Adding Fee Schedules

WinOMS accommodates an unlimited number of fee schedules. In most cases, alternate fee schedules are associated with insurance plans; however, you can assign a fee schedule to a patient.

WinOMS uses the following rules when applying fee schedules:

When a procedure is posted, the fee is determined by the insurance coverage of the patient. If a fee schedule is attached to the plan, the fee schedule of the plan applies.
If there is no fee schedule attached to the plan, the software determines if a fee schedule is attached to a patient. If so, the fee assigned to the patient is used.
If there is no fee schedule specified for the patient, the standard fee schedule specified in the Financial section of the Practice Data Entry window is used.

Creating a New Schedule

You can select, copy, and rename an existing schedule and make changes, or you can create a new fee schedule and manually add codes and fees.

To copy an existing schedule:

Select Tables > Procedure > Fee/Allow Schedules. The existing Fee/Allowable Schedules are displayed.
Use the Search field to find and select the schedule you want to copy. The properties of that schedule are displayed in the Actions panel.

You cannot change the type of schedule (fee or allowable) when you copy it.

Click the %Update button. The Update [Name of Schedule] window is displayed.
In the Save As Criteria section, select Make a copy.
In the Save As Name field, enter the name of the schedule you are creating.
To adjust the Percentage of Original Fees, enter a percent in the Factor % field. All fees copied from the existing schedule will automatically be adjusted to the entered percentage.
Select a Rounding Option for the newly-calculated fees: Do Not Round or Round to the Nearest Dollar.
Click Ok. The new schedule is added to the list and available for selection.

The ID number is assigned automatically.

To add a new fee schedule:

Select Tables > Procedure > Fee/Allow Schedules. The existing Fee/Allowable Schedules are displayed.
Click New.
In the Name field, type a name or description of the new schedule.
The ID number is assigned automatically.

In the Type field, select Fee Schedule.
Use the Procedure Category to Display list to select the first procedure category for which you want to enter fees. A list of procedure codes is displayed. All procedures are gray.
For each procedure in the category, type the appropriate fee in the Fee column. The procedure changes from gray to blue.
To set a fee back to $.00, click and drag the procedure to the trash can. The procedure is set to $.00 and turns gray. You can type $0.00 to turn the procedure blue. The procedure and the zero fee are then displayed on the printed fee schedule. Gray items are excluded from the printed list.

Repeat steps 5 and 6 for the next category. Each time you select a new category, you are prompted to save your changes.
Click Ok.