Allowed Fee Exception Report

Allowed Fee Exception Report

This report compares posted allowed amounts to contractual allowed and is beneficial in finding underpayments. If the report is Output As a CSV Text File, it will include the Patients' DOBs and Policy #s, which can be used as part of an Insurance appeal process.

Force Fee ScheduleThis option allows you to compare the Insurance(s) selected above to the Allowed Fee Schedule of a different insurance. For example, comparing reimbursements from a payer where you have no contractual Allowed Fees loaded in the system, to the Medicare Allowed amounts that you do have loaded.
  1. Include:
    1. Under and Over Payments
    2. Under Payments Only
    3. Over Payments Only
  2. Discrepancy is greater than: Dollar amount or Percentage
  3. Include Non-Discrepancies: Select to include all posted Allowed amounts and not just the discrepancies.  This provides a comprehensive look at posted Allowed amounts for a given Insurance and time-frame. Review the adjudication of claims for correct payment.
  4. Group By one of the following:
    1. Billing Provider
    2. Rendering Provider
    3. Facility
    4. Insurance
    5. Procedure


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