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Configure Fee Tables in Practice Settings

Faris Peerukannu Mohamed Kasim
  • Updated
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Let's explore how to configure different areas of the Fee Tables via Practice Settings.

Topics Covered

  • Fee Schedules
  • Assignments
  • Hierarchy
  • Table of Allowance
  • Fee Register
  • Settings

The fee schedule determines how much to charge the insurance company or the patient and can help track figures such as total contractual adjustments.

Watch this video for a quick walkthrough!

To add a fee schedule:

  • Navigate to the System Menu > select Practice Settings > Fee Tables > Fee Schedules.

  • Click + Add Fee schedule.
Note: You can click Import and upload a file that contains the required procedure codes and their corresponding fees.
  • Enter Name, Type, and Description for the fee schedule.
  • You can enter Notes, if needed.
Note: You can also click Import from existing fee schedule below the Details section to import the desired fee schedule.
  • Select Procedure Codes.
  • Enter Fees, Future Fees, and Effective Date.
  • Click Save & Close.
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Other Actions

  1. View: You can adjust the view by Fee Schedule, Code, or Provider.
  2. Sort: You can sort the fee schedules according to different criteria such as Name, Date Selected, etc.
  3. Delete: Click the trash icon to delete the fee schedule.
  4. View Notes: Click to see if there are any notes related to the selected schedule.
  5. Print: You can take a printout of the fee schedule.
  6. Download: Click this button to download the fee schedule to your device.
  7. Edit: Click this button to customize the fee schedule.
  8. View History: Click this hyperlink to view the fee history.

Watch this video for a quick walkthrough!

To add a fee schedule assignment:

  • Navigate to the System Menu > select Practice Settings > Fee Tables > Assignments.
  • Click + Add Assignments.
  • Select the Fee Schedule from the drop-down menu.
  • You can choose other optional information such as the following:
    • Carrier: The carrier of the assignment.
    • Plan: The insurance plan of the assignment.
    • Assign By: You can set the assignment by location or location group. You can also assign by Provider or Specialty.
    • Location: You can select the intended location of the assignment. If no specific location is assigned, it will be considered applicable to all locations.
    • Provider: Select the provider for the assignment.
  • Click Save.
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Other Actions

1. Edit: Select an assignment > click Edit > make the required changes > click Save.

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2. Delete: Checkmark the required assignment checkboxes from the grid > click Delete.

3. Filters: Use the filters to find the required fee table assignment from the grid.

4. View Fee Schedule: Click the quick link to view the corresponding Fee Schedule.

Watch this video for a quick walkthrough!

You can edit the Estimation and Billing Hierarchy in CareStack.

1. Estimation Hierarchy: CareStack allows you to estimate the patient's portion of the bill after insurance is considered. This estimation is based on the coverage percentages and maximums entered into the patient's insurance plan details.

2. Billing Hierarchy: When a patient has multiple insurance plans, you need to set the billing hierarchy to determine which insurance is billed first (primary), second (secondary), and so on. The primary plan is usually the one that covers the patient directly as a member of the plan that has been effective the longest.

To rearrange the order of either of the hierarchies, perform the following steps:

  • Navigate to the System Menu > select Practice Settings > Fee Tables > Hierarchy.
  • Select the Estimation Hierarchy or Billing Hierarchy as required.
  • Click Edit > drag and drop the items to change the order.
  • Click Save.
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Watch this video for a quick walkthrough!

A Table of Allowance (TOA) is a list used in dental practice management to determine co-pay amounts for patients or insurance receivables based on the insurance plan contract. When setting up a Table of Allowance, you can either enter the maximum allowable amount for the insurance, after which the remaining amount will be the patient's responsibility, or vice versa. This table is essential for calculating the co-pay charges for various dental procedures according to the terms of the insurance plan.

Add a Table of Allowance

  • Navigate to the System Menu > select Practice Settings > Fee Tables > Table of Allowance.
  • Click + Add Table of Allowance.
  • Enter the Name and Description of the new Table of Allowance. You can also add any Notes if intended.
  • Select Category from the left side > select the Codes from the right side of the page.
  • Enter the Fees, Future Fees, and Effective Date of the TOA.
  • Click Save & Close.
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Import a Table of Allowance

To import a table of allowance instead of creating one from scratch, perform the steps below:

  • Click Import.
  • Drag and drop the intended file OR click Browse to select the file and upload.
  • Select the Mode of import: You can import as a new table, merge with an existing table of allowance, or replace an existing table. 
    • Select the intended Existing TOA for the last two options.
  • Enter the Name and Description of the new Table of Allowance. You can also add any Notes if intended.
  • Click Import.

Edit a Table of Allowance

To edit a Table of Allowance, perform the following steps:

  • Select a Table of Allowance from the left.
  • Click Edit.

On the Edit Table of Allowance slide-out, you can edit the following details:

  • The Name and Description.
  • Apply Undulation: To update fees, choose if the undulation should apply to the Current Amount or the Future Amount.
    1. For Current Amount, 
      • Specify the percentage change.
      • Choose if the fee should Increase or Decrease.
      • Click Apply.
    2. For Future Amount, 
      • Specify the percentage change.
      • Choose if the fee should Increase or Decrease.
      • Choose the Effective Date.
      • Click Apply.
  • Procedure Codes: Check or uncheck the required codes to add or remove.
Note: If a code is not listed in the Table of Allowance for either the patient or the insurance, it will be treated as a non-covered code. In such cases, the entire fee (UCR or Max. Allowable, based on the plan-level settings) will be billed to the patient.
  • Notes: You can edit the notes or add if empty.
  • Click Save after making the changes.

Other Actions

  1. View: You can adjust the view by Allowance or Code.
  2. Sort: You can sort TOAs according to different criteria such as Name, Date Selected, etc.
  3. Delete: Click the trash icon to delete the TOA.
  4. View Notes: Click to see if there are any notes related to the selected TOA.
  5. Print: You can take a printout of the TOA.
  6. Download: Click this button to download the TOA to your device.
  7. Edit: Click this button to customize the Table of Allowance (TOA).
  8. View History: Click this view the history of changes made to the fees by different users.

In CareStack you can also use Fee Registers to supplement your Fee Schedules for Fee Calculation. When using Fee Registers, CareStack will take the entered amount from the Fee Register in place of the amount from the Fee Schedule, regardless of the patient's coverage for that plan.

Watch this video for a quick walkthrough!

Add a Procedure Code

  • Navigate to the System Menu > select Practice Settings > Fee Tables > Fee Register.
  • Select the Fee Register from the left.
  • Click Edit.
  • Select the required Category and Code(s).
  • Either click Save,  or click Save & Close.
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How to Import a Fee Register

  • Click Import.
  • Drag and drop the intended file OR click Browse to select the file and upload.
Note: The file to be imported should contain the procedure code and its corresponding fees.
  • Select a system-defined Name from the drop-down menu.
  • Click Import.

Other Actions

  1. View: You can adjust the view by Fee Register or Code.
  2. Sort: You can sort the fee registers according to different criteria, such as Name, Date Selected, etc.
  3. View Notes: Click to see if there are any notes related to the selected fee register. 
    • To add a note, click +Add Note > enter notes > click Save.
  4. Print: You can take a printout of the fee register.
  5. Download: Click this button to download the fee register to your device.
  6. View History: Click this to view the history of changes made to the fees by different users.

Watch this video for a concise summary.

To configure Fee Table settings, perform the following steps:

  • Navigate to the System Menu > select Practice Settings > Fee Tables > Settings.
  • Click Edit to configure the following settings.
    • Take percentage split for UCR type fee schedule: This option is set to Yes as the system default. The UCR fee schedule represents the standard office fees that are charged at your location.
    • Use Fee Registers for Fee Calculation: Select Yes to use fee registers for fee calculation.
    • Associate two coverage tables to Insurance Plans: Select Yes to integrate two coverage tables into insurance plans.
    • Default Lock Period for Fee Estimates: Set the number of days as the default lock period for fee estimates. The common value used by practices is 30 days.
    • Use fees from pre-auth for calculating insurance estimate: Select Yes to use fees from pre-auth for calculating insurance estimate, if needed.
      • This setting applies only to COVERED codes. Non-covered codes will not experience any fee impact from a pre-auth.
    • Use exclusions and limitations for fee calculation: Select Yes to use exclusions and limitations.
    • Consider codes in different phases to be completed on different dates: Select Yes if codes in different phases should be completed on different dates. This ensures treatment estimates are accurate when date of service is not available.
  • Click Save.
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Practices can leverage this elaborate guide to learn about configuring fee tables easily via practice settings.

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