• Double click on an existing Entity to edit or select Add on the sidebar to add a new Entity
• Health Fund contracts are entered and maintained in the Location Rate Insured by selecting the green Edit button
• Fees for patients without Private Health Fund Insurance are entered and maintained in the the Location Rate Uninsured by selecting the green Edit button. Even though there is no Medicare Rebate, these fees can be based on existing fee schedule (eg: AHSA) or a percentage of

Entering and maintaining Health Fund Contracts

• Select Use check box on the Insured Rate line to activate
• Select the green Edit button
• The Entity Insured Rates form is divided into two sections
  • The top section is where you add and maintain Item Codes per Insurer Group and the contracted fee
    • These Item Codes need to be in Utilities - Lookups - General - Items before you can select them in here
      • MBS Item Codes are maintained by DCM
      • ACC1 through to ACC4 for Same Day / Day Surgery are already in DCM, as are
      • Band1a through to Band9
        • On entering an MBS Item Code on the IFC or Invoice, DCM will populate the correct fee based on that Item Code's banding
    • Select the Item Code
    • Select the Insurer Group
    • Enter the contracted fee
  • The bottom section is where you enter the scaling for the Insurer Group

• Maximise the screen for a better view
• Use Grouping and Filtering to manage
• Click on the first row under the column heading Item Code to select an Item Code. Non-MBS Item Codes (Prosthetics, etc.) need to be added in Utilities - Lookups - General - Items in order to select them here
• Select the Insurer Group
• Only select an Insurer Fund should that individual Fund have a different contract to the Insurer Group
• Enter the Fee
• Select if DRG or Casemix
• Tick Default for this fee to be the default fee on entering the Item Code on the IFC/Invoice.
• If an Item Code can be a 2nd Procedure, enter it twice and do not select Default on the 2nd entry and enter the 2nd Procedure fee. On generating the IFC/Invoice, right-click on the Item and select Contract Fee - 2nd Procedure