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How Do I Choose the Correct Fee Schedule?

DaisyBill’s Calculator is comprised of six separate Fee Schedules and five separate Calculators. Each Calculator references specific Fee Schedule or Fee Schedules. Choosing the correct Calculator is vital to ensuring accurate reimbursements.

Physician Services Calculator

To use the Physician Services Calculator to calculate reimbursements for Physician Services, follow these instructions.

Pharmacy (Single Prescription) Calculator

To use the Pharmacy Calculator to calculate Pharmacy (Single Prescription) reimbursement and dispensing fees, follow these instructions.

Pharmacy (Compound Pharmaceuticals) Calculator

The Pharmacy Fee schedule can be looked up using the California DWC Workers' Compensation Pharmacy Fee Schedule - Compound Prescription. However, whereas the DWC calculator does not provide historical reimbursement information, DaisyBill’s Calculator does.

Pathology Calculator

To use the Pathology Calculator to calculate Pathology reimbursements, follow these instructions.

DMEPOS Calculator

To use the DMEPOS Calculator to calculate durable medical equipment prosthetics, orthotics and supplies (DMEPOS) reimbursements, follow these instructions.

Copy Service Calculator

To use the Copy Service Calculator to calculate reimbursements for Copy Services, follow these instructions.

Physician Services - Dispensed Drugs

Per § 9789.13.3. Physician-Dispensed Drugs the maximum reimbursement for physician-dispensed drugs is determined by the Pharmaceutical Fee Schedule found in § 9789.40. Pharmacy.

Calculator Results Explained

The California Official Medical Fee Schedule (OMFS) Calculator instantly provides the correct reimbursement for a Bill based on Date of Service.

Physicians Services OMFS Calculations Explained

Calculating OMFS reimbursement is a complex process that involves multiple tables, formulas and Billing Ground Rules. The OMFS Calculator considers all these factors.

Physicians Services Detailed Explanation Explained

A Detailed Explanation is provided for each Procedure Code entered. The Detailed Explanation provides information about the calculation factors DaisyBill uses to determine OMFS reimbursement.

Physician Services NCCI Edits

If a Procedure Code or combination of Procedure Codes violates NCCI edits, a $0 OMFS reimbursement will display. View the CCI Edits section of the Procedure Code’s Detailed Information for specifics about the NCCI violation.

BR - Reimbursement for Procedure Codes Designated as 'By Report' Explained

The display of ‘BR’ in the OMFS reimbursement field indicates that the reimbursement amount for the Procedure Code is determined ‘By Report’ (BR).

California Explanation of Fee Schedule (EOFS)

The California Explanation of Fee Schedule (EOFS) contains a summary of the reimbursement and a Detailed Explanation for each Procedure Code entered.

Wizard Subscription Manage Users Explained

Invite your team to use the Wizard from the Manage Users page.

Billing and Invoices Explained

Update Billing Information, view Invoice History, or cancel your Wizard subscription from the Billing and Invoices page.

Multiple Calculations

Use the Multiple Bills feature to calculate the reimbursement for several bills at once.  Calculate across multiple Fee Schedules and Dates of Service.  View and print a Detailed Explanation for each bill in addition to a handy summary of all bills.

Outpatient ASC Calculator

To use the Outpatient ASC Calculator to calculate reimbursements for outpatient hospital and Ambulatory Surgical Center (ASC) facility reimbursement, follow these instructions.

Outpatient ASC Detailed Explanation Explained

A Detailed Explanation is provided for each Procedure Code entered. The Detailed Explanation provides information about the calculation factors DaisyBill uses to determine OMFS reimbursement.