Fee Schedule Development and Management

FEE SCHEDULE FOR HEALTHCARE PROVIDERS

Align Your Charges with You Expertise–Transparent & Competitive Fee Schedules for Maximum Reimbursement

Have you ever wondered if you are being UNDERPAID because your FEE SCHEDULE is not created according to healthcare guidelines and demographic localities?

Understanding your fee schedule is essential for maintaining a financially healthy practice. Our comprehensive fee schedule services provide custom fee schedule to each provider according to their specialty.  We assist providers in setting competitive, compliant, and profitable rates, ensuring proper reimbursement from commercial insurers and government payers.

Fee Schedule Creation and Management Services Irving TX

Our Fee Schedule Services Includes:

  1. Custom Fee Schedule Creation
  • Custom Fee Schedules: We work closely with you to develop a fee schedule that reflects your practice’s unique needs, payer contracts, and industry standards. We ensure that the schedule supports both the operational goals of your practice and the reimbursement policies of your insurers.
  • Payer Contract Alignment: Our team ensures that your fee schedule is aligned with the terms of your payer agreements, including insurance companies, Medicaid, Medicare, and other third-party payers.
  1. Fee Schedule Maintenance
  • Regular Updates: Healthcare reimbursement rates change frequently, and so do the requirements set by payers. We help keep your fee schedule up to date with regular reviews, ensuring it remains aligned with current regulations, market trends, and payer contracts.
  • Rate Adjustments: As your practice grows and evolves, we assist with necessary adjustments to your fee schedule to maintain competitive and accurate pricing for your services.
  1. Compliance Assurance
  • Regulatory Compliance: We ensure your fee schedule complies with all federal, state, and payer-specific regulations, including those related to Medicare, Medicaid, and commercial insurers. This helps to avoid compliance issues and penalties.
  • Payer-Specific Guidelines: Our team updates payer policies regularly and ensures that your fee schedule complies with specific payer guidelines, reducing the chances of claim rejections or underpayments.
  1. Fee Schedule Audits
  • Audit and Analysis: We perform regular audits of your existing fee schedule to identify potential gaps, inconsistencies, or opportunities for improvement. Our team ensures that your schedule is optimized for maximum revenue.
  • Optimization Recommendations: After reviewing your fee schedule, we provide actionable recommendations to optimize pricing for services, ensuring your practice is maximizing its reimbursement potential.
  1. Fee Schedule Implementation
  • Seamless Integration: We help integrate your updated fee schedule into your practice management system (PMS) or electronic health record (EHR) to streamline billing and coding processes. This ensures accurate pricing for all services provided.
  • Training and Support: We provide training and ongoing support for your administrative team to ensure that they are fully equipped to manage and implement the new fee schedule effectively.

Our Process: From Discovery to Delivery

  • Discovery Call & Data Collection: Gather existing fee schedules, payor contracts, and service utilization reports.
  • Analysis & Recommendations: Deliver a detailed report outlining suggested rate changes, projected revenue impact, and implementation plan.
  • Implementation & Training: Coordinate with your IT/billing teams to update systems; conduct staff training sessions.
  • Ongoing Support & Review: Provide scheduled audits, regulatory updates, and ad-hoc consulting whenever payor agreements change.

Why Choose CMM:

  • Decades of Specialized Expertise: Our team has decades of experience in fee-schedule optimization for practices of all sizes
  • Data-Driven Approach: We leverage leading industry tools e.g. CMS, Availity, Medicaid, BCBS for precise fee schedule development.
  • Customized Solutions: Whether you’re a single‐provider clinic or a multi‐specialty group, we tailor our services to your volume, specialty mix, and payor landscape.
  • Transparent Pricing: Our a la carte model lets you pick only the services you need –  no hidden fees or long-term lock-ins.

Contact Us and let us help you create a strategic fee schedule that boosts your revenue while staying compliant.