This article is part of the systems administration guide. You will require administration access to view the pages mentioned in this article.
Overview
The following describes the Multiple Procedure Rule sort order.
For some health funds, they require the items to be sorted according to the scheduled (MBS) price instead of the fund price before the rule is applied. BUPA is one of those funds and in the attached document you can see that the MBS price of the (currently) second item is higher than that of the first item. This would result in the order of the items being changed before the MPR is applied.
There you have 3 items, currently sorted in health fund price order, awaiting the application of the MPR. In the most common scenario, the application of the MPR would leave the items in their current order and re-calculate the prices according to the 100/50/25 rule.
| Item | MPR based on Fund Price | MPR based on MBS Price | ||||||||
| Number | Fund Price | MBS Price | Item Price | Sort Order | Scale Factor | Adjust Price | Item Price | Sort Order | Scale Factor | Adjusted Price |
| 45614 | $1,018.25 | $587.60 | $1,018.25 | 1 | 100% | $1,018.25 | $1,018.25 | 2 | 50% | $509.13 |
| 42602 | $989.30 | $631.75 | $989.30 | 2 | 50% | $494.65 | $989.30 | 1 | 100% | $98930 |
| 42590 | $529.90 | $338.35 | $529.90 | 3 | 25% | $132.48 | $529.90 | 3 | 25% | $132.48 |
| Invoice Total | $1,645.38 | Invoice Total | $1,630.91 | |||||||
Invoice Total | $ 1,645.38 | Invoice Total | $ 1,630.91 | |||||||
This difference in the invoice price between the 2 methods can be made worse if the fund pays their reduced price on what they consider to be the second item and only pay your already reduced price on the first item.
The setting of which method is used to calculate the MPR is set on the Rate Definition and would, therefore, apply to all the guarantors that use that particular rate.
Change the sort setting for a rate:
- Click Administration.
- Select the Accounting menu item.
- Select the Rate Definitions sub-menu item.
- Identify the Rate in question (it will be 6 or higher).
Sections Descriptions Index Identify the number of rates Name Download date The date when download it Override CareRight has the ability to "on the fly" define a different rate table to use on an Private Account during invoicing. When raising an invoices for a Private Account Types you are able to select a rate override value. Show If you click show, there will be a detailed information for that specific rate Region price In the event of accidental import of regional pricing into a rate definition, a bulk deletion tool has been added to quickly delete prices added to a region on a specific date - Click the Show button for that rate.
- Click the Edit button.
- Set the 'Sort (for MPR)' to the required option.
- Click the Update Rate Definition button.
Notice
NB In the example prices used above, the 'Arithmetic' rounding method has been used on the scaled price. In this scenario, when the price is scaled and it does not result in an exact number of cents, it is rounded off to the nearest cent. The other rounding method is known as 'MBS' rounding where if the price is not a multiple of 5 cents, it is rounded up to the next 5 cents. This rounding method is set on the Rate Definition and changing it is done the same way as changing the Sort for MPR
