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Report / Edit / Delete Discount Contract
When provider contracts result in discounts below the Official Medical Fee Schedule (OMFS) use Discount Contract track and report on them.
Recording Discount Contracts lets you:
- See which claims administrators/employers are utilizing which contracts
- Confirm contracts are being applied correctly
- Report on the number of bills subject to contracts
Here’s how to add, edit, or delete Discount Contracts.
Step 1. From the Bill Page, review ‘% OMFS Allowed’ for ‘Procedure Code’, then determine if reimbursement was discounted due to a pre-existing contract
For each procedure code reimbursement, DaisyBill calculates ‘% OMFS Allowed’ which is ‘Total Allowed’ reimbursement divided by the ‘Expected’ reimbursement.
Step 2. To add a ‘Discount Contract’, click the ‘Scissors’ icon in the ‘Bill Payments’ section
Step 3. In the ‘Report Discount Contract’ modal, enter ‘% OMFS Allowed’
When determining if reimbursement is discounted due to a pre-existing contract, remember E/M codes may be downcoded and procedure codes may be subject to cascading reductions.
Step 4. Review the EOR to determine the Contract Name applied
California state regulations require that the name of the contract be listed on the paper EOR.
Step 5. Choose the correct ‘Contract Name’, and click ‘Report Contract’
If you don’t see the Contract Name as it appears on the EOR, chat us in the Help Center.
Step 6. To Edit a ‘Discount Contract’, find the contract in the ‘Bill Payments’ section on the Bill Page, then click the ‘Pencil’ icon
Step 7. Update the information, then click ‘Update Contract’
Step 8. To delete a ‘Discount Contract’: click the ‘Trashcan’ icon