Procedure Allowances - Allowed Amounts

Procedure Allowances (allowed amounts) are the amounts a third party payer will allow for a given service.  

To setup your procedure allowances go to billing/settings/third party payers.

Once you are there, select a third party payer. Next, In the top right, click the 'Configure' button (see below). This will open up the Procedure Allowances dialog.

In the "Configure Procedure Allowances" dialog you will see all of your services. For any given service, select, first, if it is covered (check box). If it is not covered by that third party payer, leave the checkbox blank. This check box is used when estimating PMR. If a service is not covered then the estimate belongs to the patient (not the insurance).

Next, for any given charge that you marked as "Covered" you may enter the allowed amount. This can be done for up to 6 units. Below you can see for our 98941 with a default price of $40.00 that we entered $30.00 for 1 unit.

You do not need to populate all six units. The more you populate, the more accurate PMR estimation will be, of course. In addition, some services could never be billed as two units as well. If you do not populate any allowed amount, not to worry. The software will use the charge amount when calculating PMR instead of the allowed amount.

*Make sure to "Apply and save payer"

You may have also noticed a modifier section on the procedure allowances dialog. This lets you add modifiers to any service. This way when these services are added at the Fee Slip they will automatically be added! This is not only a huge time-saver, but also reduces errors as modifiers will no longer be forgotten.

*Make sure to "Apply and save payer"