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Additional Service Fee Configuration Fields - Registry Setting

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Avatar PM > System Maintenance > Service Code Maintenance

Enable the following fields in the Service Fee/Cross Reference Maintenance form. These fields configure service fees according to fee type, client ID, modifier:

  • 1 - enables the Client ID field
  • 2 - enables the Fee Type field 
  • 3 - enables the Modifier field
    • This modifier is included in the service fee definition and is not a billing override.
    • The 'CPT-4 / HCPCS Modifier' field in this form is used as a modifier billing override.

Selections:

  • Selecting '1' adds the Client ID field to the Service Fee/Cross Reference Maintenance form to specify a service fee for a particular client.
  • Selecting '2'  adds the Fee Type, Pro-Rate Fee For, Pro-Rated Fee Calculation, and Yearly Days Calculation fields to the Service Fee/Cross Reference Maintenance form. This allows the user to specify whether a fee is 'Daily' or 'Monthly' and determine when a prorated monthly fee should be used and how it should be calculated. The Maximum Amount To Distribute Per Month field is added to the Guarantor Definition section of the Service Fee/Cross Reference Maintenance form to allow the Maximum Amount To Distribute Per Service to be overridden with a prorated amount per service.
  • Selecting '3' adds the Modifier field to the Service Fee/Cross Reference Maintenance form to include modifiers in service fees. If modifiers are associated with a charge, the system checks the service fee defined for each modifier and use the highest fee found.
  • Separate multiple entries with '&'.

Leaving this setting blank removes these fields from the Service Fee/Cross Reference Maintenance form: Client ID, Fee Type, Pro-Rate Fee For, Pro-Rated Fee Calculation, Yearly Days Calculation, Maximum Amount To Distribute Per Month, and Modifier.

  • Note: If this registry setting is blank, no additional service fee definitions can be accessed in the Service Fee/Cross Reference Maintenance form.