Each Sliding Fee Schedule master contains one or more detailed sliding fee schedules. Each detailed sliding fee schedule is created with specific parameters such as sliding fee mode, CPT4 code ranges, diagnosis code ranges, locations, etc. It also includes a grid that defines discount percentages based on family size and annual income.
- Access File Maintenance.
- Select .
The Sliding Fee Schedules List window opens.
- Select the desired sliding fee schedule master, select the Open Menu
button and select Open.
The Sliding Fee Schedule Maintenance window opens.
- In the Sliding Fee Schedules section at the bottom of the window, do one of the following:
- To add a new sliding fee schedule, select the Open Menu button and select New.
- To modify an existing sliding fee schedule, select the item in the list, select the Open Menu button and select Open.
The
Sliding Fee Schedule Detail Maintenance window opens.
- In the Name field, enter a descriptive name for the sliding fee schedule. This field is required.
- In the Eff Date and Exp Date fields, enter effective and expiration dates for the sliding fee schedule. These fields are required.
Note: The Expiration Date for the current year’s family size and income schedule is typically extended until values are obtained for the next year. Once new values are obtained for the next year, expire the current year’s schedule and create a new schedule.
- In the Family Size field, use the up/down arrows
to select the number of Family Size rows to display in the table at the bottom of the window. The default value is 10, the maximum value is 20, and the minimum value is 2.
- In the Nbr of Columns field, use the up/down arrows to select the number of Percent of Discount columns to display in the table at the bottom of the window. The default value is 10, the maximum value is 20, and the minimum value is 2.
- In the Schedule Fee Mode section, select one of the following:
- Line Item Based (default): A separate adjustment takes place after each charge is entered on the encounter.
- Encounter Based: A single adjustment takes place after all charges have been entered on the encounter.
- In the Sliding Fee Mode section, select one of the following:
- Minimum Value Mode (default): Charges are adjusted using the discount % for the patient’s family size and income. If an adjustment results in a balance that is less than the defined Minimum Value, the adjustment amount is reduced to ensure the balance is equal to the minimum value.
- Flat Rate Mode: Charges are adjusted to the defined Flat Rate amount regardless of the discount % for the patient’s family size and income.
The text Min Value or Flat Rate displays in the header of the last column in the table.
- In the Min / Flat Rate Value Mode section, select one of the following:
- By Family Size (default): A column is added to the right end of the table and, depending on the Sliding Fee Mode selected, the column heading is either Min Val or Flat Rate.
- By Percent/Flat Rate: A row is added to the bottom of the table and, depending on the Sliding Fee Mode selected, the row heading is either Min Val or Flat Rate.
- In the Associated CPT4 Codes section, select one of the following:
- All CPT4 Codes (default): The sliding fee schedule applies to all CPT4 codes.
- CPT4 Code Range: The sliding fee schedule applies only to specific CPT4 code ranges.
To define CPT4 code ranges, select the
Open Record 
button.
The
Sliding Fee CPT4 Code Ranges window opens.
To create a new CPT4 range, select the Open Menu button and select New.
The CPT4 Range window opens.
In the CPT4 and Thru CPT4 fields, enter a range of codes to be associated with the sliding fee schedule. The CPT4 field is required.
Select the Question Mark 
button to display the CPT4 Code Search window to lookup a CPT4 by code or by description.
- In the Associated Dx Codes section, select one of the following:
- All Dx Codes (default): The sliding fee schedule applies to all ICD codes.
- Dx Code Range: The sliding fee schedule applies only to specific ICD code ranges.
To define ICD code ranges, select the
Open Record button.
The
Sliding Fee Dx Code Rangeswindow opens.
To create a new ICD range, select the Open Menu button and select New.
The
Sliding Fee Dx Code Ranges window opens.
In the ICD and Thru ICD fields, enter a range of codes to be associated with the sliding fee schedule. The ICD field is required.
Select the Question Mark button to display the ICD-CM Code Search window to lookup an ICD by code or by description.
- In the Sex field, do one of the following:
- Leave blank or select <none> if the sliding fee schedule applies to patients of all genders.
- Select Male, Female, Undifferentiated, or Unknown if the sliding fee schedule applies only to patients of a specific gender.
- In the Age fields, do one of the following:
- Leave blank (or 0) if the sliding fee schedule applies to patients of all ages.
- Enter an Age Range if the sliding fee schedule applies only to patients in a specific age group.
- In the Service Location field, do one of the following:
- Leave blank if the sliding fee schedule applies to all locations.
- Select one or more Locations if the sliding fee schedule applies only to specific locations.
- In the Percent of Discount and Annual Family Income table, do the following:
- Column Headings: Enter the discount (adjustment) percentages in descending order from left to right. For example: 100, 75, 50, 25, 0.
- Family Size Rows: Enter the annual income amounts in ascending order from left to right. For example: $0.00, $10,000, $20,000, $30,000, $40,000.
- Min Val or Flat Rate (column): Enter the minimum value or flat rate amount for each family size row, if applicable. This is optional.
- or -
- Min Value or Flat Rate (row): Enter the minimum value or flat rate amount for each percent of discount column, if applicable. This is optional.
- To save changes and close the window, select OK.
