Claiming Telehealth Items in Genie

The process for invoicing a Telehealth item number is similar to your standard invoicing procedures. You may begin by creating the invoice as per usual, and adding the consult item number to the invoice.

After adding the consult item, please follow the below steps specific to invoicing Telehealth:  

1. Select the Add Item to Invoice button. 
2. Enter the Telehealth item to be used, then press the Tab key. 
3. Enter a figure into the Amount field. This is generally half the value of the Consult item. 
4. Select the Save button. 

You may then enter any other details on the invoice as per usual, then select the Save button. Your invoice should look similar to the example below:  

This invoice can then be transmitted to Medicare via File > Maintenance & Reports > Daily > Bulk Bill/DVA Transmissions, along with your regular invoicing.  

After sending your Telehealth and consult items to Medicare, it is not unusual that these will be returned with an exception on both items. The exceptions would generally appear as in the screenshot below:  

In this screenshot, we can see that the Telehealth item (288) has no payment made from Medicare, and the consult item (304) has more paid against it than what was claimed. You will see that the payment for the consult item includes both the payment for the consult item and the payment for the Telehealth item. 

You will also note the Payment Problem indicates “Derived item assessed with other item on statement”, meaning that the derived (Telehealth) item has been paid with the other item (consult). This is caused by the way the claims are assessed and paid by Medicare, in which the payment is rolled into the main/consult item number rather than being distributed against each item number.  

Dealing with the Exceptions

You will first need to ensure that the total paid amount covers both items. To do this simply add the claimed amounts together and ensure the total amount invoiced has been paid.

For example, the screenshot above shows that that the total paid is equal to the fees of the two items invoiced: $135.10 (Item 304) + $67.55 (Item 288) = $202.65 (Total Paid).

If this is correct, you are able to simply select Delete Exception for both the consult and Telehealth item. When it is time to receipt this batch, the payment will be distributed accordingly across the two items. 

If the claimed amount does not add up to the paid amount, this may indicate that the original fees used were incorrect. To remedy this, select the Edit Item button to adjust the Total Charge field as necessary, then choose Save. This would be required for both item numbers.

The new fee can generally be determined by dividing the payment amount. One third of the payment amount should be set as the Telehealth item fee, and two thirds should be set as the consult item fee. After correcting the fees as required, you can continue to select Delete Exception, then receipt as necessary.