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Q1: It's Time to Update Fee Schedules and Optimize Payment!


Welcome to Quarter 1 of the OP Educational Experience!

Every year, payers update their fee schedules. When was the last time you reviewed your practice's? It's important that you do so on a regular basis because if your fee schedule is outdated, you are most likely leaving money on the table. In Quarter 1, our focus is on updating your Fee Schedules. 

Our OP educational materials will be forthcoming in the next few weeks, so you can roll up your sleeves and get to work!

Return to the Educational Experience Homepage

Expand the sections below to get started!

Webinar Recording: "Updating Your Practice Fee Schedule" 

In this webinar, presented by Sue Kressly, MD, FAAP, you will learn:

  • The importance of reviewing and updating your fee schedules on a regular basis
  • Methods to create a fee schedule that is consistent and supports practice financial metrics
  • The impact of monitoring payments throughout the year to maximize revenue

Resource Links

Identify Underpaid CPT Codes

Learn how to run an SQL/script to identify any CPT codes that you have been potentially underpaid for because you are getting paid 100% of your charges.

Leverage CMS RVUs

Learn how to download the CMS RVU spreadsheets off their website and use them as the basis for this work.

Part 1: RVUs and the Medicare Fee Schedule

Part 2: Creating a Medicare Physician Fee Schedule

Resource Link

Part 3: Other Medicare Fee Schedules

Resource Links

Pay Attention to Vaccine Charges

Learn how to manage your vaccine CPT codes and fee schedule(s) in OP so that you can maximize your vaccine payments.

Update Your Vaccine Fee Schedule

Resource Link

Part 1: Monitor Vaccine Charges and Payments

Part 2: Monitor Vaccine Charges and Payments 

Resource Links

Optimize Payments Throughout the Year

Learn what you should do throughout the year to make sure you are still optimizing payment.

Check back soon! We're working on creating great content for you!

OP Help Resources 

Fee 
Schedules
Fee Schedules
Modify and Copy Fee Schedules
SQL: Entire CPT Code Table Record, Including Fee Schedules
Video: Fee Schedule Maintenance

Block and Substitute 
Rules
Block and Substitute Rules
Video: Blocked and Substitutes Codes

Insurance 
Contracts
Add, Edit, and Copy Insurance Contracts
Associate an Insurance Contract with a Payer
Update Insurance Contracts
Using the Update Insurance Contracts Window
SQL: Contracts Module Review
SQL: Expected Revenue - Charges and Contracted Rates
SQL: Decreased Payment for Sick with Well

*** All of the topics above play a part in a payer's setup in OP ***