The fee table hierarchy is the order in which the system determines which fee schedules to use when calculating charges for the services provided to patients. This hierarchy is important because it dictates how much to charge the insurance company or the patient. The system uses this hierarchy to provide accurate fee estimates during treatment planning and other billing processes.
There are two types of hierarchies namely Estimation Hierarchy and Billing Hierarchy.
Estimation Hierarchy determines the sequence in which the patient's insurance plans are billed. For example, if a patient has dual coverage, the primary insurance is billed first, and then the secondary insurance is considered for the remaining amount. The primary insurance is usually the one that covers the patient directly as a member of the plan that has been effective the longest.
Billing Hierarchy is related to the order of billing the different insurance carriers when a patient has multiple coverages. It lets the system know which plan is in the first position and payment priority.
Watch this video for a complete understanding.
To manage the fee schedule hierarchy:
- Navigate to System Menu > Practice Settings > Fee Tables > Hierarchy.
- Select Estimation Hierarchy or Billing Hierarchy as needed.
- You can see their Order as 1,2,3, etc where number 1 is the highest hierarchy. You can also see the description of the Assignment.
- To change the hierarchy, click Edit.
- Click on the dots for the required hierarchy and drag to the intended position.
- Click Save to update the hierarchy order.
- If you need to reset the hierarchy to system default, click Reset to Default.
| Note: The system default is the recommended hierarchy for both estimation and billing. If you make changes to the hierarchy, you need to make informed changes by consulting the support or admin to ensure nothing goes wrong as altering hierarchies impacts the workflows! |
Practices can use this simple guide to learn about the Fee Table Hierarchy and update the order in the right way!