Track Out-of-Network Insurance Estimates with Blue Book Fee Schedules

If you are out of network with certain insurance carriers, you may still want to track estimated insurance amounts to give your patients accurate estimates. 

Archy offers a way to track these "Blue Book" fees for out-of-network carriers. 

When Blue Book fees are applied to a patient's insurance plan, any coverage percentages will be ignored when that Blue Book is used to calculate estimates. The insurance estimate will be the amount set on the Blue Book, and the patient estimate will be the Practice UCR minus the Blue Book amount. For Blue Book fees to apply, the treating provider must be associated with the Blue Book.

Follow these steps to set up a Blue Book fee schedule in Archy:

Go to Settings.

Select Insurance.

Click Fee Schedules.

Click the Blue plus icon next to Fee Schedules to add a new Blue Book.

Name the Blue Book fee schedule.

Choose Blue Book as the schedule type.

Attach providers who’ll use this Blue Book.

Add the relevant insurance carriers from the drop-down.

Set the Effective Date for your Blue Book.

Scroll down to see different fee categories.

Enter the amounts that insurance carriers are estimated to cover under the New Fee column.

These fee amounts should come from past EOBs (Explanation of Benefits) where you notice trends in what insurance typically reimburses for each procedure or service.

Once all Blue Book fees are entered, click Save.

Find your new Blue Book fee schedule listed with your others.

Now the Blue Book can be assigned to patient insurance plans just like any fee schedule. Estimates use the fees you just entered—making patient estimates clear and reliable.

Creating Blue Book fee schedules helps your practice give out-of-network patients the transparency they need.