❗️You need to populate your Payors database before populating your billing code database. 

Building out your billing code database with your most frequently billed CPT codes is crucial. This enables you to associate billed amounts, payor details, and default modifiers with codes, streamlining transaction and claim processing. You can bill CPT codes that are not in the database, but it's highly recommended to create a robust database during setup.

Here's how to populate your billing codes database: 

1) Navigate to the profile icon in the top right corner and select Databases.

2) Then, navigate to the Billing Codes tab.

3) Click the +Add button. 

4) You can either use the Reference Code Finder to easily search for and select CPT codes or manually enter a New Clinic Billing Code. 

• If using the Reference Code Finder, simply click either the CPT or ICD option and search for and select your code. Click Link. 
• If entering a New Clinic Billing Code manually, select your code type and enter pertinent details. 

5) For CPT service codes, input the billed amount, default modifiers, and include payors along with their allowed amounts and default modifiers for the respective code. Once you've entered all details, click Add to add the code to your database. Repeat for your most frequently billed CPT codes!

💡Pro tip: 

It is important to add Payor-specific details to your service codes because this information will auto-populate and calculate in a patient purchase. 

Here is what you need to know about payor-details within the billing codes database. 

• Allowed amount: the amount used for payment estimation when both the service code and an insurance policy from this payor are applied to a purchase.
• Code: replace the service code with a different code entered in this field when the specified payor is the primary payor on a purchase.
  • example: in the settings for CPT code 97014, you can select specific payors (such as Medicare) to automatically replace 97014 with a different code (such as G0283). So, when 97014 is selected and Medicare is applied to the purchase, the code will update to G0283.
• Modifiers: a modifier that will populate with the service code when an insurance policy from this payor is applied to the purchase. 

 

6) Once you've built out your database, all codes will be listed. You can search for codes using the search bar, or you can edit codes by clicking them and then the lock icon to open editing.