Configuring Payor Rules
Payor or service rules are identifiers used to highlight something about a service when charting.
For example: If a patient is on a dental care plan where they receive 2 free exams per year, an identifier can be displayed to notify you when the patients allowance has been reached.
Configuring payor rules
In this example we will configure a service to allow 2 of a service in a set time before displaying a red X to identify the limit has been reached.
- Log into EXACT as a superuser or admin user.
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Click on file - payors.
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Select the required payor.
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Click fee schedule (if this option is unavailable, the payor is likely using the fees of another configured payor, you will need to set the rule for that payor).
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Locate the service code and double-click to edit.
- Select the add rule option.
- Choose the required option for the you wish to create (in this instance we are using test service by time).
- The rule will now be added to the service.
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- Double-click the rule to add configuration to your rule.
- Add the service code in the service area, you can use the selection button to choose from all your available services.
- Set how many times the service is allowed within the time frame.
- Set the time frame using the drop-down menu and number field.
- This will now be set on the rule.
- You can now set the symbol to be shown.
- Setting the option on the left will display the icon/s when the rules are met.
- Setting the option on the left will display an icon/s when the rules are not yet met.
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