Calculating the Total Service Fee

BillingTracker automatically calculates the Total Service Fee based on several factors.

How a Total Service Fee is Calculated

BillingTracker will charge the Default Unit Price for a Service on a Patient Contact Record where the Appointment Status is Showed Up unless the system notes another fee that should apply instead. BillingTracker will apply pricing in the following order:

  1. Bill the Patient Directly for the Default Unit Price.
  2. Charge the Override Price Manually Entered on the Patient Contact Record.
  3. Change according to a Reduced Fee Schedule if the Patient is Eligible based on their Gross Income.
  4. Charge according to a Fee Schedule.
  5. Charge a Cancelation Fee.(if the Patient Contact Record is not Showed Up or Pending).
  6. If none of the above apply, then BillingTracker will charge the Default Service Price.

Bill a Patient Directly for the Default Price

  1. Go to ClinicTracker > Utilities > Maintenance Menu > Service Input.
  2. In the lower section, select the CPT Code and double-click.
  3. In the Pricing Information section, you will see the Default Price for the Service along with the effective dates.
  4. The price will be per 1 Unit unless the Price Based on Time checkbox is checked in the Billing Interval section.
  5. If the Bill Patient Directly box has been checked, the Default Price will be charged and no additional calculations will be made.

Charge the Override Service Price Manually Entered on the Patient Contact Record

  1. This is a per-user feature that is set in the Staff Info Form ClinicTracker > Staff > Staff Info > System Permissions > Allow Price Override.

  2. Go to Patients > Patient Contacts > Override Price.

  3. If there is an Override Unit Price entered in the Billing Details section of the Patient Contact Record, the Override Price will be charged that amount per 1 Unit.

There are several ways other ways to override the default Unit Price:

  • Demographics > Insurance tab > Service Specific Fees button.

  • BillingTracker > Settings > Modifiers > Modifier Rules. To override the Default Unit Price add/subtract a specific dollar amount or percentage of the total service fee at transition.

Change According to Reduced Fee Schedule for an Eligible Patient

  1. Go to Patients > Demographics > Financial tab > Reduced Fee Eligible to see if the patient is eligible for a Reduced Fee.

  2. If the patient is eligible for a Reduced Fee, based on their Gross Income and Family Size, the service fee will be charged according to the matching Reduced Fee Schedule found at BillingTracker > File > Setup > Fee Schedules > Configure Reduced Fee Schedules.

Charge According to a Fee Schedule

  1. Go to BillingTracker > File > Setup > Fee Schedules > Configure Fee Schedule.
  2. If a Fee Schedule applies, the matching fee schedule will determine the Total Service Fee.
  3. Fee schedules only apply to per-unit-based services, and not when based on Time.

Charge a Cancelation Fee

  1. If the Appointment Status on the Patient Contact Record indicates Pending or Showed Up, no Cancelation Fee Applies
  2. If the Appointment Status indicates any other status besides Pending or Showed Up then:
  3. Go to Utilities > Maintenance > Appointment Status > Cancelation Charge.
  4. See if there is a Cancelation Fee Applied to the Service.
Additional Resources
 
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