DA Billing to Debt Manage: Combinations (Protocols)

Combinations (Protocols)

When you have procedures where the procedure codes and stock used are stable, you can set up a combination. Combinations help you to do your billing in a structured way.

The billing clerk will use the correct stock code(as set up in the Combination) and therefore will not bill the wrong items and create the necessity to do credit notes.

Sign in to the GoodX Desktop using your GoodX user name and password.
From the Navigator Double Click on the MedDebs Module

The MedDebs screen will open

Set-up a Combination

From the Menu bar, Click on Lists

Click on Combinations from the drop-down list

Click on Combination codes from the submenu

You will be directed to the Combination Lists screen

Click on + to add a new Combination List.

New combination details

Add a unique Combination Code
Add a unique Combination Name

Combination Type

Fixed: A series of codes that are regularly used for a specific procedure will be pulled into the invoice as set up with the quantities (can be changed in the invoice screen)
Choose: Choose combinations are set up with a certain list of items and tariff codes that may be used on the patient for a specific treatment; the items that were used can be selected in the combination screen that will pop up.

Type of pricelist

Tariff: As set up by the medical aid/practice
CPT4: A uniform coding system consisting of descriptive terms and identifying codes that are used primarily to identify medical services and procedures

Prices

Look up Tariff Prices on Pricelist: Uses price list prices
Use prices as filled on Combination: Uses the custom prices as set up on the combination *Disclaimer: These prices will need to be updated manually at least once per year when the practice reviews prices, this will be the responsibility of the practice to maintain these prices

Tick the ''Force Combination'' checkbox if you would like to include the original code when billing

Click on the + button at the bottom of the sidebar if you would like to link a specific ICD-10 Code to your combination and will always be applied on the specific combination

You will be directed to the ICD-10 Direct Search screen

Choose the ICD-10 code from the list by typing the code in the Search Phrase field at the top of the page.

Double click on the correct ICD-10 code to populate the selection field.
The ICD-10 Selections are now associated with the specific combination this is seen on the following screen: Combination

To confirm that all your information is correct, Click on OK

If you don't want to complete the combination click on Cancel

After clicking on OK you will be directed back to the Combination Lists screen and your Combination will have been created on the Combination list.

Start the population of your combination by selecting Items (F3)

You will be directed to the Combination Details screen where you are able to perform many actions as you have only completed the basis of the combination and you are able to build the combination by adding items and procedures to it

Procedure Item

Click on Procedure Item to capture Procedure codes included in the Combination

You will be directed to the Combination input screen

Charging : How items will be charged on the invoice

Balanced Billing (Rand Value): The Practice charges more for the procedure than what the medical aid is willing to pay, so this determines the extra amount (rand value) that the practice wants to charge extra

Post to: This will determine where the outstanding amount will post to if it is more than the tariff code

Patient: The patient is liable for the costs
Medical Aid: The medical aid is liable for the costs

Co-Payment: Certain procedures have a co-payment as set by the medical aid option and plan the practice will need to fill in the co-payment here as it does not pull through automatically

Post to: This will determine where the outstanding amount will post to if it is more than the tariff code

Patient: The patient is liable for the costs
Medical Aid: The medical aid is liable for the costs

Balanced Billing (Percentage): The Practice charges more for the procedure than what the medical aid is willing to pay, so this determines the percentage value that the practice wants to charge extra

Post to: This will determine where the outstanding amount will post to if it is more than the tariff code

Patient: The patient is liable for the costs
Medical Aid: The medical aid is liable for the costs

Select the correct price list number (Click the ellipse ... to search on the Price Lists screen ) the procedure in the combination will always use this price list if left blank the pricelist will revert to the pricelist on the patients' medical aid

By clicking the ellipse ... you will be directed to the Price Lists screen

Select/Enter the procedure code (use the ellipse ... to search)

By clicking the ellipse ... you will be directed to the Set Default Procedure Code screen where you can search and select your code

Add the Description Suffix: What you would like the code to appear as on the invoice when used

Add the quantity: How many of these procedures you want to be added to the invoice

Add Modifiers: These modifiers will only apply to this item and not to other items on the invoice.

Click on OK or press "F2" key on your keyboard to complete

Or Cancel to edit or go back to the previous screen

Post Item as Private (New Feature)

Ease of use for billing items without making use of a shortcut or marking items by hand

When this option is ticked it will override any other settings and automatically bill as patient liable this will only be applicable to the current item
Items posted as private will come up on the invoice screen in a billing group of its own marked with an X
Items posted to the medical aid will come up on the invoice screen in an invoice group of its own marked with an M
Items posted to the patient will come up on the invoice screen in an invoice group of its own marked with a P
Lab Items will come up on the invoice screen in an invoice group of its own marked with a L

Click on OK or press "F2" key to complete

Or Cancel to edit or go back to the previous screen

Material Item

Click on Material Item to capture Material codes included in the Combination

Charging: How items will be charged on the invoice

Chargeable: Items are charged for ,the sales price will be used on the invoice
Not Chargeable (prescription): Item will be charged as a prescription item, but won't have an amount on it
Not Chargeable (prescription), no print : Items will not be charged for and will also not print on the invoice
Not Chargeable (medicine): Medicine items are not charged, this is only applicable to medicine items

Code : Click the ellipse ... to search on the Material Stock List screen

By clicking the ellipse ... you will be directed to the Materials Stock List

Quantity: How many of these items you want to be added to the invoice

Pack Size: The pack size will pull through as all items will always have a pack size

Price: This is the sales price as imported from the list

Post Item as Private: When this option is ticked it will override any other settings and automatically bill as patient liable this will only be applicable to the current item

Click on OK or press "F2" key to complete

Or Cancel to edit or go back to the previous screen

Medicine Item

Click on Medicine Item to capture the Medicine codes included in the Combination

Charging: How items will be charged on the invoice

Chargeable: Items are charged for, the sales price will be used on the invoice
Not Chargeable (prescription): Item will be charged as a prescription item, but won't have an amount on it
Not Chargeable (prescription), no print: Items will not be charged for and will also not print on the invoice
Not Chargeable (medicine): These are items that the doctor includes in the consultation fee and these items will not be charged for separately

Code : Click the ellipse ... to search on the Medicine Stock List

By clicking the ellipse ... you will be directed to the Medicine Stock List screen

Quantity: How many of these items you want to be added to the invoice

Pack Size: The pack size will pull through as all items will always have a pack size

Price(per pack): This is the sales price as imported from the list

Post Item as Private: When this option is ticked it will override any other settings and automatically bill as patient liable this will only be applicable to the current item

Medicine Type : The item will either post to the invoice as a chronic or acute item

Acute: For short term or once-off, sudden conditions, prescriptions are not repeated eg. Broken Bones, Cuts & Bruises and Influenza
Chronic: For long term conditions, medication is typically taken daily prescriptions are repeated, eg. Diabetes and Asthma

Click on OK or press "F2" key to complete

Or Cancel to edit or go back to the previous screen

Laboratory Item

Click on Laboratory Item to capture the Laboratory codes included in the Combination

Charging: How items will be charged on the invoice

Chargeable: Items are charged for, the sales price will be used on the invoice
Not Chargeable (prescription): Item will be charged as a prescription item, but won't have an amount on it
Not Chargeable (prescription), no print
Not Chargeable (medicine): Medicine items are not charged, this is only applicable to medicine items

Code: Click the ellipse ... to search on the Laboratory price list. PRACTICE RATE

By clicking the ellipse ... you will be directed to the Laboratory price list. PRACTICE RATE screen

Quantity: How many of these items you want to be added to the invoice

Pack Size: The pack size will pull through as all items will always have a pack size

Price: This is the sales price as imported from the list

Post Item as Private: When this option is ticked it will override any other settings and automatically bill as patient liable this will only be applicable to the current item

Item Behaviour: How an item will act on the invoice

Mandatory: Item will appear on the invoice automatically the item has to be used in conjunction with the combination
Select Item : It will give the option to advise if the lab code was done or not