Updating a Payer's Fees/Required Credentials/Modifiers

If the requirements or fee schedule from a payer changes, you will want to update your rates in Aloha.  This also applies if you decide to raise your charge rates as an organization.  

1.  Go to the Payer   section and select the Payer who's rates you would like to change.

2.  Click on Services to view all the services under that Payer.

3.  Click the  button for a particular service.

4.  Click the button in the top right corner of the service.

5.  You will see a new set of rates and requirements drop down.  Fill this out with new charge rate, contract rate, required credential, diagnostic code, billing code and modifiers. 

6.  There will be an option at the top to put an "Effective Date".  This cannot begin before any completed appointments in the schedule so it is recommended to choose a future date.

If you need to retroactively update rates for completed appointments that have not yet been billed, please contact support@alohaaba.com. 

As always, if you have any questions, please contact your CSM or support@alohaaba.com. 

• Related Articles

• Billing Rules per Payer

  Aloha gives you the flexibility to customize billing rules to fit your organization’s workflows and preferences. However, it’s important to remember that each payer has its own specific billing and documentation requirements. We recommend reviewing ...

• Preparing for Aloha's Insurance Billing Services

  Before you meet your assigned RCM manager from the Aloha Billing team, please complete the following steps: Required Steps to ensure accurate billing: Review the status of your payers on Office Ally or Availity and verify if they are ...

• FAQ: Billing

  These frequently asked questions will help provide guidance as you troubleshoot through the billing section of Aloha. I settled a claim, but then ended up getting paid for it. How can I unsettle? Start by going to Billing > AR manager and double ...

• Staff/Client/Payer Management Overview

  Setting up Payers Pay close attention to this section, this will determine the methods and rates to bill each payer. You will have a few choices when adding a new payer and they are Insurance, Regional Center, School and other payers. Please make ...

• Secondary Billing in AlohaABA

  As of 7/3/24, our Secondary Billing feature will exclusively support Office Ally as the selected clearinghouse at this time. Secondary Billing cannot be completed with an Availity integration. As this feature is newly released, we recommend ...