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Overview

Charge Capture & Fee Schedules manages the billing lifecycle for clinical encounters. It translates clinical documentation into billable charges using AHCCCS-compliant timed-code calculation and auto-modifier assignment.
  • Charges: Sidebar → Practice Management → Revenue Cycle → Charges (/pm/charges)
  • Fee Schedules: Sidebar → Practice Management → Revenue Cycle → Fee Schedules (/pm/fee-schedules)

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Key Features

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Charge Capture

  1. Create Charge: Click “New Charge” → select Patient, Provider, CPT code, Place of Service, and service date.
  2. Auto-Unit Calculation: Enter duration in minutes; units auto-calculate per AHCCCS 15-minute increment rules (≥8 min = 1 unit, 23–37 min = 2 units, etc.).
  3. Auto-Modifier Assignment: Check applicable encounter context boxes (Group, Telehealth, Family, Court-Ordered) to auto-populate BH modifiers (HQ, 95, FQ, HR/HS, H9, CG).
  4. Rate Lookup: If a fee schedule is selected, the rate auto-fills from matching entries.
  5. Status Workflow: Pending → Reviewed → Approved → Billed. Void available from any non-terminal state.
  6. Approval: Transitioning to “Approved” requires the pm.charges.approve permission.

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Fee Schedules

  1. Create Fee Schedule: Click “New Fee Schedule” → enter name, effective date, optional payer and end date.
  2. Add Rate Entries: Navigate to a fee schedule detail page → add CPT code, modifier (optional), rate, and effective date.
  3. Deactivate: Soft-delete via the trash icon; existing charges are unaffected.

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Permissions

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AHCCCS Timed Code Rules

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Integration Points

  • CL-04 → PM-07: clinical_note_finalized event triggers charge creation.
  • PM-07 → PM-08: Approved charges feed into claim generation.
  • Event: charge_status_changed published on status transitions.