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RCM & insurance

Import and publish contracted tariffs

Map performed services to the correct contract price with a dry run and independent approval.

Current source · source reviewed · 7 min read

Before you begin

1. Prepare service mappings

Confirm service codes, units and the applicable contract tariff assignment. The charge master describes the performed service; a tariff describes its price in a specific context.

2. Stage the price list

Stage the source with its file name, hash and deduplication keys. Use named headers and check unsupported values instead of coercing them into a nearby category.

3. Inspect the dry run

Review row errors, foreign-key resolution, rate differences, package components, modifiers, tax and rounding. Resolve each unmapped service before publication.

4. Obtain maker-checker approval

Have an approver other than the author review the change and representative encounter simulation. Publish approved, effective configuration through the normal lifecycle.

No guessed fallback

If no unique traceable rate can be resolved, pricing returns a hold. It does not fall back to the cash tariff, last year’s rate, zero or an arbitrary amount.

Import is not activation

Imported rows become drafts. Separate review, source verification, approval and effective-date activation are still required.

Troubleshooting

An item has no contracted price

Open the hold to identify the missing mapping, unit or tariff field. Correct the mapping under its source and effective period, then repeat the dry run.

Source evidence

References are pinned to the private MANSOQ source repository. Repository access is required to open these links.