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            Add Fee Schedule Information for Fee-for-Service Contract Payment Types

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            Add Fee Schedule Information for Fee-for-Service Contract Payment Types

            As an actuary, you can create a library of fee schedule information based on the comprehensive list published by CMS (Centers for Medicare and Medicaid Services). Your contracting specialist can then use this fee schedule information as a base to define the payment terms for contracts of Fee-for-Service payment type.

            Required Editions

            A fee schedule library provides information on the standard fees for different time periods. To create a well-defined library, you need:

            • Fee schedule definition records that indicate the effective time period.
            • Care fee schedule item records that specify the fees for each procedure code. These records are always created within the context of a fee schedule definition and multiple records can be associated with a fee schedule definition.

            Available in: Lightning Experience

            Available in: Enterprise and Unlimited Editions with Health Cloud
            User Permissions Needed
            To add fee schedule information Create, Read, Update, and Delete access on Fee Schedule Definition and Care Fee Schedule Items objects
            1. From the App Launcher, find and select Fee Schedule Definitions.
            2. Click New and enter the name, effective start and end date, and description of the fee schedule definition. Then save your changes.
            3. Click the Related tab, then click New in the Care Fee Schedule Items related list.
            4. Provide the facility and non-facility price for a selected procedure and save your changes. Specify the price based on the data published by CMS.
            5. Add more care fee schedule item records for all the required procedure codes and save your changes.

            We now have the fee schedule information all set for the selected time period. Your contracting specialist can now select this fee schedule definition when creating a contract payment agreement of Standard Care Fee Agreement type. And, the payment terms defined in the selected fee schedule definition are applied for the contract.

             
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