We have been using the production report by ADA code for over a year. We are unsure as to where the figures are generated for the Group UCR Amount and the Provider UCR amount. Can you explain what fields are used to determine these amounts? Is there something in the set-up of the program that is used to determine the UCR amount?
In some of the ADA code reports, some of the UCR amount are close/equal to the Provider/Group Amount. However, in other ADA code sections, there is a BIG difference in the 2 to 4 columns.
Any helps will be greatly appreciated.
I saw this posted from July 2017. However, I need further explanation of the fields mentioned in my original request. The information provided for the UCR fields do not say what figures are used to arrive at the reported numbers. We have tried to analyze factors that could cause the differences, but since some production code groups do not vary at all and some do, we are not understanding what figures are used for the UCR amounts.
Some of the discrepancies may be because the office has either "changed" the fee for that ADA code, or may have zero'd out the fee for that code. Also, if you had a fee increase during the given year that may account for some as well.
When using this report the UCR amounts are your office fees per service in your computer. For example D2752 for our office is $995.00 When I pull up the report for today it reads
Fee: $995.00 Prov QTY: 1 Prov AMT: $612 (BC we adjusted a patient's cost)
Prov UCR Amt: $995.00 (our office fee)
So in this specific case the UCR is your office fee but the Provider amt is different because we charged out a different fee. The UCR will always be the production from the procedure codes at you office's full price. If the Provider amount is less or more it is because you may have charged less or more on a patient.
You can always pull up a transactions report for a specific time to see specifically what charges were charged per patient during a specified time.