Allowed Fee Exception Report

Allowed Fee Exception Report

To find underpayments, this report compares posted allowed amounts to contractual allowed amounts.

  • The Allowed Fee Exceptions Report shows discrepancies on Posted Allowed amounts against the Allowed Fee Schedule. 
  • It does not report on CO's and adjustments.
  • If the report is Output As a CSV Text File, it will include the Patients' DOBs and Policy #s.
  • These can be used as part of the Insurance appeal process.
  • If the report is Output As a CSV File and Group By is -Select- or if Insurance is selected.
  • If Plans are not selected in Fee/RVU Management, the allowed amounts will not be reported.


Allowed Fee Exception Report

(Reports > Financial Panel > Allowed Fee Exceptions)

Allowed Fee Criteria

Report Options

  • Date Type: DOS, Charge Post Date, or Payment Post Date
  • Date Span: Choose the dates for reporting purposes.

  • Insurance, CPT, Modifier, Billing, Rendering, Facility, Patient, Case

Allowed Fee Filters

  • Force Fee Schedule: This option allows you to compare the Insurance(s) selected above to the Allowed Fee Schedule of a different Insurance.
  • Example: Compare the reimbursements from a Payer where there are no contractual fees loaded in the System to the Medicare fees that have been 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:
  • - Select - (no grouping)
  • If left as - Select - and the report is output to a csv file, the report will include an Insurance Reporting Group column.

  • Billing Provider
  • Rendering Provider
  • Facility
  • Insurance
  • If Insurance is selected and the report is output to a csv file, the report will include an Insurance Reporting Group column.

  • Procedure

Report Examples

Grouped By Insurance (PDF Format)

Grouped By Insurance (CSV Text File)

Learn More

Fee/RVU Management

Reports Criteria Overview

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