Overview
Fee schedules in ChiroHD allow you to automate allowed amounts, patient responsibility settings, and billing behavior for services and inventory items.
Fee Schedules are only available if you are using the Insurance V2 Dashboard.
How to Enable Fee Schedules
Before you can set up or use fee schedules, you must first enable Insurance V2:
Go to Settings → Office → Office Configuration.
Toggle Insurance V2 to ON.
Creating a Fee Schedule
Go to Insurance → Settings → Fee Schedules.
Click Create New Fee Schedule.
Name the fee schedule appropriately (e.g., "Blue Cross Fee Schedule").
Add items by clicking Add Item to Fee Schedule:
Service or Inventory Item: Choose the CPT code or inventory item.
Modifier (optional): Add any required modifier.
Allowed Amount: Enter the contracted rate for the service.
Default Responsibility (optional): Set if the item should be Patient Responsibility or Insurance Responsibility by default.
Billable: If checked, this item will always be considered for billing even if patient responsibility is set.
You can add multiple services and inventory items into one fee schedule.
Applying a Fee Schedule to a Patient
After creating a fee schedule, you need to apply it to a patient's default services:
Open the patient profile.
Navigate to Default Services.
Under Fee Schedule, select the desired fee schedule (e.g., "Blue Cross Fee Schedule").
Add the appropriate services.
You will see "Controlled by Fee Schedule" appear, meaning the amounts are locked in based on the schedule settings.
Services not tied to the selected fee schedule will remain editable.
Click Save Changes.
When Fee Schedules Apply
Fee schedules influence billing at two key points:
When services are added to the patient's ledger:
Build amounts and allowed amounts are automatically populated.
Any set patient responsibility settings will automatically apply.
When posting EOBs:
The system will automatically reference the allowed amount from the fee schedule when processing payments and write-offs.
Important Notes
Fee schedules only function in the Insurance V2 Dashboard.
Once services are tied to a fee schedule, users cannot edit the amounts manually unless the fee schedule is removed.
Default services set up with a fee schedule will automatically apply when a SOAP note is posted.
Summary
Fee schedules are a powerful tool in ChiroHD that:
Ensure billing consistency.
Save time during EOB posting.
Eliminate manual entry errors.
Simplify patient responsibility assignments.
By setting up and applying fee schedules correctly, your insurance billing process will be more efficient, accurate, and easier to manage.