Theatre Banding and Multiple Theatre Rule for IHC Billing

Theatre Banding for IHC Claiming

When claiming multiple procedures via IHC you have to ensure that each procedure is correctly classified to the required theatre band (number).

Theatre Band to use is generally standardized across all funds, but some funds use custom banding.

Defining a band

Administration > Accounting > Theatre Banding allows users to create theatre bands. These can be defined as:

  • National Theatre Banding
  • WA Theatre Banding
  • Other

Once a band has been created then users can import data into the user-defined band.

Importing data

You will need to import a CSV file containing 2 columns of data. 

The following title must be used in the first column:

  • item_number
  • theatre_band
item_numbertheatre_band
                    
14100

                    
1A

31235                    
2

NOTE: theatre_band can only be 2 characters long

Guarantors

Once a theatre band has been defined then Guarantors can link to the bands. Users can also define the theatre multiple procedure percentages 

  • Procedure 1 Percentage
  • Procedure 2 Percentage
  • Procedure 3 Percentage
  • Procedure Procedure Percentage

Procedure ordering is by price so Procedure 1 will be the most expensive and Procedure procedures will be the cheapest.

Creating an invoice

When creating a hospital invoice and charging for theatre items the user will be asked to apply the mulitple theatre rule as defined in the guarantor. In the case defined below the guarantor was defined with 

  • Procedure 1 Percentage 100%
  • Procedure 2 Percentage 25%
  • Procedure 3 Percentage 0%
  • Procedure Procedure Percentage 0%

so procedure 1 will be changed at 100%, procedure 2 at 25% and all other procedures at 0%

Invoice Claiming

After the invoice has been created clicking the Claim button will generate the IHC claim the theatre band and  theatre band type have been populated from the theatre band linked to the guarantor.

So If the guarantor is linked to the National Theatre Banding and item 31235 has a theatre band of 2

Then the claim for item 31235 will have a theatre Band of 2 and Theatre Band type of N where

  • N = National Theatre Banding 
  • W = WA Theatre Banding
  • O = Other