Invoicing Radiation Oncology

Invoicing Radiation Oncology

Radiation Oncology Billing items require specific price calculations for some items and a specific way to submit claims electronically.

 Rebate Calculation

Similar to some Anaesthetic items some Radiation Oncology billing items rebates are derived based on quantity and a base price.

For example item 15236 can be billed for 2 to 5 treatments (fields). The price is calculated as;

"The fee for item 15221 + for each field in excess of 1, an amount of $37.95".

 Item 15221 has the MBS 85% rate of $44.75. If someone had 3 fields treated the MBS rebate would be calculated as $120.65 (37.95+37.95+44.95)

To facilitate this all rebate and private, fund prices will need to be pre-calculated with a new item created to represent each number of fields.

Please refer to Adding a new Item Code in the System Admin Guide for instructions on how to add an item code.

 Here in this scenario, each line item is to be added as a separate line item with the rebate price. (ie; 15236/2 , 15236/3, 15236/4 , 15236/5)

Creating an Invoice:

From the patient record follow the steps under Raising an Invoice to the Adding item details section:

1. Go to Patients and select/search the required patient.
2. Select Invoices and Credits from the menu.
3. Select New Invoice Button.
4. Select the most relevant option:
   1. Guarantor
   2. Service / Account Provider (If the configuration: Always the service provider for their own accounts is set on Provider details CareRight skips the confirmation steps when a new Invoice is created. Please refer to Add a new medical provider in the system admin guide.)
   3. Service Location
5. Select the New Invoice button.
6. If a Referral is required for the service, select the Referral details.
   1. When selecting a referral during invoice creation, select Show Expired to include expired referrals in the listing.
7. Update any other details as required.
8. Select Create Invoice.
   1. The Invoice screen will display.
9. Scroll down to the New Line items section.
   1. Enter the base  line Item which is configured for  Radiation oncoloogy billing - (Eg:15236 )
10. Select Add line item to Invoice (this will populate the line items section).
11. Select the Add item to invoice
12. Then add the multi-field items (e.g. 15236/4 for 4 additional fields),
13. Fill in appropriate fields
14. Select Add item to invoice
15. Complete the Raising an Invoice process

This treatment can then be receipted and claimed as per the normal process.