Fee Schedules

Gentu comes with the major Australian health insurance funds' fee schedules built-in.

We handle all organisational fee schedule updates on our end (excluding the AMA schedule), so you never have to worry about making sure your fees are up to date.

Gentu also maintains a historical record of legacy fee schedules for the last two years, so when you create back-dated invoices, Gentu will automatically populate each item with the correct fees as of the date of service. 

The only time you'll need to manually update fee schedules in Gentu is to keep your Private fees up to date; to import the latest AMA fees; and to update any custom-added item numbers you use. 

Private & custom fees

Gentu lets you set your private fees in two ways:

• By configuring your own private fee schedule based on a formula: a percentage or amount above/below another organisational schedule.
• By manually inputting the private fee for certain items individually.

You can also create as many custom fee schedules as you'd like.

Formula-based fee schedule

Formula- or percentage-based fee schedules must be based on an existing organisational schedule (such as the MBS or the AMA fee schedules).

1. Navigate to Settings > Billing Items & Fee Schedules.
2. Under the Custom Fee Schedule table, select Private.
3. In the new window, you'll see where you can set the formula used to generate your private fee schedule.
   
4. Select the Percentage or Dollar amount option, as per your preference.
5. Select above or below.
6. Select the organisational fee schedule you wish to base your private fees on.
7. Select the rounding option.
8. Press Save.

Gentu will then take a few moments to process and save your new private fee schedule.

Manually enter fees

If you wish to add or change the private fee for individual items:

1. Navigate to Settings > Billing Items & Fee Schedules.
2. Under the Billing Items heading, search for the item number whose fee you wish to change.
3. Select the item number from the search results list to view its details.
4. From the fee schedule drop down list select the custom fee schedule whose fee you wish to change. Gentu will select the Private schedule by default.
5. In the box underneath the fee schedule drop down list, manually type in the new fee.
   
6. Press Save to save the changes.
7. Repeat as necessary for any items whose fee you wish to change.

Custom fee schedules

You can add your own custom fee schedules - as many as needed - and update their fees as described in the Formula-based fee schedule and Manually entering fees sections above.

To add a new custom fee schedule:

1. Navigate to Settings > Billing Items & Fee Schedules.
2. Under the Custom Fee Schedule table, select Private.
3. In the new window, you'll see where you can set the formula used to generate your custom fee schedule.
4. Refer to the Formula-based fee schedule section above for further information.

To edit individual items' fees under your custom schedule:

1. Navigate to Settings > Billing Items & Fee Schedules.
2. Under the Billing Items heading, search for the item number whose fee you wish to change.
3. Select the item number from the search results list to view its details.
4. From the fee schedule drop down list select the custom fee schedule whose fee you wish to change. Gentu will select the Private schedule by default.
5. In the box underneath the fee schedule drop down list, manually type in the new fee.
6. Press Save.

Update custom fee schedules

Once a fee schedule has been created, you can edit it at any time to update its formula.

1. Navigate to Settings > Billing Items & Fee Schedules.
2. Under the Custom Fee Schedule table, select the custom fee whose schedule you wish to update.
3. Click the Edit button to the far right.
4. This will unlock the fields and allow you to make the desired changes as necessary.
5. Click Save to save the changes when complete.

Custom billing items

Gentu comes pre-loaded with all current MBS item codes. You can also add your own custom billing items as needed.

Please note: it is not possible to bill custom/non-MBS items in electronic claims. 

1. Navigate to Settings > Billing Items & Fee Schedules. 
2. Select Add Custom Item. 
3. Add the item code - this can be any combination of letters & numbers.
   
4. Enter a description if desired.
5. Enter the private fee for the item.
6. If the item's fee is GST inclusive, tick GST included.
7. Press Save to save the new custom item.

Update custom item fees

To edit the fee for a custom item under any of your custom fee schedules: 

1. Navigate to Settings > Billing Items & Fee Schedules.
2. Under the Billing Items heading, search for the custom item number.
3. Select the item number from the search results list to view its details.
4. From the fee schedule drop down list select the custom fee schedule whose fee you wish to change. Gentu will select the Private schedule by default.
5. In the box underneath the fee schedule drop down list, manually type in the new fee.
6. Press Save.

Please note: custom items' fees must be updated individually using the method above. Custom items' fees will not be updated when you add or edit custom fee schedules. 

AMA Fees

If you are a member of the Australian Medical Association (AMA), you are entitled to charge AMA fees.

AMA fees must be downloaded from the AMA website, and then manually uploaded into Gentu. 

• Please see the Upload AMA fee schedule to Gentu article for more information and instructions.

Please note: the AMA fee schedule file must be downloaded in .CSV format. Other formats, such as .PDF, will not import the fees correctly into Gentu.

TAC fees

The Transport Accident Commission (TAC) fees are pre-loaded into Gentu for use with third party billing. 

To bill TAC fees, simply select the TAC schedule from the Fee Schedule drop down list above the items when creating an invoice.

For more information please see the third party billing article.

WorkCover fees

Gentu currently offers the WorkCover QLD, WorkSafe VIC, and Return to Work SA fee schedules and billing items. 

When creating an invoice, you can simply select the relevant fee schedule from the drop down menu above the Item column.

WAGMSS

Please see the dedicated WAGMSS article for information on configuring, and billing under, WAGMSS.