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The Multiple Procedure Rule (MPR), also referred to as Multiple Operation Rules or Multiple Item Rules, are a set of rules applied to item fees and/or rebate amounts.
The MPR is based on the MBS schedule fee for each item.
The MPR specifies the total amount that a certain organisation will pay for procedures where multiple items are charged, to reflect the efficiency of performing multiple surgical procedures at the same time.
Gentu automatically applies the relevant MPR to item's rebate amounts for all account types except for the Other account type.
As you add items to the invoice, Gentu will automatically re-order the items to align with the given MPR, based on the MBS schedule amount for the item.
Gentu also allows you to apply the MPR to the item's fee amounts for certain account types. This applies to both Self and Known Gap health fund invoices.
Gentu automatically selects and applies the correct rebate MPR for Bulk Bill and DVA accounts.
For these type of accounts, the fee MPR is not applicable.
Gentu automatically applies the rebate MPR to No Gap accounts.
The item fee MPR is not applicable.
For Known Gap accounts, Gentu will automatically apply the rebate MPR to all items added to the invoice.
You can then apply the MPR to the item fees by clicking Apply MPR.
Alternatively, you can press Apply This Gap to apply the health fund's known gap amount to the item fees. This will also cause Gentu to automatically apply the MPR to the item fees.
For Self account type invoices, Gentu will automatically apply the MPR to the item rebate amounts.
You then have the choice of applying, or not applying, the MPR to the item fees.
If you choose not to apply the item fee MPR, Gentu will leave the item fees unchanged. The patient will receive a reduced rebate amount, and therefore will have a higher out of pocket (gap amount) cost.
If you choose to apply the fee MPR, you can so by clicking the Apply MPR button. Gentu will scale the item fees in line with the multiple procedure rule, resulting in a reduced out of pocket (gap amount) cost to the patient.
Other... account types, used for third party billing, operate differently.
For Other account types, you have the option of leaving the item fees unchanged, or you can choose a specific MPR scale to apply. This is based on the organisation's requirements, so if you are unsure which MPR to use, you should contact the third party organisation.
To apply the MPR to an Other account type invoice, click the Apply MPR button to reveal a drop down menu with several MPR scale options:
From this list, select the relevant MPR to apply it to the invoice fees.
If desired, you can exclude specific items on an invoice from being MPR applicable.
Excluded items will not have the rebate MPR or the fee MPR applied to them.
To exclude an item; first add it to the invoice and then click the flag icon to open the Overrides window.
Tick the Not Multiple Procedure override, and then enter the explanatory Service Text.
Click Apply to save.
Once you have done this, the item will be excluded from both the rebate and fee MPR scaling.