Add a contract

Follow the steps below to create a new contact based off an existing contract (i.e., duplicate prices and options), based on the Medicare Fee Schedule, or based on payments entered.

  1. Select Customer Setup > Codes... > Contracts.

  2. Click the New Contract button. 

  3. Select how you want to base the contract from:

    1. From an existing contract?

      1. Select the Set prices based on another contact option.

      2. Use the Specify Contract drop-down menu to select the existing contract.

    2. From the Medicare Fee Schedule?

      1. Use the Medicare Fee Schedule Year drop-down menu to select which Medicare Fee Schedule year to use.

      2. Enter your Zip code to enter the Carrier and Locality.

      3. Select the Pricing Method, you can Use Non-Facility Pricing or Use Facility Pricing.

    3. From Payments Entered?

      1. Use the Specify Payer drop-down menu to select which payer payments to use.

      2. Enter the number of Days you would like to base your contracts off of.

  4. Select one of the Adjust Prices options to determine how you would like to adjust the prices for your new contact based from the existing contact.

    1. Do not adjust the prices of the new contract: Do not adjust any of the procedure code prices on this contact.
    2. Increase prices by: Increase the procedure code prices by adding a percentage of change to the original amount.

      If a procedure code with a price of $200 is increased by 140% it will calculate for a total of $480. ($200 + $280 (140% of the price)).

    3. Decrease prices by: Decrease the procedure code prices by subtracting a percentage of change from the original amount.

      If a procedure code with a price of $200 is decreased by 40% it will calculate for a total of $120. ($200 - $80 (40% of the price)).

    4. Adjust prices to: Adjust the procedure code prices by a set percentage based off of the original price.

      If a procedure code with a price of $200 is adjusted by 140% it will calculate for a total of $280.

    5. Round prices up the next whole dollar amount: Automatically adjust the prices to the nearest whole dollar amount
  5. Click the Show Preview button to review the price adjustments.

  6. Type the name for this contact in the Name field.

  7. Use the Type drop-down menu to select whether the contract will be FFS (Fee For Service) or CAP (Capitated).

    This is only used for tracking purposes.

  8. Place a check in the box if you would like to Allow users posting payments to update prices

  9. The Sequence# will be auto-populate once the contract is saved.

  10. The table below will display all the codes that have been added or created for your account.

    To learn how to add or create codes, please visit our Procedure Codes Help Article.

  11. In the Price column, enter your contract price for each billing procedure code as agreed upon with the payer.

  12.  Optional: If the payer does not cover a particular procedure, check the Exclusion checkbox. Checking this box will make any remaining balance due to the patient after the insurance payment; meaning, the status of the charge will be set to Balance Due Patient automatically.

  13. Open the Payers window to associate this contract with a payer.

    To learn how to associate contracts with the payer, please visit our Add a Payer Association Help Article.

  14. Click Save.