How To: Enter Standard Rates and Custom Rate Schedules

Standard rates, often referred to as "cash rates," are the amount you would charge an individual not using an insurance benefit for your service. This amount is typically more than what you would be reimbursed under an insurance contract. To reduce the amount of time you spend on billing tasks, TherapyNotes automatically includes your standard rate on claims. Our straightforward  payment posting allows you to quickly write off the difference between your standard rates and your contracted rates if needed.

By entering standard rates for each service, you never need to worry about figuring out and maintaining rates for your payers. We recommend using your practice's standard rate for all payers to ensure that your billing records are accurate and that you always receive the maximum allowable payment from your payers.

Standard rates are entered per service code. To learn more about service codes, read  How To: Add, Edit, and Delete Service Codes.

Role Required: Practice Administrator, Practice Biller, or Clinical Administrator

To enter a standard rate for a service:

  • Click the User Icon > Settings > Service Codes
  • Click on the service code

  • In the section labeled Edit Your Service Code, enter the Standard Rate for the service
  • Click the Save Changes button

If you have previously entered custom rates for a service, the custom rates can be viewed and edited in the  Custom Payer Rates for this Service table.

Custom Rate Schedules

Custom rate schedules may be entered for payers that you are in-network with and may be used to override your standard rates when billing insurance. When a custom rate schedule is entered for a payer and assigned to a clinician, the custom rate will be automatically included on claims for that payer and clinician. Using custom rate schedules allows you to bill different amounts for a service for different clinicians in your account. For example, if one member of your practice has credentials that allow them to bill more for a service, a custom rate schedule allows you to reflect this difference without having to create a separate instance of this service code.

To enter a custom rate schedule for a payer:

Note: Only Practice Billers can add custom rate schedules.

  • Click Payers > Payer Name > Rate Schedules tab
  • Click anywhere on the Rate Schedules box to edit
Quick Tip: To keep record of your contracted rate schedules while continuing to use your standard rates on claims, do not make changes to the default In Network rate schedule. Instead, click the Add Rate Schedule button to record your contracted rates and do not assign the rate schedule to any clinicians.

  • In the Rate Schedule field, enter a name for the rate schedule
  • Deselect the Use Standard Practice Rates checkbox
  • Enter the Custom Rate per service code. If your contracted rate for a service is the same as your standard rate, leave the corresponding Custom Rate field blank
  • To enter additional rate schedules, click the Add Rate Schedule button
  • Click the Save Changes button

If there is only one rate schedule entered for a payer, TherapyNotes will use those rates to bill. If there are multiple rate schedules entered for a payer, assign the appropriate rate schedule to each clinician in your practice.

To assign a custom rate schedule to a clinician:

Note: Only Practice Billers can assign custom rate schedules to clinicians.

  • Click Payers > Payer Name > Clinicians tab
  • Click anywhere on the Clinician Assignment box to edit
  • For each clinician, select the appropriate rate schedule from the Rate Schedule dropdown
  • Click the Save Changes button

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