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.
- Include:
- Under and Over Payments
- Under Payments Only
- Over Payments Only
- Discrepancy is greater than: Dollar amount or Percentage
- 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.
- Group By one of the following:
- Billing Provider
- Rendering Provider
- Facility
- Insurance
- Procedure
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