Are the fees listed on the rate card based on one unit?

TL;DR

Yes, the fees shown are per unit. You may adjust your billing to reflect the total number of units per procedure code based on what was performed.

What You Need to Know

The following rates reflect the contracted amounts between Zaya Care and the respective payer as of July 2024, and represent the average rates for services rendered in the New York City metropolitan area and New Jersey. Rates can vary based on the location of service, and the CMS MPPR reductions, which many commercial payers have elected to

apply to their fee schedules. 

The Professional Entity pays Zaya Care a service fee of the total allowed amount for claims processed by Zaya Care, which covers: payer relations, benefits verification, prior authorization management, rejections and denials management, and provider education programs. The service fee will be withheld from collected revenues prior to remitting the remaining balance to the Professional Entity.

The Professional Entity is responsible for all aspects of the collection of patient cost-shares. Zaya Care will provide the necessary information to facilitate patient collections, including details of insurance payments and patient responsibility amounts.

If the Professional Entity bills a code not listed on the rate card, the Professional Entity will receive the amount reimbursed by the payer after deducting Zaya Care’s service fee. The Professional Entity is responsible for ensuring that all claims submitted for billing are accurate and comply with applicable laws, regulations, and payer-specific policies.