Billing to Debt Management (Desktop App)

A medical aid levy is a percentage or an amount applied to specific medical aid schemes to apply a certain mark-up to billing codes based on the medical aid plan.

• Please refer to the user manual Medical Aid Lists in order to follow the steps on where to make these changes.

• From the Medical Aid Options screen. 
• Use the Filter on options to search for a specific Medical Aid:

• Administrator: Who manages this medical aid. 
• Scheme: Medical Aid Name.  
• Option: Plan name. 

• Click on the Medical Aid Option to select it. 

• Click on the Options menu button.

• Click on Levy on the drop-up menu.

• The Pharmacy Rule screen of the selected medical aid will open.

 

• Levy: Medicines/Materials: The levies that are charged by the medical aid for medicine and material items. 

• Per script: The levy that will be charged per prescription, irrelevant of how many items have been prescribed.
• per item: The levy that will be charged per item that has been prescribed.
• plus ... on the balance: a levy amount that will be charged and added to the balance. 
• Minimum: the least that can be charged as levy.
• Maximum: the most that can be charged as levy.

• Medicine levy rules applies for material: The same levies will apply on material items that have been set up for medicine items. 
• Dispensing Preferred Provider: When a patient goes to a preferred provider a certain levy may be charged, but if they go to a Non-preferred provider the percentage as set up, will apply. A Preferred provider is a practice or practitioner that has a contract with the medical aid for special rates.
• Non-Preferred Provider Levy: The percentage that will be charged by non-preferred providers, Medical Aids see all non-network doctors as Non-Preferred Providers. 

• Discount: A reduction in the regular price.

• Discount: The percentage by which the original price will be reduced.
• Levy calculated after discount: This will allow the levy to be added after the discount has been applied, therefore there will be no discount on the levy.

• Procedure Levy: a levy that will be added to the procedure for example the procedure is high risk so a risk levy is charged to the procedure.

• % per invoice: Adds a percentage to the entire invoice.
• plus: To include a levy on both the invoice and the balance.
• % on the balance: Adds a percentage to the balance of the procedure.

• Rule supplied by data provider: A summary of what rules have been applied by Medprax.

• Ethical Markup Rules: Rules that will apply to Medicine Items regarding how the levy will be charged.

• Consumable Markup Rules: Rules that will apply to Material and Surgical Items regarding how the levy will be charged.

• Click on the Link another Markup Rule button to add a new rule.
  

• The Med.Aid Markup Rules screen will open where a pre-setup or custom rule can be added to the list. 

• The Rules will be divided into columns: 

• Rule Code: A unique number allocated to the rule to identify it.
• Tier: At what level the rule will be applied.
• Rule Description: An explanation of what the rule consists of.

• Click on Cancel to close the Pharmacy Rule screen without saving.

• Click on OK to save the changes if changes have been made.

• The Pharmacy Rule screen will close and return to the Medical Aid Options screen. 

• Click on OK to return to the main MedDebs screen.
  

To see if the Medical Aid Levies have calculated properly a new screen will advise the user how