Rate monitoring
Know the month a payer moves your rate.
Payers republish their rate files every month, and a rate can change without a letter. On the 1st of each month we re-read every payer on your fee schedule and email you what moved: the code, the payer, was, now and the change.
On every paid plan, from $99/month · cancel anytime
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Why it matters
A small cut on a busy code adds up quietly.
Rates don’t only change at renewal. An amendment, an annual update, or a contract that follows another schedule can move a rate in any month, and the notice, if there is one, is easy to miss.
A few dollars off an established-patient visit doesn’t look like much on one claim. Across every claim for that code, every month until someone notices, it does.
Then the renewal letter arrives saying rates are unchanged. Without a record, there’s no way to know whether that’s true, or for how long.
How it works
Nothing to remember. It runs every month.
- 01
Your fee schedule is the baseline
Every rate on it is stored with the month of the file it came from. Fee schedule →
- 02
Re-read on the 1st, automatically
At the start of each month we re-read every payer on every one of your fee schedules and compare each rate with the last one. Need it sooner? Refresh a schedule and it’s re-read straight away.
- 03
An email when something moved
If a rate changed, everyone on your team with rate-update emails on gets the list: code, payer, was, now and the change. If nothing moved, nothing arrives.
- 04
Every change, kept
The Monitoring view lists every rate that moved across your fee schedules, newest first, with how many went down, up or stayed the same. On your fee schedule the new rate shows with its change beside it, and each rate keeps its history.
What you get
What moved, by how much, and where.
This month’s re-read of your fee schedule found 3 rates that moved.
| Code | Payer | Was | Now | Change |
|---|---|---|---|---|
| 99214 | Payer C | $131.50 | $127.20 | −$4.30 |
| 99213 | Payer C | $92.40 | $88.40 | −$4.00 |
| 99396 | Payer A | $168.00 | $171.25 | +$3.25 |
The same table arrives by email after each monthly re-read when a rate moved, and every change stays in the rate’s history in the app.
Putting it to use
Two things to do with a change.
Check you’re being allowed the new rate. Run an underpayment check on the following months’ allowed amounts: a payer that published a higher rate but still allows the old one shows up as a gap.
Take the history to your next contract conversation. You can show exactly which codes moved, when, and which haven’t moved since you started tracking them, from the payer’s own published files. On the Group plan, the renegotiation packet puts it next to your other payers and Medicare.
Honest limits
A monthly record, on purpose.
This watches what each payer publishes for you, month over month. It isn’t continuous claim monitoring, and we don’t pretend it is. A brand-new fee schedule has nothing to compare against until its first re-read. When a payer publishes several office rates for a code and its file doesn’t say which applies, changes to that code aren’t tracked yet; the rates are still on your sheet.
Questions
Rate monitoring, answered.
How often are my rates checked?
Every payer on your fee schedule is re-read on the 1st of each month, automatically. You can also refresh a schedule any time to re-read it straight away.
Who gets the email?
Everyone on your team who has rate-update emails switched on. It lists each rate that moved, with the code, the payer, the old rate, the new rate and the change. If nothing moved, there is no email.
Does it watch my claims?
No. It watches the rates each payer publishes for you. To check what you were actually allowed against those rates, use the underpayment check.
Why would a payer change my rate without telling me?
Payers republish their rate files every month. A rate can move because of an amendment, an annual update, or a contract that follows another fee schedule, such as a percentage of Medicare. The notice, if there is one, is easy to miss.
Is anything not tracked?
When a payer publishes more than one office rate for a code and its file doesn’t say which applies, changes to that code aren’t tracked yet. The rates are still on your fee schedule. A brand-new schedule has nothing to compare against until its first re-read.
What does it cost?
Rate monitoring is on every paid plan. The Practice plan is $99 a month and includes your fee schedule and underpayment checks. Cancel anytime.
Stop finding out at renewal.
Rate monitoring is on every paid plan, from $99 a month, with your fee schedule and underpayment checks. Cancel anytime.