From time to time, Medicare will release updates to the Medicare Benefits Schedule. Likewise, private health funds also tend release fee schedule updates, sometimes multiple times throughout the year. When a fee schedule requires updating, there are three methods that can be used: the Software Updates window, importing .csv files, and the Increase Fees function. The method used depends on the particular fee schedule being updated.
Before you begin
Important Note: There have been changes made by Medicare to the Assistant Threshold. These changes apply as per 1 July 2019. It is essential that the Assistant Threshold is updated in your Genie to accurately reflect this, or you may receive rejections to your claims. For more information on updating your Assistant Threshold, please refer to the Assistant Invoicing article.
It’s important that no one in the practice performs any billing while fee schedules are being updated. For fee schedules being updated via the Software Updates window, it’s also important that no one opens the Billing Items window for the duration of the update.
When applying fee schedule updates, it is important to always apply the Medicare update first. This ensures that any new item numbers are added to Genie before your other fee schedules are updated.
Important Note: After you update your Medicare Schedule, any health fund schedules that use the MBS to calculate their own fees will need to be re-run using the steps listed in the Using the Increase Fees function section below.
Please note: If your Genie registration is passed the expiry date and has not been updated you will not be able to access the Software Updates window to download your new fee schedules. Please ensure that your Genie Registration invoice has been paid and you have navigated to Special> Update Genie Registration and selected Register.
Medicare, DVA and most private health funds supply their fee schedules to Genie Solutions, and once these schedules have undergone internal testing, they’re made available through the Software Updates window.
Navigate to Special > Software Updates.
Click on the Fee Schedules tab.
Place a tick in the checkbox to the left of the fee schedule you would like to update.
Note: We recommended you only download one schedule at a time. Performing multiple downloads at once will increase the download time and possibly result in Genie timing out.
Click on the Install 1 Item button at the bottom left-hand corner of the window.
You will be prompted to either Apply Update or Store and Activate Later. Unless you have a specific reason to avoid updating now, click Apply Update.
Note: If you choose Store and Activate Later, you will be prompted to select which Genie user you would like to be notified of this update and what date you want them to be notified. The new fees will only override the old fees once the update has been applied.
If you’re updating the Medicare Schedule, you’ll be prompted to Update All or Update Current. If you select Update Current, only the fees for your existing item numbers will be updated – that is, any new item numbers won’t be downloaded. With that in mind, we’d typically recommend selecting Update All so that any new item numbers are downloaded.
The fee schedule will now be downloaded and applied. Repeat this process for any other fee schedules you would like to update.
Please Note: when downloading the fee schedule of a health fund, you may receive a prompt asking you to select which health fund you would like to apply the schedule to (seen below):
If you receive this prompt it may be due the fee schedule being named differently to how the fund is named in Genie. You can search through the list that appears to see if you can find the relevant fund. If you are not able to find the fund in the list, it may be because it hasn't been configured in Genie correctly.
To check this, navigate to Open > Billing Items > Health Funds and check to ensure the fund is appearing on the list, and that it is not ticked for either AHSA or BUPA. If it is ticked for one of these, untick the relevant box and try downloading the fee schedule again.
Some health funds fee schedules can’t be downloaded through the Software Updates – instead, some health funds will supply a .csv file that contains the schedule. Before you can import a fee schedule in .csv format, you’ll need to track down a copy of the schedule in .csv format. Typically health funds make their fee schedules available via their websites, often in a number of formats. Ensure you download the schedule in .csv format. If you require assistance downloading a fee schedule in .csv format, it’s best to contact the health fund for support.
Download the fee schedule in .csv format and save it in a location you can find easily (e.g. the desktop or Documents folder)
Once the download completes, open Genie, log in and navigate to Open > Billing Items
From the Import Fee Schedules dropdown, select the relevant schedule. Typically this will be Import Other Schedules
Note: if you’re importing the AMA schedule, the process is a little more complex. Please see 'Importing the AMA Fee Schedule' below
In the subsequent window, you’ll be prompted to select the corresponding health fund. Highlight the fund and press Select
Note: If your fund is not listed in this window, it may be marked as an AHSA or BUPA fund. These funds can be updated using the Software Updates method in the previous section. If it should not be marked as AHSA, you can unmark it by navigating to Open > Billing Items and clicking on the Health Funds button.
Once you have selected the fund, you will be presented with a Browse window. Browse to the .csv file you saved earlier
- Genie will now import the fee schedule. Once the import is complete, check your billing items to confirm the new fees have been applied to the appropriate health fund.
You can also update an entire fee schedule using Genie’s ‘Increase Fees’ function. Some health funds use a schedule that’s derived from another schedule - for example, some funds will use a fee schedule that’s the Medicare Benefits Schedule plus an additional percentage. Likewise, a lot of practices will decide to derive their Private fees from another schedule – for example, the AMA fees or the MBS plus an additional percentage – or will want to regularly update their private fees to match any changes in the MBS or AMA fees.
To use the Increase Fees function:
- Navigate to Open > Billing Items and click View All
- Click on the Increase Fees button. This will open the Fees Increase window.
- Select the fund (or your Private schedule) from the Increase the fee for drop-down.
- Select the relevant radio button and enter your values.
|By a Percentage||Allows you to increase the fees by a percent.||For example, selecting this radio button and entering "10" would increase the fees for the selected schedule by 10%.|
|By an Amount||Allows you to increase the fees by an amount.||For example, selecting this radio button and entering "10" would increase fees for the selected schedule by $10.|
|To a Percentage Above||Allows you to increase the fees by a percentage above the fee schedule you select using the subsequent radio buttons (i.e. Schedule or AMA).||For example, selecting this radio button and entering "10" would increase fees to 10% above the fee schedule you select (i.e. Schedule or AMA).|
|To an Amount Above||Allows you to increase the fees by an amount above the fee schedule you select using the subsequent radio buttons (i.e. Schedule or AMA).||For example, selecting this radio button and entering "10" would increase fees to $10 above the fee schedule you select below (i.e. Schedule or AMA).|
- The rounding field at the bottom allows you to set how Genie rounds the increased fees. Enter 5 in the Round to the nearest X cents field, unless you have a reason for rounding to an alternate value.
Example: To prevent Genie from rounding, enter ‘1’ in this field, or to round to the nearest dollar, enter '100' in this field.
- Click OK and allow Genie to update the fee schedule.
As with private health fund fees and the Medicare Benefits Schedule, the Australian Medical Association (AMA) fee schedule is updated periodically by the AMA and can be downloaded from the AMA website.
The AMA Schedule is only available to members of the AMA. To download the AMA fee schedule, you’ll need to visit the AMA website where you’ll be required to log in with your AMA issued username and password. You will need to download the AMA fee schedule in the .csv format.
Genie Support is unable to assist with downloading the AMA fee schedule from the AMA website. If you require support accessing the AMA website to download the AMA fee schedule, you will need to contact the AMA for support.
The AMA fee schedule is imported using Genie’s ‘Import Fee Schedule’ function. This process can be completed on any Genie Client computer in the practice, however no one else should perform any billing or access the Billing Items window on any other clients for the duration of the update.
You will need to complete the steps below whenever a new AMA fee schedule is made available.
Download the fee schedule in .csv format from the AMA website and save it in a location you can find easily (e.g. the desktop or Documents folder);
Navigate to Open > Billing Items;
Click on the Import Fee Schedule drop-down menu and select Import AMA Schedule;
A window will appear asking you to select the text file to import; click OK;
Browse to the location on your computer where you saved the .csv file, select it, and click Open.;
A window will appear asking you if you would like to ‘Create Billing Items using AMA Item Numbers or keep MBS Item Numbers?’ Click Keep MBS. If you also require the AMA-specific item numbers, import the AMA schedule again, this time choosing Use AMA;
Genie will now import the AMA fees. Once the import is complete, check your billing items to confirm the AMA fees are present.
If you would simply like to increase the fee for a single item, you can do this via the Billing Items window.
- Navigate to Open> Billing Items and search for your item number.
- Double click to open the item profile and you'll be presented with all settings for this particular item. Locate the relevant Fee Type in the bottom right corner and then slow double click on the corresponding fee in the Fee column. This will allow you to type in your new fee for this item.
- When completed, select Save and the item fee will update.