Provider Module

Card Set Information

Provider Module
2014-06-07 23:32:14
Provider Module
Provider Module
Provider Module
Show Answers:

  1. Fee Tables are used to...
    Fee tables module is used to create, modify and maintain fee schedules for use within QNXT system.

    The Fee Tables module allows many of the components that providers can include in their contract can be defined, such as the use of Usual, Customary and Reasonable (UCR) fee schedules and unique custom fee schedules.
  2. What modules are Fee Tables generally attached?
    Fee tables hold numerous fee schedules that can be attached to a program or a contract.
  3. How is the Usual, Customary and Reasonable (UCR) table used?
    A UCR is the prevailing fee charged for a specified healthcare service in a specified geographical area.
  4. What code types can be used in UCR table?
    CDT, CPT, Revenue, Long Term Care, NDC, HHPPS and RUGS.
  5. What is a custom fee table used for?
    A custom fee table is a schedule of negotiated rates for services that are not UCR or Resource Based Relative Value Scale (RBRVS) and is used for pricing claims for different types of services.
  6. What is RBRVs?
    Resource Base Relative Value Scale (RBRVS) was to reimburse physician fees based on time and resources expended in treating patients.