}