What is a fee schedule?
A fee schedule is the group’s price list: what the practice charges for each service. Set it once, and it fills in the price on every claim you make.
Each line is two things: a code, which names the service, and an amount, which is the price. The list also carries an effective date, the day those prices start.
This is why you never type dollars on a claim. You pick the code, and the price fills itself in from the group’s list. If you do type over a price, the line is marked as overridden, so a reviewer always knows a human changed it and it was not a silent edit.
Two things follow from having a real price list, and both are money:
- New claims price themselves. A group with no fee schedule makes a person type every amount, which is slow and wrong more often.
- Underpayments become visible. A shortfall can only be flagged where a contracted rate is loaded. See How do I know if a payer underpaid me?.
Every price list starts as a draft. A draft prices no claim until you commit it, whichever way you built it. That is deliberate: it gives you a review step between “these are the numbers somebody handed me” and “these are the numbers going out on real claims.”