Set Up an Activity Code Service Rate Override for an Insurance Payer

Path: Maintenance and Setup > Activity Codes > Activity Codes

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When setting up an Activity Code's service rates, the information is set at the Party Type level (see Set Up an Activity Code for more detail). Sometimes it may be necessary to set a different service rate for a specific Insurance Payer.

Service Rate Override for an Insurance Payer

  1. Navigate to the Master Activity Code List by following the path above.
  2. Select an Activity Code.
  3. Click the Srv Rate button. The Activity Code Rate List for Services is displayed and lists all the Disciplines associated with the Activity Code you've selected.
  4. Select a Discipline Code.
  5. Click the Override By Ins button.

  1. Click the Ok button.

  1. In the Activity Code Service Rate Override By Ins Form, click the Add button. The Activity Code, Agency ID, and Discipline will pre-populate based on what you selected in the previous steps.
  2. Select the Insurance from the drop-down menu that the service rate override is for.
  3. Enter the Rate ($). This is the override value.
  4. (Optional) Add Effective From and Effective to dates. If left blank, the system assumes this is active.
  5. Select the Allow Service For This Discipline? checkbox.
  6. Click the Save button.

Note: To view the Activity Code Service Rate Override By Insurance List, click the Override List button after saving your record.