Contractual Rates
Two numbers, one billing entry
Every entry in CentralReach carries both. ClientCharges is billed rate times units. ClientAgreedCharges is agreed rate times units. CalcAdjustment is the difference between them.
Only one of those is revenue. The agreed number is what the contract obligates the payer to pay. The billed number is what you asked for, which is a different thing entirely.
The math
Say you deliver 40 units of 97153 in a week. Your billed rate is $80 per unit. The contracted rate with that payer is $52.
Billed charges: 40 x $80 = $3,200
Agreed charges: 40 x $52 = $2,080
Contractual difference: $1,120
If you book $3,200, you just recorded $1,120 of revenue that no one owes you and that will never arrive. Do that across a month and the overstatement is not a rounding issue. It is the difference between a practice that looks profitable and one that is.
It does not stop at revenue
Booking billed rates breaks four things at once.
AR is overstated by the full contractual. Your aging schedule shows money that does not exist.
Your collection rate looks terrible. If you collect $2,080 against $3,200 in charges, the report says 65 percent. Nothing is wrong. The denominator is fake.
Margin by service line is wrong. RBT-delivered and BCBA-delivered revenue both get inflated, but not by the same percentage, so the comparison between them is distorted too.
And underpayments disappear. When every claim already shows a large gap between charged and collected, a payer that is paying $48 instead of $52 blends right in.
The contractual is not an adjustment you book
This is where people double count. Charges stated at agreed rates already have the contractual removed. It is baked in. It never appears as a line.
The Sales Adjustments column in the RCM report is not the contractual. It is what someone manually adjusted over and above the programmed agreed rate. In billing export terms, that is AmountAdjustment less CalcAdjustment.
So the entry is: book agreed charges as revenue, book Sales Adjustments to payer adjustments as contra-revenue, and leave CalcAdjustment alone. Booking agreed charges and then also booking CalcAdjustment records the contractual twice.
The setting that flips it silently
One toggle in the Billing module under Miscellaneous decides whether your reports run at agreed rates or billed rates. Only the main organizational account can change it.
When it is off, the RCM report reports at billed rates with no change to any label. Charges, receivables, and collection rates all shift meaning and the report says nothing about it. Confirm the setting before you book from it. Every month.
Where Qlarity fits
Qlarity posts revenue from your CentralReach billing export at agreed rates, on an accrual basis, in the period the service was delivered. Broken out by funder, location, and procedure code, through a direct QuickBooks Online integration. Dates of service group by week and split at month end so weekly and monthly reports both tie. Every post is duplicate-checked. No PHI stored.
You get a revenue number that means what it says.
$199 per month. The first 30 days are free.
