Item Details are a set of screens used to manage the fees for a selected Item Number. The fees can represent how much a practice or specialist charges for an item or how much a payer will pay for a claim.
Overview
The Item Details screens allow you to enter an item number, and then view the fees and discounts for every payer. You can add and modify the fees shown.
To open Item Details:
- Go to Zedmed's Management tab.
- Select Practice Setup then select Items > Item Details.
- In the Item number field, enter the item number you want to view.
- Select Find to open the Item Selector.
- Select Details.
The Item Details screens will load that Items fee information.
Validity Period
Items have a Start and End Validity date so they can be phased out by Medicare (but still be visible by clicking the Left arrow by the New button). By default, all new items have a Start date of 1/1/90. This is correct and should not be changed. If the item's value is updated by a Fees Files update, the Validity End date will be updated to that date and a new item with the same number will be created with a new Start date.
To confirm a file update completed correctly, check the Validity Period date. Selecting the blue back arrow will show the previous date period, and you can see if there was any fee change. Older fees will be picked up in backdated invoices.
Tax Code
Any item may have its Item Tax Code set to be FRE (free of GST) or GST (includes GST). If it is set to GST, then the GST should be included it in the item's price. If an item may or may not include GST based on circumstances, mark it as FRE and tick "Selectable when Billing" so you can add GST when billing.
Related guides
Details tab
Shows the Full Description for the selected service item. You can also see the item's Category, Group and Sub-Group. These details may be printed out using the Detailed version of the Item Report. It is important that the Category and Group exist for surgical billing and visits. E.g Item 4.
Standard tab
Shows the Medicare and DVA fees for the selected service item, and different fees that other payers and providers apply to that item.
MA Fees and DVA Fees
These sections show the Medicare/DVA Schedule, Rebates and in-hospital rates. The field descriptions cannot be changed, and the values are updated when the Medicare Fees File is uploaded each month.
Derived items
Bulk billing Hospitals, Nursing Homes and Institutions may require a derived item for billing. This will require values in the Derivation Item, Add-on for multiples and Add-on for 7+ fields so the Get Derivation Item button can be used. To learn more, see the Derived items guide.
P1, P2, P3
These are private fee levels for practices with doctors who agree to set the prices patients or third parties pay. The 3 fee levels are often sufficient for different patient rates (E.g. private, pensioner, disadvantaged) or for 3 associates to bill at different rates. Each P Fee can have a discount value, which is entered as the final value. For example, if the value is $32, a discount value would be $29.
WorkCover and Motor Vehicle
Shows the amount paid by these 3rd Parties, who provide their own fees using a Fees File.
Legal/Hospital
Used to enter the practice's fees. Legal may often only apply to the preparation of medical reports.
Previous/Next - these buttons can be used to move forward and backward through the Item File.
Note: In accordance with the Medicare Australia MBS Schedule, all item values should be rounded to the nearest 5 or 10 cents, as values of less than five cents are not legal tender for cash transactions. If the Practice Details option is set to "Round to 5 cents", Zedmed Office will round to the nearest 5 cents automatically. This may not apply to the S.A. Hospital Board contractors.
Doctors tab
If the 3 private fee levels in the Standard Tab are not enough, the Doctor's tab provides 100 extra fee levels, each with its own ( P) code. These can be used by doctors, specialists, health funds and 3rd parties.
These Fee Codes can be used:
- By doctors or specialists to manually enter their own Fees for the selected item.
- By Payers who have their own Fee Type. For example, Acme Insurance or Acme Lawyers in the screenshot below.
The Codes/Descriptions button provides access to the Item Fee Label Function.
Insurers tab
Specialist practices are increasingly involved in direct billing to health funds. The Insurer's screen provides fee levels for 10 different funds. The values will be uploaded by Fee Files provided by the Health Fund as explained in the Upload Other Fees guide.
The Codes/Description button opens the Item Fees Code screen so you can create custom Item Fee information for an insurer.
Manually adding fees
Most fee information is uploaded using Fee Files, however, you can also manually add fees directly into the Value field.
For specialists
If a practice has specialists with their own fees, it will be common to manually enter those fees because there will be a limited number of Items. When billing, each specialist will have their P (1-100) applied to the invoice. If required, a Fee Type could be created for each specialist so that a meaningful description can be used.
For payers
Some small payers like law firms may have their own fees. To set these payers up, you will create an Item Fee type, then add the payer to Zedmed. The payer will now appear in Item Details in the Doctors tab, but there will be no fees for the service items.
There are 2 options:
- Manually add - open each item in Item Details and enter the fee for the item.
- Fee file upload - provide an Excel spreadsheet of the fees to Zedmed support, who will create an uploadable Fees File.
Fees Lunch & Learn video
The documentation referred to in this video is now located in the Zedmed Knowledge Base under Payer Fees.