Before you begin to deal with your Telehealth items in Gentu, you can benefit from familiarising yourself with the Bulk Bill/ DVA Invoicing process.
You may also be interested in perusing the Department of Human Services page on MBS and Telehealth for conditions and eligibility for Telehealth items. The MBS Online website also provides a number of resources and fact sheets.
The process for invoicing a Telehealth item number will be very similar to your standard invoicing process. The only difference is that you will need to add a second item number - the Telehealth item - along with the standard consult item. Gentu should automatically generate a fee for the item based on the consult item number.
After adding the consult item and the telehealth item to your invoice, you can proceed at normal to Batch or Claim as necessary.
After sending your Telehealth and consult items to Medicare, it is not unusual that these will return with an exception against both items in your Claims Control window.
For example, you will find the Telehealth item (288) has no payment made from Medicare, and the consult item (304) has more paid against it than what was claimed.
You will see that the payment for the consult item includes both the payment for the consult item and the payment for the Telehealth item.
You will also note the Payment Problem indicates “643-Derived item assessed with other item on statement”, meaning that the derived (Telehealth) item has been paid with the other item (consult). This is caused by the way the claims are assessed and paid by Medicare, in which the payment is rolled into the main/consult item number rather than being distributed against each item number.
Dealing with the Exceptions
To deal with the exceptions, you will need to ensure the total paid amount covers both items. To do this simply confirm if there is any outstanding balance remaining on the invoice.
If the total amount paid matches the total claimed for the two items, you have two options:
Marking exceptions as resolved
The first option is to mark both exceptions as resolved without adjusting any fees. This can be done by ticking the 'Mark as resolved' checkbox next to each exception and saving. This is a good option to use if you are comfortable with the way the invoice has been paid and there is no outstanding balance remaining.
Adjusting fees for each item
If you would prefer the fees to match what was paid for each item (i.e. full payment for consult item, $0 payment for telehealth items), you can firstly click the adjust icon next to the Telehealth item and add a reason, which will adjust the fee to $0.
Secondly, you can click the adjust icon for the consult item and add reason for the adjustment. This will allow Gentu to match the full payment amount for the item. Once you have done this for both items, you can tick the 'Mark as resolved' checkbox on both exceptions, and save the claim to move this to finalised.