At a Glance

Adding or updating your Self-Pay Fee items will allow Insights to automatically generate Patient Responsibility (PR) charges for self-pay patients, based on your organization’s established rates for specific CPT codes.

A self-pay fee schedule will free up considerable time for your administrative staff, as they will no longer need to manually look up CPT codes and rates.

What you can do on your own Add or edit items in your schedule line by line.

What you can do with help from an account manager Upload a fee schedule with multiple items. We can review and upload it for you. This is to ensure nothing gets broken in transition.

You can select whether you want post-visit PR generated for self-pay patients, based on your fee schedule. You can also choose the earliest date of service to which the fee schedule would apply, as well as a maximum self-pay charge per encounter.

How to Do It

From the Patient Responsibility page, click the ‘Actions’ menu and choose PR Settings.

Click on the Self-Pay Fee Schedule tab. You may have to scroll the list of tabs to the right in order to see this tab.

From here, you can either use the Search function to find a CPT if you already have items in your fee schedule. For this walkthrough, start by clicking Add Single Fee.

Fill in the CPT Code, any modifiers, and the amount to charge in USD cents.

CPT modifiers (also referred to as Level I modifiers) are used to supplement the information or adjust care descriptions to provide extra details concerning a procedure or service provided by a physician. Code modifiers help further describe a procedure code without changing its definition. They are typically formatted as two characters, separated from other modifiers by a comma (For example: AB, CD)

Click Confirm.

Now you can view your new item in the fee schedule.

Click the pencil icon to modify the charge amount of the item, and the trash can to delete the item entirely.

❗ You will only be able to edit the charge amount of each item. If you would like to edit either the CPT code or modifiers, simply delete the item and add a new one.

Duplicate CPTs Codes and Modifiers.

If you input an exact duplicate CPT code and modifier combination but with a different charge amount, the original will simply be updated.

If, however, you have a single CPT code, but different modifiers requiring different prices, the system will create a new line item.

Download Your Practice’s Self-Pay Fee Schedule

In PR Settings, under the Self-Pay Fee Schedule tab, you can click Download Fee Schedule below the listed items in the fee schedule to get a CSV file. The data in this file can be viewed and manipulated in Excel or similar program.

Further Assistance

We’re here to help! Please get in touch with support@getathelas.com if you’d like some hands-on assistance.