- To set up a fee schedule you will go to Edit→Setup→Fee Schedules
- From here you will hit add and get this pop-up window
- First you will create their UCR or the practices fee schedule. These will be the fees that the practice charges for each procedure code. You will name the Fee to be UCR, the Type will be Practice, and the order will be 1 if it is the first one to be added.
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Next, you will hit Add at the bottom left and will want to hit Code to sort it by the code order. From here you can add each individual procedure item. If you're going to add everything in the list though you can hit Add All at the bottom right of the screen. Please note: You will want to make sure that you do not leave anything at $0 unless you ALWAYS want it to be $0 every time.
You can also select Add All button in the lower right-hand corner to bring in all CDT codes within Cloud9. You can then delete any codes that your office does not use.
- This is also how you will set up specific PPO fees for any insurance. You can also add in the fees for Medicaid in these fee schedules.
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When creating your contracted fee schedules, you will follow the same process. Name the Fee schedule of the insurance company it pertains to, Select the fee schedule type that this insurance is (Example: PPO.) When a dentist is in network with the insurance they provide them a fee schedule of the contracted rates for each procedure. That is the contracted rate that the dentist has agreed to charge the patient who has an active insurance plan with that insurance company. This is what you will input for each specific fee schedule.
Instead of selecting Add (to add each code individually) or Add All (to bring in every CDT code within Cloud9 that is assigned to a transaction type), you can now select Import Schedule. This will let you import a Fee Schedule that has already been created. You can Import the Practice Fee Schedule and adjust accordingly, (Fees, Adding, or Deleting procedure codes that may not be on that specific insurance fee schedule provided). Again: You will want to make sure that they do not leave anything at $0 unless you ALWAYS want it to be $0. One scenario is you may want a $0 charge is for D1330 Oral Hygiene Instructions on the insurance fee schedules. Reason being Insurance will not cover this fee a lot of times even though the patient is covered 100% for Preventive codes. If your office wants to notate that this was completed however if they have insurance but you also do not want to apply that fee to them.