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Fee and Service Item Management
Derived Fees
Some Medicare service item fees are calculated.
Derived Fees in Detail
Bluechip calculates charges and benefits for services according to how you configure your Service Items.
Step 4.2.2: Derived Fee Type - Field Quantity Billing
All Online Claims (Bulk Bill, DVA, Patient Claim, Eclipse)

All Online Claims (Bulk Bill, DVA, Patient Claim, Eclipse)

When Medicare payment is received for Bulk Bill/DVA and Private Claims (only Private claims when the Derived fee amount was not amended), Medicare calculates and handles the claim and as follows:

Medicare does not pay the Base item, and generates a reason code message. Example error message: '253 – Radiotherapy assessed with other item number on the voucher'.
Then Medicare Accepts the Derived item number and pays the amount (base item fee + derived item fee) and generates a reason code message. Example acceptance message: '516 – Benefit paid for base and derived radiotherapy items claimed'.Due to how Medicare handles the payment for the above scenario, MBS and RMFS fee List cannot generate a base item fee as $0.00. So, for a Private Patient the unpaid base item fee generates as a Gap value for the Practice.