Overview
The Scenarios feature allows you to model different billing approaches and compare potential revenue outcomes before submitting claims.Accessing Scenarios
Click Scenarios in the sidebar navigation.What Are Scenarios?
A scenario is a “what-if” calculation that shows how different billing codes or configurations would affect your revenue. Use scenarios to:- Compare billing code options
- Evaluate premium code eligibility
- Optimize billing strategies
Creating a Scenario
1
Start New Scenario
Click New Scenario or clone an existing one
2
Add Services
Enter the services you want to model:
- Billing codes
- Quantities
- Time factors (if applicable)
3
Configure Options
Adjust settings like:
- Premium eligibility
- Facility type
- Time of service
4
Calculate
Click Calculate to see the projected revenue
Comparing Scenarios
Create multiple scenarios with different configurations to compare:Sharing Scenarios
Share scenarios with colleagues:- Click Share
- Copy the generated URL
- Recipients can view (but not modify) your scenario
Scenario URLs include all configuration in the parameters, so they work without requiring login.
Cloning Scenarios
Duplicate a scenario to create variations:- Open the scenario
- Click Clone
- Modify the copy as needed
- Save as a new scenario
Use Cases
Comparing Time-Based Billing
Model different time durations to see how they affect fees for time-based codes.Premium Code Analysis
Determine if premium codes apply and calculate the additional revenue.New Service Planning
Before offering a new service, model the expected revenue based on OHIP fees.Limitations
- Scenarios are estimates based on current fee schedules
- Actual payments may vary based on OHIP processing
- Scenarios don’t account for rejection risks