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Patient360

Market

Deductions Configuration

Manage deduction statuses, appeal workflows, payer rules, SLA, auto-assignment & display settings

All Markets

Notifications

Back to Deductions

Deduction Reason Codes

Standardized codes for classifying deduction reasons

Code	Category	Label	Market	Actions

Appeal Pipeline

Visual workflow for appeal stages — click a stage to edit

Edit Stage:

Label

Color

Icon (bi-*)

SLA Days

Assigned Team

Terminal?

Status Transitions

Define which status transitions are allowed

Payer-Specific Rules

Auto-dispute thresholds, SLA, and team assignment per payer

Payer	Market	Auto-Dispute %	Max Amount	Default Team	SLA Days	Active	Actions

SLA Rules

Service level agreements by context, market, and payer

Context	Market	Payer	Category	SLA Days	SLA Preview	Escalate To	Active	Actions

Auto-Assignment & Flagging Rules

Rules engine for automatic deduction assignment, flagging, and escalation

Name	Type	Condition	Action	Priority	Active	Actions

Rule Tester

Test rules against sample deduction data

Market

Payer

Deduction %

Deduction Amount

Reason Code

KPI Thresholds & Benchmarks

Define deduction percentage thresholds, recovery targets, and review goals

Display & Behavior Settings

Configure default views, toggles, and page behavior for the deductions dashboard

Add Reason Code

Code

Category

Label

Market (optional)

Add Appeal Stage

Stage Key

Label

Color

Icon

SLA Days

Assigned Team

Terminal stage (won/lost/withdrawn)

Add Payer Rule

Payer Name

Market

Auto-Dispute Threshold (%)

Max Allowed Amount

Default Team

SLA Days

Add SLA Rule

Context

Market (optional)

Payer (optional)

Category (optional)

SLA Days

Escalate To

Add Auto Rule

Rule Name

Rule Type

Priority

Condition

When

Action Value (team name, status, or escalation target)

ESC

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