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 Schedule: This 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


    • Related Articles

    • Reports Criteria Overview

      Most Reports default to the Post Date which is controlled by the date used in the Reference Batch. My Reports Panel: The Reports that the User has run are shown in this Panel. You can choose to see Unread reports only. Report History: This is the ...

    • Fee/RVU File Formatting and Resources

      Release 4.7 Resources for Creating and Using Fee and RVU Schedules All Fee and RVU Schedules can be created in the Fee/RVU Management Library. The following resources can be found on the CMS website. Physicians Fee Schedule: ...

    • Fee/RVU Management

      Add Charge Fee, Allowed Fee, and RVU Schedules If the Items Number is 0, there is a problem with the file that was uploaded. Reference the File Formatting Guidelines to ensure a successful upload. All Charge Fee, Allowed Fee, and RVU Schedules are ...

    • Payroll Report

      The Payroll Report cannot be run with a single total. Instead, use the Practice Analysis Report. The Payroll Report calculates the total amount of Revenue generated by a Procedure (displayed by the Procedure Code) for a Provider and reports the total ...

    • Practice Analysis

      Practice Analysis This is one of the most used reports in the System due to the output calculations and the ability to create multiple Group By levels. Report Features Date Type allows reporting by Post Date, Date of Service, or on an individual ...