Updated Health Fund Fees
The schedules for QldWC and St Lukes have been updated, effective December 1. SAWC has not updated their schedule since July 2011. For all other details on the latest November fee and health fund changes etc, see our previous email, which can also be viewed online at http://www.healthbase.com.au/News/Nov_2011_News.aspx.
Medibank Private Payment Problem
Some of you may have encountered a problem with Eclipse payments for Medibank Private. There was a problem on November 1 when MP installed their updated fee schedule and this resulted in Eclipse claims being paid at only the Medicare rebate, instead of the correct gap cover amount. This affected claims submitted between Nov 1 and Nov 4, after which MP corrected the problem. Automatic top-up payments were made by EFT with a manual payment advice mailed in the following 2 weeks. You should not need to do anything about this. However, please contact Medibank Private if you believe you may be missing a top-up payment.
Medibank Private Gap Cover Eligibility
As noted previously, the online patient verification process (OPV) in Access Anaesthetics checks that the patient's health fund membership is valid. However, it does not specifically check the patient's financial status, waiting period, exclusions or eligibility for gap cover payments. This has not generally been an issue for other funds. However, for Medibank Private, quite a few patients who have valid memberships are not eligible for gap cover. This can result in Eclipse claims being paid at the Medicare rebate level only, with subsequent difficulties in recovering the missing amount from the patient. We recommend checking the gap-cover eligibility of MP patients prior to sending Eclipse claims, by calling the automated service on 1300 130 460 (access Code: 540300).
Victorian Workcover Time-Based Fees
These are now available for those who want to use them instead of the VicWC fee schedule. Generally speaking the time-based rates will result in a lower fee than the VicWC schedule. To update the rates in AA, go to Maintenance > Time based fees. Edit the VicWC calculation factors using the new rates. The fees can be added to an account using the option on the bottom of the MyOwn fee dialog box. If you don't want to use these fees, you don't need to update the rates.
Pre-anaesthetic consultation $107.88
In hours service - ANINHRS (first 2x15 mins) $117.36
- ANINHRS (subsequent 15 mins) $72.39
Out of hours emergency service - ANOUTHRS (first 30 mins) $281.82
- ANOUTHRS (subsequent 30 mins) $173.53
Program Update
Version 6.9 is now available. (Versions 6.75 and 6.8 were released earlier to a few clients for testing purposes.)
The main changes are:
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Reversal of the modifications required to work around an Eclipse problem. Medicare has now fixed this problem so the workaround is no longer needed.
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Process to manage a problem with bulk bill payments where a practice has sent more than 10,000 bulk bill claims. See below for more.
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A new 'Emergency Recovery' application has been included to provide solutions to problems that prevent AA from opening.
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BPay display format modified slightly to comply with requirements.
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If using the ASA RVG, a total fee can be set on the Fee page, without entering a specific unit value.
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Function to import an account from a backup file. Useful when an account has been deleted.
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Miscellaneous updates and bug fixes.
Emergency Recovery
Potential Problem with Online Bulk Bill Payments
If your practice has sent more than 9,999 bulk bill claims (counting all doctors), it is possible that some bulk bill payments received will have been allocated to the wrong account in AA. This is because the Claim ID numbers used by Medicare only contain 4 digits, for a maximum of 9999. After this they reset back to 0001, so payments for these claims could instead be linked to the previous claim 0001. Once program version 6.9 has been installed, this will no longer be a problem. However, if you have already sent more than 9999 claims, you may have problems with some recent payments.
To determine whether you have a problem, go to the Eclipse Menu > Setup > Maintenance, and click the <BB> button. This will identify whether your system has any bulk bill payment problems, and provide you with options to correct them. Please contact us if you need any further advice with this. We anticipate that very few if any practices will have reached this number of claims.
Missing ERAs
We have received a number of queries over the last month or so regarding Eclipse claims that stay as 'Payment approved' for a lengthy period. Unfortunately the process used to retrieve Eclipse Remittance Advices (ERAs) is quite complex and sometimes does not pick up all ERAs. This appears to have been made worse recently by the Medicare problems described in our previous email (which are now fixed).
- Open Access Anaesthetics and click <Maintenance Menu>.
- Click <Web Update>.
- Click <Search for Updates>. A list of available updates will be shown.
- Click the <Download and Install> button.
For group practices, AA needs to be closed on all other PCs when updating the health fund file. Once the web update is done on one PC, it does not need to be done on the others. However, you should close and reopen AA on the other PCs to complete the final process in the program update.
To verify that the updates were installed correctly, check the version information on the lower left of the Main Menu. The Pgm version should be 6.9, Data 6, Items 11.2 and Funds 11.4.
Online FAQ
Disk Updates
Clients who normally receive disk updates should expect these in the next few days.
To coincide with the low activity of many hospitals and other workplaces in January, the Healthbase office will be closed from Jan 3 - 24. Telephone support will not be available during this period, and email support may be delayed by up to 24 hours. We have gone to considerable effort to include solutions to most common issues in our website FAQ and request that you consult this first if you need assistance. Also, please try the Emergency Recovery application described above if Access Anaesthetics won't start. For urgent attention, please send an email, but be advised that we may not be able to respond quickly. If you are planning significant upgrades, please do these before Christmas, or delay until late January.