Using Guideline Pricing to set up your Pricing Matrix
Take a bit of time to save lots of time and effort in the future. Setting up your Pricing Matrix means your charges can be automatically entered when you raise invoices by clicking the calculator icon next to the fee box. You can easily set up price lists for all your payors and even set different fees for your locations.
Click Accounting on the left-hand menu and then click Guideline Pricing. The Guideline Pricing grid will display with columns for “Self Pay” and “All Other” already available. If you want to charge most payors the same you can use the All Other column.
Adding new payors
Click Manage Payors either at the bottom right of the screen or the top left of the grid. The Manage Payors screen will open and you’ll see “All Other” and “Self Pay” at the top of the pane as Selected Payors.
Click the drop-down menu under Select Payor Type to select from the available options – these are the same ones as used for your Contacts (more information on this can be found here).
To add an insurer, you’ll see that the Insurer option is at the top of the list with the rest in alphabetical order. Click on Insurer and an alphabetical list will appear in the Select Payors section at the bottom of the pane. This is split into two – the insurers at the top accept electronic invoices using the Clearing Service with the rest appearing below these. Then follow these steps – these stay the same whatever payor type you’ve chosen:
- Click on the required payor
- Click on the + symbol on the right-hand side of the Select Payors bar
- The payor will appear in the top Selected Payors list
- Click Save
Adding your services – all professions
You now need to add the items you want to invoice for. You can do this all in one go or start with the ones you require more often adding the rest as you come across them. You may find that some “Services” are already pre-populated on the left-hand side of your grid.
Click Manage Services either at the bottom right of the screen or the top left of the grid. The Manage Services screen will open – just follow these steps.
- At the top of the pane, enter a code (if you know it) or a description to search for a service e.g. consultation, physiotherapy, counselling etc
- A Services box will open listing all the options – simply scroll through to find the correct one
- Click it to add to the list
- Click Save to return to your grid or repeat to add more services
Adding procedures – surgeons and anaesthetists
If you’re a surgeon or anaesthetist before you can add any procedures you must first add the code for “Surgeons Fee For Surgery” or “Anaesthetists Fee For Surgery”. Follow the steps above and type “surgeon” or “anaesthetist” into the search box and choose the relevant option. Once this is in your list, you’ll see there is an option to Add Procedures/Treatments.
- Click Add Procedures/Treatments
- A list of suggested procedures will open in a new box based on your specialty
- Scroll through ticking the ones you want to add – you can also use the search option at the bottom of the pane to search for a specific procedure
- Click OK
- The selected procedures/treatments will now appear on the right-hand side of the Manage Services pane
- Click Save to return to your grid or repeat
Adding your fees
Your grid will now be larger from top to bottom and left to right. There’s a fee box for each service under each payor. Click on Add/Edit Fee for each one. The Add/Edit Fee screen will open and you should add the price you want to charge. You also have the option to tick the box “Vary Fee By Treatment Site”, if you don’t charge the same everywhere. This will show all the locations where you see patients and you should enter the different fees charged for each site.
Once you’ve entered your fee click Save.
Editing your fees
Click on Add/Edit Fee for the service and payor you want to edit. Make amendments and click Save.
Depending on your current recognition status with Vitality you may either see the usual Add/Edit Fee in their column, in which case you proceed as above, or Set Fee if they want to validate the procedure code for your profession/specialty.
- Click Set Fee
- A message will pop up giving you a guideline range of fees typically charged by other recognised practitioners for this service – this message is provided and maintained by Vitality
- Type your fee in the Agreed Fee box – this must be the maximum you’ll charge
- If you work at multiple treatment sites there’s an option to charge different rates at each one – if this is required tick the box next to Vary Fee By Treatment Site
- A list of where you see patients will appear in the Location pane
- Add your fee for each one – this mustn’t be higher than your stated Agreed Fee
- If you’ve entered a fee higher than the guidelines suggested you’ll be shown a further message from Vitality and will need to change the fee you’ve entered
- Click Save
- The fee will be added to the pricing matrix – the only option to Edit Fee will be to change the fees you’ve set at various treatment sites
- Continue setting fees for your other procedures and services
Removing a payor
If you’ve added a payor in error or simply wish to use the “All Other” option going forward rather than list the same prices multiple times, it’s easy to remove it. If you’d added any fees these will be lost once you’ve deleted the payor.
- Click Manage Payors at the bottom right of the screen or the top left of the grid
- Highlight the payor you want to remove from the top Selected Payors list
- Click the x symbol on the right-hand side of the Selected Payors bar
- Click Save
Want more support?
Our Service Delivery Associates at the Healthcode Academy offer practical and relevant modular 1-2-1 training on ePractice functionality. Want to know more about the settings available in ePractice and how to configure it for you? Then Electronic billing & collection | Module 1 (30 minutes) is for you. For those who just want to focus on creating your Pricing Matrix we offer a 15-minute bite-size option – you’ll need module 1C.