Client Rates

This feature can be used when you want to charge a specific client a different amount for services than what is listed on your Fee Schedule. This can be useful if you have a client that is going through a financial hardship.

Note: Client Rates do not affect service lines that have a lesser charge amount or a zero balance.

Navigation

1. Navigate to Clients > Client List.
2. Locate the desired client and select the  icon. 
3. Select Client Rates from the list. A new window will appear.

Setup

You have the option to indicate a Default rate or you can add Rules for further specification.

Default

This rate will affect all service lines that are not influenced by a Rule.

1. Enter the desired charge amount into the Amount field. 
2. Use the Rate Type drop-down menu to indicate:
   1. Fixed: Flat rate regardless of units/minutes
   2. Per Unit: Charge amount per X units
   3. Per Minute: Charge amount per X minutes
3. Select Save Default Rate.

Rules

If a service line is affected by a rule, then the Default rate will be ignored. You can enter multiple rules for each client.

1. Start by clicking Add Rule. You will see fields for Begin/End Date, Service Code, Modifier, Amount, and Rate Type.
2. Fill out the desired information. The Begin/End Date, Service Code, and Modifier fields are optional, allowing for complex customization.
   1. Begin Date: Service lines with dates on or after this field will be affected
   2. End Date: Service lines with dates on or before this field will be affected
   3. Service Code: The CPT code the rule applies to
   4. Modifier: Use in conjunction with the Service Code. Separate modifiers using a period (GP.KX). If no modifier is entered, the rate will apply to all variations of the code (97010, 97010.GP, 97010.GP.KX, etc) 
3. Enter the desired charge amount into the Amount field.
4. Use the Rate Type drop-down menu to indicate:
   1. Fixed: Flat rate regardless of units/minutes
   2. Per Unit: Charge amount per X units
   3. Per Minute: Charge amount per X minutes
5. Select Save.

Examples

Let's review different examples using the rules below to see what rate should apply.

Example #1

The Date of Service is outside of the Rule date range, so the Default rate is applied.

Example #2

While the Date of Service and Service Code match the Rule, the Modifier field does not. This causes the service line use the Default rate.

Example #3

This service line falls within the date range, matches the Service Code, and also matches the Modifier requirement of the Rule. Therefore, the Amount and Rate Type is applied.

How does this reflect on the Client Balance Statement?

After a Client Rate has been implemented, you will see it reflected on the statement as an adjustment. Any service line that should have a Client Rate applied will have the adjustment amount underlined and clickable.

5/21/18, 97110.GP: This service line should have the Default rate of $50, so the system is indicating that a $100 adjustment should be applied.

6/18/18, 97010.GP.KX: This service line is being affected by the Rule entered previously, so the system wants to add a $60 adjustment.

6/18/18, 97250: This service line is not affected because it doesn't meet the Rule requirements and it is already less than the Default rate of $50 that was set up.

All adjustments that are underlined will be applied when a Client Balance Statement is created. Once applied, adjustments can only be removed on the Single Session window.

How do I remove the Client Rate on a service line?

If you find a specific service line that you no longer want to apply, simply click on the adjustment amount and select Remove Adjustment.