In some situations, a line item-based sliding fee schedule can produce dramatically different charges for a patient than an encounter-based sliding fee schedule.
For example:
- If you apply a line item-based sliding fee schedule with a minimum payment of $50 and a 90% discount to a patient encounter with charges of $150, $40, and $10, the schedule applies the minimum payment to each charge resulting in a total charge of $150 to the patient. (When a discount results in a charge that is less than the minimum payment, as in this example, the application overrides the discount and applies the minimum fee. No charge can be less than the schedule’s minimum payment.)
- If you apply an encounter-based sliding fee schedule with the same discount and minimum payment to the encounter, the schedule takes the total of the charges ($200) applies the discount and minimum payment, and arrives at a total charge to the patient of $50.
Note: When a patient has insurance, the application does not automatically apply the sliding fee schedule discount to the encounter’s charges. You must manually apply the schedule after you create the encounter.
