Service Item Numbers
Payments to the Day Procedure Centre are solely for the 'use' of the facility and are not related to the surgeon's fees that the patient receives. Therefore the MBS fee list found in Bluechip is not used within a Day Procedural Centre environment unless the Centre is also providing billing for the performing practitioner.
Instead, MedicalDirector recommends creating custom Service Item lists for each health fund. Some Service Item numbers are created based upon a modified MBS Service Item number used to identify the surgical/medical services offered. Their descriptions and the Service Item fees are changed as required to show the health fund negotiated rate. Other Service Item numbers are created to account for accommodation and theatre banding levels.
The advantages of following this consistent approach in creating custom price lists for each health fund are:
- Generation of invoices for heath funds
- Reporting to health funds, the PHDB and Department of Health
- Providing Service Item analysis for management
If Prosthetics and Disposables are used in the Centre, only one price list needs to be setup as the reimbursement amount by the health fund is set at the national level.