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, whereby their fee schedule is required to be added manually in two different ways.
For information on how to import standard fee schedules, see our article on Updating Fee Schedules.
Before you begin
For the Hunter Health fee schedule to be accurate, the latest Medicare Benefits Schedule (MBS) will need to be downloaded and installed in your Genie. To check that this has been installed, navigate to Special > Software Updates. In the Fee Schedule tab, see that a tick has been placed under the Done column next to Medicare Schedule as shown below.
Hunter Health Insurance will also need to be included in your list of Health Funds. Follow the instructions in our Configuring Health Funds article to add this fund in your Genie. You may already have the 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.
Note: Each time your practice updates the MBS in Software Updates, the CDH custom fee schedule will need to be set up again to match the new MBS fees. You can check the Department of Health website to see if the most recent Medicare fee 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;
- Confirm that you wish to make the Hunter Health Insurance fee 50% above the Schedule Fee;
- 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;
- Confirm that you wish to make the Hunter Health Insurance fee 50% above the Schedule Fee;
- Click OK.
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