Encounter Level Sliding Fee Scenarios

You can set up the sliding fee schedule details using the parameters on the Sliding Fee Schedule Detail Maintenance window.

A patient with a family size of one and an annual income of $20000 has a sliding fee attached to an encounter on the Encounter Maintenance window.

The following table lists the encounter-level sliding fee scenarios, and their calculations.

Level	Schedule Fee Mode	Sliding Fee Mode	Min / Flat Rate Value Mode	Calculations
Encounter	Line Item-based	Minimum Value	By Family Size	The patient’s family size of one and an annual income of $20000 allows a 50% discount. A separate adjustment is made for each service line, and it gets adjusted by 50%. The application adjusts the balance on each charge to equal it to the minimum value resulting in a minimum amount of $20 to be paid by the patient. For more information, see Sliding Fee Calculations for Encounter Level Line Item Based Scenarios.
Encounter	Line Item-based	Minimum Value	By Percent/Flat Rate	The patient’s family size of one and an annual income of $20000 allows a 50% discount. A separate adjustment is made for each service line, and it gets adjusted by 50%. The system adjusts the balance on each charge to equal it to the minimum value resulting in a minimum amount of $20 to be paid by the patient. For more information, see Sliding Fee Calculations for Encounter Level Line Item Based Scenarios.
Encounter	Line Item-based	Flat Rate Mode	By Family Size	The patient’s family size of one and an annual income of $20000 allows a 50% discount. However, since a flat rate of $10 is defined in the sliding fee schedule, this overrides the 50% discount. The system applies the flat rate of $10 to each service line resulting in a estimated patient amount of $20. For more information, see Sliding Fee Calculations for Encounter Level Line Item Based Scenarios.
Encounter	Line Item-based	Flat Rate Mode	By Percent/Flat Rate	The patient’s family size of one and annual income of $20000 allows a 50% discount. However, since a flat rate of $10 is defined in the sliding fee schedule, this overrides the 50% discount. The application applies the flat rate of $10 to each service line resulting in an estimated patient amount of $20. For more information, see Sliding Fee Calculations for Encounter Level Line Item Based Scenarios.
Encounter	Encounter-based	Minimum Value Mode	By Family Size	The patient’s family size of one and annual income of $20000 allows a 50% discount. A single adjustment takes place and all service lines get adjusted by 50%. This results in a total patient amount of $200 and a minimum amount of $20 to be paid by the patient. For more information, see Sliding Fee Calculations for Encounter Level Encounter Based Scenarios.
Encounter	Encounter-based	Minimum Value Mode	By Percent/Flat Rate	The patient’s family size of one and annual income of $20000 allows a 50% discount. A single adjustment takes place and all service lines get adjusted by 50%. This results in a total patient amount of $200 and a minimum amount of $20 to be paid by the patient. For more information, see Sliding Fee Calculations for Encounter Level Encounter Based Scenarios.
Encounter	Encounter-based	Flat Rate Mode	By Family Size	The patient’s family size of one and an annual income of $20000 allows a 50% discount. A single adjustment is made and all the service lines get adjusted by 50%. However, since a $10.00 flat rate is specified in the sliding fee schedule, the 50% adjustment rate gets ignored, and the application ensures that the flat rate of $10.00 gets applied to the adjustment amounts and the balance on the estimation is equal to the flat rate. For more information, see Sliding Fee Calculations for Encounter Level Encounter Based Scenarios.
Encounter	Encounter-based	Flat Rate Mode	By Percent/Flat Rate	The patient’s family size of one and an annual income of $20000 allows a 50% discount. However, since a $10.00 flat rate is specified in the sliding fee schedule, the 50% adjustment rate gets ignored, and the application ensures that the flat rate of $10.00 gets applied to the adjustment amounts and the balance on the estimation is equal to the flat rate. For more information, see Sliding Fee Calculations for Encounter Level Encounter Based Scenarios.

Encounter Level Sliding Fee Scenarios

You can set up the sliding fee schedule details using the parameters on the Sliding Fee Schedule Detail Maintenance window.

A patient with a family size of one and an annual income of $20000 has a sliding fee attached to an encounter on the Encounter Maintenance window.

The following table lists the encounter-level sliding fee scenarios, and their calculations.

Level	Schedule Fee Mode	Sliding Fee Mode	Min / Flat Rate Value Mode	Calculations
Encounter	Line Item-based	Minimum Value	By Family Size	The patient’s family size of one and an annual income of $20000 allows a 50% discount. A separate adjustment is made for each service line, and it gets adjusted by 50%. The application adjusts the balance on each charge to equal it to the minimum value resulting in a minimum amount of $20 to be paid by the patient. For more information, see Sliding Fee Calculations for Encounter Level Line Item Based Scenarios.
Encounter	Line Item-based	Minimum Value	By Percent/Flat Rate	The patient’s family size of one and an annual income of $20000 allows a 50% discount. A separate adjustment is made for each service line, and it gets adjusted by 50%. The system adjusts the balance on each charge to equal it to the minimum value resulting in a minimum amount of $20 to be paid by the patient. For more information, see Sliding Fee Calculations for Encounter Level Line Item Based Scenarios.
Encounter	Line Item-based	Flat Rate Mode	By Family Size	The patient’s family size of one and an annual income of $20000 allows a 50% discount. However, since a flat rate of $10 is defined in the sliding fee schedule, this overrides the 50% discount. The system applies the flat rate of $10 to each service line resulting in a estimated patient amount of $20. For more information, see Sliding Fee Calculations for Encounter Level Line Item Based Scenarios.
Encounter	Line Item-based	Flat Rate Mode	By Percent/Flat Rate	The patient’s family size of one and annual income of $20000 allows a 50% discount. However, since a flat rate of $10 is defined in the sliding fee schedule, this overrides the 50% discount. The application applies the flat rate of $10 to each service line resulting in an estimated patient amount of $20. For more information, see Sliding Fee Calculations for Encounter Level Line Item Based Scenarios.
Encounter	Encounter-based	Minimum Value Mode	By Family Size	The patient’s family size of one and annual income of $20000 allows a 50% discount. A single adjustment takes place and all service lines get adjusted by 50%. This results in a total patient amount of $200 and a minimum amount of $20 to be paid by the patient. For more information, see Sliding Fee Calculations for Encounter Level Encounter Based Scenarios.
Encounter	Encounter-based	Minimum Value Mode	By Percent/Flat Rate	The patient’s family size of one and annual income of $20000 allows a 50% discount. A single adjustment takes place and all service lines get adjusted by 50%. This results in a total patient amount of $200 and a minimum amount of $20 to be paid by the patient. For more information, see Sliding Fee Calculations for Encounter Level Encounter Based Scenarios.
Encounter	Encounter-based	Flat Rate Mode	By Family Size	The patient’s family size of one and an annual income of $20000 allows a 50% discount. A single adjustment is made and all the service lines get adjusted by 50%. However, since a $10.00 flat rate is specified in the sliding fee schedule, the 50% adjustment rate gets ignored, and the application ensures that the flat rate of $10.00 gets applied to the adjustment amounts and the balance on the estimation is equal to the flat rate. For more information, see Sliding Fee Calculations for Encounter Level Encounter Based Scenarios.
Encounter	Encounter-based	Flat Rate Mode	By Percent/Flat Rate	The patient’s family size of one and an annual income of $20000 allows a 50% discount. However, since a $10.00 flat rate is specified in the sliding fee schedule, the 50% adjustment rate gets ignored, and the application ensures that the flat rate of $10.00 gets applied to the adjustment amounts and the balance on the estimation is equal to the flat rate. For more information, see Sliding Fee Calculations for Encounter Level Encounter Based Scenarios.

Encounter Level Sliding Fee Scenarios

Recommendations

Patient and Encounter Level Sliding Fee Scenarios

Person and Patient Level Sliding Fee Scenarios

Multiple Sliding Fee Schedules Scenario

Set Up Sliding Fee Details

Encounter-Based and Line Item-Based Sliding Fees

Encounter Level Sliding Fee Scenarios

Encounter Level Sliding Fee Scenarios

Patient and Encounter Level Sliding Fee Scenarios

Person and Patient Level Sliding Fee Scenarios

Multiple Sliding Fee Schedules Scenario

Set Up Sliding Fee Details

Encounter-Based and Line Item-Based Sliding Fees

Encounter Level Sliding Fee Scenarios