Customer detail

PAA

live contracts

cannot fire

calc types

SQL bodies

of those blocked

map conflicts

Methodology mix

SqlExpression39

FlatPercentOfCharges4

Contracts

Each is one fee logic. Base terms are first-match-wins; adjustments all apply, in order. Expand to see the terms.

AARP1 base · 0 adj

AARP
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

APWU1 base · 0 adj

APWU
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

Aetna1 base · 0 adj

Aetna
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

Aetna Mail Handlers1 base · 0 adj

Aetna Mail Handlers
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

Aetna Medicaid1 base · 0 adj

Aetna Medicaid
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

Aetna Medicare1 base · 0 adj

Aetna Medicare
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

BCBS NC1 base · 0 adj

BCBS NC
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — ASC/office anesthesia-aware fee-schedule lookup that special-cases CRNA-staffed sites and a facility's default-POS-24 override for endoscopy codes, doubling the per-unit anesthesia rate for CRNA claims.

BCBS NC Medicare1 base · 0 adj

BCBS NC Medicare
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

BrightHealth1 base · 0 adj

BrightHealth
Professional · 46 named facilities · 2021-01-01 → 2099-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

Charges1 base · 0 adj

Charges
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Facility chargemaster unit price (ASC vs. non-ASC rate) for a charge, times billed units, as of the service date.

Cigna1 base · 0 adj

Cigna
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia-style fee-schedule lookup (facility/insurance/procedure/modifier) that pays double the schedule amount for CRNA-eligible facilities or non-office-based sites, otherwise single amount, times units.

Cigna Healthspring Medicare1 base · 0 adj

Cigna Healthspring Medicare
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

Cosmetic1 base · 0 adj

Cosmetic
Professional · all facilities · 2026-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — A flat 'cosmetic fee' amount selected purely by service date and units-quantity band — no procedure-code check in the SQL itself, so correctness depends on the FeeLogic only routing the intended charge type to this expression.

Coventry1 base · 0 adj

Coventry
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

Coventry Medicare1 base · 0 adj

Coventry Medicare
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

First Carolina Care1 base · 0 adj

First Carolina Care, MedCost
Professional · 2 named facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

GEHA1 base · 0 adj

GEHA
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

100% of billed charges

Humana1 base · 0 adj

Humana
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

Humana Medicare1 base · 0 adj

Humana Medicare
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

MedCost1 base · 0 adj

First Carolina Care, MedCost
Professional · 92 named facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

Medicaid NC1 base · 0 adj

Medicaid NC
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

Medicaid SC1 base · 0 adj

Medicaid SC
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

Medicare1 base · 0 adj

Medicare
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

Medicare NC Supplement1 base · 0 adj

Medicare NC Supplement
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

Meritain1 base · 0 adj

Meritain
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

Molina1 base · 0 adj

Molina
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

NALC1 base · 0 adj

NALC
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

Novant1 base · 0 adj

Novant
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

PAA Default1 base · 0 adj

PAA Default
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

100% of billed charges

Self Pay2 base · 0 adj

Self Pay
Professional · 64 named facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

Self Pay Mobile1 base · 0 adj

Self Pay
Professional · 31 named facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Self-pay mobile-imaging rate: a facility-specific base rate plus an additional per-15-minute-increment rate applied to billed time units.

St. Jude1 base · 0 adj

St. Jude
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

Tricare East1 base · 0 adj

Tricare East
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

Tricare For Life1 base · 0 adj

Tricare For Life
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

UHC-Mobile (WAA)1 base · 0 adj

UHC-Mobile (WAA)
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Plain per-unit fee-schedule lookup by procedure/insurance/facility-type/modifier, times units -- no multiplier applied.

UMR1 base · 0 adj

United Healthcare
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

USAA1 base · 0 adj

USAA
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

United Health One1 base · 0 adj

United Health One
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

100% of billed charges

United Healthcare1 base · 0 adj

United Healthcare
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

United Healthcare Medicare1 base · 0 adj

United Healthcare Medicare
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

Veterans Administration1 base · 0 adj

Veterans Administration
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.

Workers Comp NC1 base · 0 adj

Workers Comp NC
Professional · all facilities · 2021-01-01 → 2999-12-31

Base terms — first match wins

custom SQL — Anesthesia fee-schedule lookup with a CRNA doubling rule: looks up a base fee from the customer's fee schedule by code/insurance/facility-type/modifier/date, then doubles it (x{Units}x2 instead of x{Units}) when the facility is flagged as a CRNA site and the matched schedule entry is itself flagged as an anesthesia line.