> ## Documentation Index
> Fetch the complete documentation index at: https://docs.athelas.com/llms.txt
> Use this file to discover all available pages before exploring further.

# How to Create Suggested PR Rules

> Build rules that auto-suggest copay, coinsurance, and deductible at check-in, with priority-based overrides.

#### At a Glance

**Suggested PR Rules** save your staff time by automatically recommending what to collect (copay, coinsurance, deductible, etc.) based on criteria you define, so they don't have to look up fee schedules and benefits by hand.

### How to Set a Suggested PR Rule

Go to the **Suggested PR Rules** tab in [PR Settings](/insights_front_desk/patient_responsibility/pr_settings) and click **Add Rule**.

1. Give the rule a **Name** and a **Priority**. (You can also set an optional **End date** after which the rule stops applying.)
2. In the **Actions** block, click **Add Action** and choose what the rule should do — for example, **Set Copay Amount in USD Cents** (enter `1000` for \$10), then **Add Action** again to **Prioritize Family Deductible**.
3. In the **Conditions** block, add the conditions that must be met. Choose **All** or **Any**, then add single- or multi-statement conditions. Each statement is a **Variable / Operator / Value** — for example, *Patient Age ≥ 65* and *Appointment Type = Diagnostic X-Ray*.
4. Click **Save**. The rule appears in the **Rules** list, where you can edit, copy, or archive it.

<Note>
  **Priority determines overrides:** rules with higher priority values override rules with lower priority values. For example, a Priority 2 rule overrides a Priority 1 rule. (Global rules can't be edited — create a specific higher-priority rule to override one.)
</Note>

### Where Suggestions Appear

Suggested PR Rules don't preview in Settings — they surface at check-in:

* In the eligibility result, a **Suggested PR Rules Applied** section lists each applied rule (the highest-priority rule first).
* In the payment flow, a **Suggested Charges** alert shows the recommended copay/coinsurance/deductible/self-pay amounts.

### Actions Reference

| Action | What it does |
| - | - |
| Copay Filter In | Pulls the chosen text from the eligibility response to display as a recommendation (e.g., PCP copay). |
| Copay Filter Out | Excludes the chosen text so it isn't displayed as a recommendation. |
| Copay Filter Place of Service | Filters the amount to collect by place of service (e.g., Hospital – Outpatient). |
| Find Limitations and Set Charges | Finds the input limitation in the eligibility response and defaults to a chosen charge. |
| Notify | Leaves a message on the appointment for the front desk to read. |
| Prioritize Copay | Prioritizes copay over coinsurance or deductible. |
| Prioritize Family Deductible | Prioritizes the family deductible over coinsurance or copay. |
| Set Coinsurance Amount in USD Cents | Sets a specific coinsurance amount to collect. |
| Set Copay Amount in USD Cents | Sets a specific copay amount to collect. |
| Set Deductible Amount in USD Cents | Sets a specific deductible amount to collect. |
| Set Self-Pay Amount in USD Cents | Sets a specific amount to collect for self-pay patients. |

Conditions include appointment reason/type, facility, patient age or date of birth, QMB status, and primary/secondary insurance details (payer, company type, member ID, plan/group), as well as remaining deductible and out-of-pocket amounts. If you need options beyond these, contact your account manager.

### FAQ

<Accordion title="Two rules conflict — which one wins?">
  The rule with the **higher priority value** wins. For example, a Priority 2 rule overrides a Priority 1 rule.
</Accordion>

<Accordion title="Where do I see the suggested amount?">
  At check-in — in the eligibility result's **Suggested PR Rules Applied** section and the payment flow's **Suggested Charges** alert. There is no preview inside PR Settings.
</Accordion>


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