S e c t i o n s

Using MPM's Reimbursement Manager

Getting Started

1. Double click on Reimbursement Manager icon.
2. Double click on desired client. Entering

Expected Reimbursements
Expected Payments can be entered by carrier or by carrier plan. There are four possible methods for calculating payments:

• Fee Schedule by CPT-Enter specific fees per CPT code.
• Percentage of Charge Amount-Enter percent of charge amount
• Reimbursement Per Base Unit-Enter dollars per unit.
• Reimbursement Per RVU-Enter dollars per RVU.

1. Click on the Run button.
2. Enter either carrier or carrier plan. (Carrier plans are specific carriers while carrier ID represent a group of carrier plans. For instance, if there is one fee schedule for Aetna, it would be entered under the Aetna carrier ID instead of under the individual Aetna carrier plans.) The Scan feature is available here to look up carrier or carrier plan numbers. (To scan either double click in the field or press the F2 Key.)
3. Select one of the four methods for calculating payments. You will be required to enter an effective start date. If fee schedule method is selected the fee schedule screen will appear. Enter CPT codes and expected payments. When complete click on the Save button.
4. For other methods, enter the percent or dollar amount. Click on OK to return to the Reimbursement Manager Home screen.
    

Reimbursement Manager Home Screen

Expected Payment Screen

Fee Schedule by CPT Code Screen

Getting Appeals

1. From the Reimbursement Manager Home screen, select Appeal Letter Requests. Click on the Run button.
2. All payments that updated since the last appeal letter run will be displayed.
3. Review each payment to ensure there are no extenuating circumstances (modifiers, deductibles, etc.) that may result in a legitimate variance from the anticipated payment. Delete any payments that fall into this category.
4. Highlight all legitimate underpayments and click on the Print Appeal Letters button. Appeal letters will print for each underpayment. A message indicating that an appeal is being sent will be placed on the patient account. Once the appeal letter is generated the underpayment will be removed from the list.
5. When finished click on the Exit button.
    

Appeals Letter Screen