Add or Edit Schedule Data in a Provider Specialty Percentage Lookup Table

The Edit Schedule page allows you to define the rate schedule associated with a particular provider specialty percentage lookup table. You can select specific provider type or specialty, depending on the type of lookup table, and then define a reimbursement percentage.

The provider type percentage lets you define reimbursement for a specific type of provider. For example, the provider type “Certified Clinical Nurse Specialist” might reimburse at a different rate than “Nurse Practitioner.” Provider type reimbursements are calculated as a percentage of the total reimbursement at the point that the reimbursement tool appears in the reimbursement calculation.

The specialty code percentage lets you reimbursement for specific areas of specialty. For example, “Cardiology” might reimburse at a different percentage than “Cardiac Surgery.” Provider specialty reimbursements are calculated as a percentage of the total reimbursement at the point that the reimbursement tool appears in the reimbursement calculation.

When you want to add data to a provider specialty percentage lookup table, you must add codes manually. You cannot import codes from another file.

  1. Access the Edit Schedule page.
    1. Select Go To > Contract Loading > Lookup Table Management. The Lookup Table Management page opens.
    2. Select Provider Specialty Percentage Lookup for the Table Type.
    3. Select Checked out by me for the Check Out Status, and then click Refresh View. A list of available tables appears.
    4. Click a link in the Table Name field of a table that is checked out to you. The Edit Lookup Table page opens.
    • Click the Edit Schedule link. The Edit Schedule page opens.
  2. Enter the code for the provider type or specialty in the Provider Type/Specialty Code field.
    • The lists of valid codes for provider type and specialty are maintained by FinThrive.
    • Valid codes for a particular lookup table are determined by the code type selected when the table was created. If you selected Provider Type, you can only enter provider type codes. If you selected Provider Specialty you can only enter specialty codes.
    • If you are unsure of the specific code, click Lookup Code Descriptions to select from a list of codes and then click Select Provider.
  3. Enter the percentage at which the provider type or specialty should be reimbursed in the Percentage field.
    • Enter the number value only, without the percent sign. For example, to enter 50%, type 50.
    • Valid percentages are not limited to 100%. For example, type 130 to reimburse at 130%.
  4. Click Add. The code description is added to the lookup table.
  5. Optionally, you can perform one of the following functions:
    • Click Clear to delete the data you entered and return each field to its default value.
    • Click Edit to change existing data, change the data in the Provider Type/Specialty Code and Percentage fields, and then click Update.
    • Click Edit, and then click Delete to delete an entry.

The following table describes the fields on the Edit Schedule page for Provider Specialty Percentage Lookup tables.

Field

Description

Description

The description of the provider type/specialty code

Edit

Link for editing an item

No.

Sequential reference number of the item

Percentage

The percentage at which this provider type/specialty code is reimbursed

Provider Type/Specialty Code

FinThrive code for provider type or specialty. The lists of valid codes are maintained by FinThrive. Whether this field accepts provider type codes or specialty codes is determined by the code type selected when the table was created.

Updated

Date, time and user information of when the lookup table was last updated
  • Lookup Table Management displays the Lookup Table Management page. For more information, refer to Manage Lookup Tables .
  • Edit Lookup Table displays the Edit Lookup Table page. For more information, refer to Edit a Lookup Table.