How to Create a Sliding Scale Fee Structure

Looking to provide a sliding fee scale for your clients?

A sliding scale structure can be created by:

• Creating a Fee Program for each scale
• Creating a central billing template for all relevant services
• Setting a clients default fee program for the correct scale

We will go through the steps setting up a sliding scale for the following structure based on client income level:

Income	Individual Therapy Price
Less than $25,000	$50
Between $25,000 and $50,000	$75
Between $50,000 and $85,000	$100
Over $85,000	$125

Setting Up the Fee Programs

For each scale for your sliding scale we will need to

• Create a fee program for it
• Create service codes for the price point

Create the Fee Program

If you have not seen or used fee programs previously, they define what fees the client will pay.

For more information on fee programs, please see here

1. Navigate to Billing Setup->Fee Programs under Billing
2. Press Add on the right side of the screen

   

3. Enter the name of the scale in the name field (ex. 'Less than $25,000 Scale')

   

4. Select No Insurance under the type dropdown

   

5. Press Save

   

All other fields can be left blank

Repeat the above steps for each of the other scales

• Between $25,000 and $50,000 Scale
• Between $50,000 and $85,000 Scale
• Over $85,000 Scale

Next, we will create the appropriate service codes

Creating the Service Code

Service codes are the individual line items that appear on invoices

For each service code you can define:

• The price
• How it appears on the invoice (ex. Individual Therapy)
• Taxes that should be charged

Let's start with the Less than $25,000 Scale fee program we just created.

1. Click the three dots under the Actions column
2. Press Add on the right side of the screen
   
   
   
3. Enter 'Individual' in the code field
• This is an internal reference name and does not appear on invoices

  

4. Enter 'Individual Therapy' in the label field
• This is what appears on the invoice as a line item

  

5. Enter $50 in the price field

   

6. The following details can be ignored for this example
   • Tax / VAT code - Taxes that this service code supports
   • Description - Internal description for reference
     
7. Click Save

   

Repeat the above for the other fee programs

Creating the Appropriate Billing Templates

The next step is creating a billing template which will help auto populate the invoice

Billing templates allow to configure exactly when specific codes are used based on the selected fee program and service type

For more information on billing templates, please see here

1. Navigate to Billing Setup -> Billing Templates
2. Click Add in the upper right

   

3. Enter 'Individual Therapy' in the name field

   

4. From the healthcare service dropdown select the Counselling 60 (or other relevant service)

   

5. Now to add each fee program and service codes that we previously created
   Click add under Fee Program

   

6. Select the fee program from the fee program dropdown

   

7. Select the individual service code

   

8. Enter 1 in the quantity field

   

9. Repeat for the 4 fee programs

   

10. When done, click Save

Setting a Clients Default Fee Program

At this point, you are able to create invoices by manually selecting the fee program, please see here for more information. However to have it pre fill the clients default fee program will need to be set

To set or update a clients default fee program from their details, please take these steps:

1. Locate the client on All Clients or My Clients
2. Click on their name to open their profile
3. Click on edit client details in the upper right
   
   
4. Go to the Coverage and Insurance section

   

5. Select the appropriate fee program from the Default Fee Program dropdown

   

6. Click Save