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Kareo Help Center

About Contracts and Fees

Healthcare providers keep track of the procedures they perform, and associated fees for those procedures, through fee schedules. Fee schedules can be divided into two different categories: Standard Fees and Contract Rates.

Though most practices bill out claims utilizing a standard fee schedule, Kareo also provides an option to bill by contract rates. It is important to note that there are laws and terms within payer contracts that govern what practices can bill individual payers, especially if billing Medicare. Be sure to confirm with your payers regarding rules and restrictions before submitting by contract rates.

Standard Fees

These are typically the default charges for the practice. Many consider it a best practice to always bill out based on the practice's standard fee schedule and make adjustments after reimbursement from the payer. Standard fee schedules typically contain fees that are higher than the contract rates for the same procedures.

Get started by adding a standard fee.

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Contract Rates

Used to track a pre-negotiated or capitated fee schedules associated with a contract between a health care provider and a government payer or an insurance company. It's important for the practice to import contract rate schedules so they can be referenced when receiving reimbursement from a payer.

Get started by adding a contract rate.

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