Halaxy allows you to charge for a derived fee by adding it onto the invoice as a second fee. This requires you to set up the derived fee in your Fees List with a default price of 0.00 and a default rebate amount of 0.00. You can then edit the fee amount on any individual invoice by editing the invoice line.
Just like other preset fees, derived fees can be imported from Halaxy's global fee database but are given a price of 0.00 by default. You can then set the correct amount to charge on a case-by-case basis.
Please see this related article about how to import fees from Halaxy's database.
In order to process a derived fee or rebate, you will need to set a charge amount and a rebate amount on an invoice-by-invoice basis.
The charge amount is the total that you will be charging for your service, whilst the rebate is the total that you will be expecting the funding body to pay for your service. Unless you intend to charge a gap, you should ensure that these two amounts are the same.
For a derived fee, both the charge amount and the rebate amount will be blank by default. You can edit them directly on the invoice and clicking the Edit (pencil) icon under the Actions column on the right-hand side.
In the Edit invoice line window that appears you can set both the Amount and Rebate fields. Halaxy will not automatically calculate this for you.
Taking the example used in the above screenshot, the associated fee being charged is for $106.75. If the derived fee is calculated at 20% of the associated fee, then the Amount and Rebate fields can be set as $21.35.
Click Save to save the new charge amount and rebate amount on the invoice.
Note
Medicare online claiming will not allow you to submit a derived fee of $0.00, even if that is the expected amount. When submitting a claim with a derived fee, ensure you set a non-zero fee amount for the derived fee and that the rebate amount is equal to the fee amount (Medicare will calculate the expected amount and correct this in processing, even if you make an error).
When Medicare pays for these item numbers, your Medicare payment report will show that one fee is paid out at $0.00 while the other fee is paid out at the claim value for both fees, balancing your claim.
Comments
Article is closed for comments.