Setting up each health fund with their own fee schedule can seem like a daunting task if you're unsure where to start. Most health funds have their own set fee schedule or are part of a larger schedule group such as AHSA, or BUPA, which can all be downloaded from the Special > Software Updates window. Hunter Health Insurance Benefits Fund (formerly Cessnock District Health Fund) is slightly different, wherein their fee schedule is required to be added manually in two different ways.
Note: The following rates do not apply to assistant surgeons and as such you should always contact the health fund to confirm accurate fees.
Before you begin
To correctly set the Hunter Health fee schedule, the following must be done:
- The latest Medicare Benefits Schedule (MBS) needs to be installed through Special > Software Updates.
- Hunter Health Insurance needs to be in your list of health funds within Open > Billing Items > Health Funds. See our Configuring Health Funds article for steps on how to do this.
Note: You may already have this fund in your list under a variation of the fund's name e.g. Hunter Health Insurance, Cessnock District Health, Cessnock Health, CDH Fund, etc.
For the Hunter Health fees to remain accurate, the below instructions need to be followed each time you update your Medicare Schedule. You can check with the Department of Health to see if the most recent schedule has changed the fees for your regularly charged items.
The Hunter Health Insurance Schedule is different than other health funds, in that it uses the below logic.
- Items with a Schedule fee of $200 or more is calculated as MBS + 50% = Hunter Health Fee
- Items with a Schedule fee of less than $200 is calculated as MBS + 20% = Hunter Health Fee
To obtain these figures, we need to first separate all items into two sections, where section one is the items that are $200 or more, and section two is items less than $200. Once these groups have been obtained, we can use the Increase Fees function to set the accurate fee schedule.
Part 1: Items with a Schedule fee of $200 and above
Follow the below instructions to update the Hunter Health Fee Schedule for items with a Schedule fee of $200 and above.
- Navigate to Open > Billing Items;
- Go to Records > Search;
- Under Available Fields, highlight "Schedule" in the [BillingItem] table;
- In Comparisons, select "is greater than or equal to";
- In the Value Field, type the number "200";
- Click Query;
- You will be presented with a list of all items with a schedule fee of $200 or more;
- Click on the Increase Fees button;
- Click on the drop-down at the top of the window, and select "Hunter Health Insurance";
- Select the "To a Percentage Above..." radio button, and type the number "50" into the corresponding text field;
- Ensure that the "Schedule" radio button is selected, and change the Round to Nearest field to "1" cent;
- Click OK
Part 2: Items with a Schedule fee of less than $200
Follow the below instructions to update the Hunter Health Insurance Fee Schedule for items with a Schedule fee of less than $200.
- Navigate to Open > Billing Items;
- Go to Records > Search;
- Under Available Fields, highlight "Schedule" in the [BillingItem] table;
- In Comparisons, select "is less than";
- In the Value field, type the number "200";
- Click Query;
- You will now be given a list of all items that have a Schedule fee of less than $200;
- Click the Increase Fees button;
- Click on the drop-down at the top of the window, and select "Hunter Health Insurance";
- Select the "To a Percentage Above..." radio button, and type the number "20" into the corresponding text field;
- Ensure that the "Schedule" radio button is selected, and change the Round to Nearest field to "1" cent;
- Click OK
Comments
0 comments