Agencies can customize billing codes and rates listed in Checkpoint. This is commonly referred to as a Fee Schedule. We highly recommend providers set up their Fee Schedules to allow for a more customized billing experience. The Fee Schedule will also assist your staff with choosing the correct billing code and billing code being sent at the correct rate. Only System Controllers and Agency Admins with Billing Access can add, edit, and delete Fee Schedules. Also, remember that all dates below refer to dates of service and not calendar dates.
To set up your Fee Schedule, follow the steps below.
1. Click on the cog wheel in the upper right corner.
2. Under the Settings section, click on Agency Billing Codes.
3. To set up your Fee Schedule for the first time, click on the pencil icon.
If you see “No records found.” you do not have a Fee Schedule setup.
4. Search for your billing code.
You should now see all the billing codes available in our system. Each column is searchable by entering the value or characters in the white box below the column header and hitting enter. The easiest way to search is by the Billing Code and/or Modifier fields. The Billing Domain column separates the billing codes by states. Make sure you add the applicable billing codes for each of your locations. For example, if you bill 90837 in your Louisiana and Texas office, you’ll want to add 90837 for both. Only the locations in which you have offices will be listed.
5. Check the box to the left for the billing code you wish to add.
Keep in mind only the billing codes selected will be displayed for your staff. This means you’ll have access to all system codes until you add at least one billing code to your Fee Schedule. If you only add one code, staff will only see that one code. We recommend adding all billing codes at one time to avoid errors when creating sessions.
6. Continue adding until all billing codes have been added. Then, click on the clipboard to go back to your billing code list.
7. Next, you will want to add your custom rates. Before you do, there are a few things you will want to keep in mind.
-
You can have 1 rate per billing code. This means you’ll want to set your rate to the highest allowable amount across your insurances. For example, if you receive $130 for 90837 from Aetna but Blue Cross Blue Shield pays $110 and Medicaid pays $90, you will set the 90837 rates to $130.
-
If the billing code is based on units, be sure to enter the per unit rate. For example, you receive $100 for H0036 for 1 hour. When entering the rate, you would enter $25 because 1 hour equals 4 units.
-
All billing codes are set to the system-wide default rates. If you wish to set up your own rate, you will need to follow the steps below.
-
All Start and End Dates are based on Date of Service.
To set up your rates, follow the steps below.
8. Select the Rate icon ($) for the code you wish to set the rate for.
9. On the Agency Rate page, you will see the current rate and effective dates. To set your agency's specific rate you will first need to end the system-wide default rate and then ADD your agency's specific rate.
10. Click on the pencil icon.
11. Enter the end date.
12. Click on Save.
13. Click on the plus sign to add your agency's rate.
14. Enter the Start Date and leave the End Date blank.
15. Enter your agency specific rate.
***If a rate is based on units, enter the single unit rate***
16. Click on Create.
17. Once the rate is added, click the clipboard to go back to the list of billing codes.
18. Continue updating the rates until all rates are set.
19. If you wish to stop using a billing code but need it for past sessions, select the Rate icon ($).
20. Select the Edit icon (pencil) on the most recent Rate line.
21. Enter the deactivated date, and select Save.
Comments
0 comments
Please sign in to leave a comment.