Hospital Invoicing / Billing an Episode – Simple

Once the episode is complete, an invoice can be raised to a health fund or patient.
For an invoice to be raised, the episode needs to be:

– Admitted
– Discharged
Theatre Complete tick box checked (depending on the facility requirements)
– Coding Grouped (depending on the facility requirements)

  1. Open the Appointments Screen and locate the required episode
  2. Right Click to reveal the menu & select Create Invoice

  1. The Create Invoice page will display with the following necessary information:

  1. All patient information specific to the episode
  2. Billing information including:
    Billing Type
    Theatre Times
  3. Procedure Items being billed (drawn from Theatre Screen if entered)
  4. Other Services being billed (drawn from Theatre Screen if entered)
  5. The Bill To feature allows other services to be billed to the patient or a third-party company, even if the main invoice is being billed to a health fund. Selecting Patient from this dropdown will create a separate invoice/invoice number for the patient account
  6. The Financial Notes & Episodes notes fields will reflect notes that have been entered into the patients’ Episodes screen.
  7. As long as all required information has been previously entered into the Theatre Screen, there should be few reasons that anything on the Create Invoice page needs to be amended
  8. Click Proceed to see charges

  1. The invoice information is displayed, including:
    Accounting Period (That the revenue will be applied to)
    Bill Type
    ECLIPSE transmission status
  2. The Accommodation charges will be shown
  3. The Theatre & Other Services Charges will be displayed
  4. GST can be amended with a Right Click in the GST Field
  5. Custom Invoice Messages are able to be added. (Invoice Message Templates can also be added in Settings > Invoice / IFC Messages, so that they can easily be selected from the dropdown list)
  6. Invoice template can be selected
  7. Print & Save can be selected when the invoice isn’t able to be sent via ECLIPSE & the user requires a printed or PDF copy of the invoice
  8. Save can be selected when the invoice is able to be transmitted electronically via ECLIPSE & the user does not require a hard copy of the invoice

Once the user has selected Save for an invoice that can be transmitted electronically via ECLIPSE, they will then need to send this invoice by following the FYDO wiki instructions
Claiming Hospital – Not Yet Sent

For a more detailed explanation of FYDO invoicing please see:
Hospital Invoicing / Billing an Episode Detailed




Hospital Invoicing / Billing an Episode – Detailed

Once the episode is complete, an invoice can be raised to a health fund or patient. For an invoice to be raised, the episode needs to be Admitted & Discharged. Depending on the requirements that the facility has stipulated in System Configuration, the Theatre Complete tick box may need to be ticked in order to confirm the item numbers are correct for billing. And the episode may need to be Grouped in order for billing to be able to be done.

A simple invoicing & billing explanation can be found at:
Hospital Invoicing / Billing an Episode – Simple

  1. Navigate to the Appointments Screen
  2. Use the Search field to locate the required episode or
  3. Use the Calendar to select required date & Theatre Tabs to select required theatre
  4. Locate required episode & Right Click to reveal the menu
  5. Select Create Invoice

  1. The Create Invoice page will display with the following necessary information:

  1. All patient information specific to the episode
  2. The health fund being invoiced
  3. Billing Type can usually be left as default. This allows FYDO to review the fees entered for the health fund & bill accordingly by Casebase, Per Diem or DRG
  4. The Status of the invoice being billed: either Full Fee or Basic Fee
  5. The Accommodation Type
  6. The anaesthetic type being billed
  7. The theatre times that the invoice will be based on
  8. The Mode of Separation
  9. The items being billed
  10. The Other Services being billed
  11. The Re-order Item Numbers tick box allows users to keep the item numbers in the order they have been entered in. However, if this box is checked, then FYDO will order the item numbers from highest to lowest banding
  12. The Bill To feature allows other services to be billed to the patient or a third-party company, even if the main invoice is being billed to a health fund. Selecting Patient from this dropdown will create a separate invoice/invoice number for the patient account
  13. The Financial Notes & Episodes notes fields will reflect notes that have been entered into the patients’ Episodes screen.

    7. As long as all required information has been previously entered into the Theatre Screen, there should be few reasons that anything on the Create Invoice page needs to be amended

    8. Click Proceed to see charges

  1. The Accounting Period date, which the revenue will be applied to, is displayed. (The default date that is selected in this field is set in Settings > System Configuration)
  2. The Bill Type that has been used will be displayed
  3. The invoice’s ability to be transmitted via ECLIPSE will be shown with the tick box
  4. The Accommodation charges will be displayed
  5. The Theatre & Other Services Charges will be displayed
  6. GST will be displayed if the fees for that item have been set up to include GST. Otherwise, users are able to calculate the GST amount by Right Clicking in the GST Field
  7. Custom Invoice Messages are able to be added & the user is able to type the required messages. However, Invoice Message Templates can also be added in Settings > Invoice / IFC Messages so that they can easily be selected from the dropdown list
  8. FYDO allows for multiple Invoice Templates to be added. A default template can be set, but if another template is required, it can be selected from the Template dropdown
  9. Print & Save can be selected when the invoice isn’t able to be sent via ECLIPSE & the user requires a printed or PDF copy of the invoice
  10. Save can be selected when the invoice is able to be transmitted electronically via ECLIPSE & the user does not require a hard copy of the invoice

 

Once the user has selected Save for an invoice that can be transmitted electronically via ECLIPSE, they will then need to send this invoice by following the FYDO wiki instructions Claiming Hospital – Not Yet Sent




Opening the Theatre on a Non-Standard Day / Weekend

FYDO allows users to have the available theatre times & default appointments to be set for every day. However, sometimes facilities will have the need to open a theatre on a day that it would usually not be opened on.
This can easily be done in FYDO by adding a Non-Standard Day to your theatre by following the instructions below.

  1. Open Settings
  2. Select Theatre Data

     

  3. Double Click on the required Theatre

  1. Select tab Add Non-Std Days
  2. Selected the required Date or click the Close Day tickbox to close the theatre for a day that is usually open
  3. Select the Start Time that the theatre will be available from
  4. Select the End Time that the theatre will be available to
  5. Once the Start Time & End Time have been entered, the appointments will populate with the Default Appointment Type for this theatre
  6. The Appointment Type can be amended using the dropdown under the Type column
  7. Once all required settings are added, click Save

  1. Once Non-Standard dates have been added, a new tab View Non-Std Days will be available where users are able to view all non-standard entries
  2. The user is able to View the appointment times
  3. The non-standard day is also able to be Deleted by selecting the checkbox to the left of the date then selecting the blue bin symbol above the date.



Unadmit or Undischarge a Hospital Episode

If an episode is accidentally admitted or discharged, the user can Un-admit or Un-discharge following the steps below.

  1. Navigate to the appointment that needs to be Un-admitted and/or Un-discharged
  2. Use the Right Click Menu to select Episodes

  1. If the episode has been admitted, & discharged, Right Click on the required Episode and select
    Un-discharge

  1. The user will be asked to Confirm that they are sure they want to un-discharge the episode.
  2. The Right Click process will need to be repeated to then Un-admit the episode.

  1. The user will again be prompted to confirm that they want to un-admit the episode.
  2. Once this process has been followed, click Back to Appointments and the episode will have been returned to the status of B for Booked



Hospital Cancer Registry Data

FYDO gives users the ability to enter Cancer Registry information & export the data for ease of submission.

Once the coding has been entered, by following the instructions on Hospital Coding, you are able to click on the Cancer Registry icon.

This will open up a screen that allows you to Add Cancer Information.

Once in the Cancer Registry screen, enter all relevant information for your state & click Save.

The Cancer Registry Data can then be exported in the same manner that you export all your monthly data.

For more information on Data Extracts, see Hospital Data Extracts




Hospital Health Fund Fees – Same Day Fees Set Up

When new contracts are negotiated with health funds, amended fees need to be loaded into FYDO to facilitate a seamless IFC & Billing process.
  1. Fees can be entered in Settings > Hospital > Fees Setup

  2. For multi location databases, ensure the correct Location is selected
  3. Use the Fund drop down to select the required health fund
  4. The Start of Current Fee date indicates the date that the Current Fees will be utilised from. Any episode from before the start date will utilise the Old Fees
  5. The End of Current Fee date indicates the date that the Current Fees will expire. Users will still be able to create IFC’s for admissions after the End of Current Fee date. However, the system will prohibit billing for episodes that fall after this date. (This date isn’t mandatory. However, it is a good way to ensure accounts aren’t accidentally billed at outdated prices)
  6. The Same Day Fees tab contains the Same Day Accommodation Fees and the Theatre Banding Charges 
  7. Users are also given the ability to Print the health fund fees, for the selected fund
  8. To edit these fees, click the Edit button
  9. Once in edit mode, you will be able to amend the Start of Current Fee & End of Current Fee dates to indicate when the new contract fees apply
  10. Use the More Actions drop down to Click to Move Current Fees to Old Fees before the new fees are entered. This will replicate all the current accommodation fees into the Old Fees columns
  11. Enter the new fees in the Full Fee column for the corresponding bands. (C is for Type C procedures)
  12. Once all Full Fees are entered, use the More Actions dropdown, and select Click to Move Charge into Full Rebate. This will copy all fees from the Full Fee column over into the Full Fee Rebate (Do not do this step for un-insured fees or for other ‘funds’ that don’t attract a rebate)
  13. Depending on the contract agreement, facilities may need to add the Full Fee amount into the Basic Fee column. This can easily be done by using the More Actions drop down.
  14. Repeat the same steps 10 > 12 for the Theatre Banding Charges on the right side of the screen
  15. Click Save

For further information on how to set up fees, please visit our pages:

Other Settings
Casebase Fees
Casebase Multi Fees
DRG Fees
Overnight Accommodation Fees




Hospital Health Fund Fees – Casebase Fees

When new contracts are negotiated with health funds, amended fees need to be loaded into FYDO to facilitate a seamless IFC & Billing process.
The Casebase Fees tab allows the entry of any contracted All Inclusive Procedure Fees.
For more information on adding Same Day Fees, please see our page 
Hospital Health Fund Fees – Same Day Fee Set Up

  1. Fees can be entered in Settings > Hospital > Fees Setup

2. For multi-location databases, ensure the correct Location is selected
3. Use the Fund drop down to select the required health fund
4. The Start of Current Fee date indicates the date that the Current Fees will be utilised from. Any episode from before the start date will utilise the Old Fees (See Same Day Fee Instructions to amend these dates)
5. The End of Current Fee date indicates the date that the Current Fees will expire. Users will still be able to create IFC’s for admissions after the End of Current Fee date. However, the system will prohibit billing for episodes that fall after this date. (This date isn’t mandatory. However, it is a good way to ensure accounts aren’t accidentally billed at outdated prices)
6. Select Casebase Fees tab
7. Click Edit
8. If entering an amended contract, use the Actions dropdown to select Move to Old Charge before the new fees are entered. This will replicate the Current fees across to the Old Fees columns
9. Use the bottom row to add new items
10. Use the to remove any items that are no longer required
11. Enter the item number in the MBS column
12. Enter the casebase fee, listed in the contract, in the Casebase column
13. If there is a procedure fee associated with the item number, it can be entered into the Procedure column
14. Select the relevant Type for the item being added.
Standard will prompt FYDO to bill just the fee documented in the Casebase column & no accommodation fee will be added
PerDiem-Proc will add the relevant accommodation fee to the procedure fee
PerDiem-Case will add the relevant accommodation fee to the casebase fee

15. The DVA column is where the DVA codes are added (e.g. the “H” codes etc.). NB. All DVA items, with an associated item number, will need to be entered with the item number in the MBS column & will need to be billed using the MBS item number. FYDO will then send the associated DVA code via ECLIPSE to ensure claims are transmitted successfully
16. Enter the outlier days, listed in the contract, in the Outlier Days column
17. Enter the outlier fee, listed in the contract, in the Outlier Rate column
18. Tick Ignore Step down if facilities wish to ensure certain fees are not subject to the usual percentage breakdown and are calculated at 100%, even when the item is performed as a secondary or subsequent procedure.
19. Tick the GST box if the fee that has been entered is inclusive of GST
20. Tick the Exclude Other Services box if the other services/prosthesis are unable to have a charge raised when billed with the item number. E.g., If a contract stipulates that any prosthesis used is included in the casebase fee. NB for this function to work, each applicable prosthesis code will need the Exclude fee when billing tick box ticked. 
21. Tick Exclude Private Room if hospitals are unable to charge for a private room add-on for certain admissions, while still allowing the private room add-on charge to be applied to all other Case Base or DRG fees.
22. Once all details have been entered click Save

For further information on how to set up fees, please visit our pages:

Other Settings
Casebase Multi Fees
DRG Fees
Overnight Accommodation Fees




Hospital Health Fund Fees – Overnight Accommodation Fees

When new contracts are negotiated with health funds, amended fees need to be loaded into FYDO to facilitate a seamless IFC & Billing process.
The Overnight Accommodation Fees tab allows the entry of any contracted fees.
For more information on adding Same Day Fees, please see our page 
Hospital Health Fund Fees – Same Day Fees Set Up
  1. Fees can be entered in Settings > Hospital > Fees Setup

  2. For multi-location databases, ensure the correct Location is selected
  3. Use the Fund drop down to select the required health fund
  4. The Start of Current Fee date indicates the date that the Current Fees will be utilised from. Any episode from before the start date will utilise the Old Fees (See Same Day Fee Instructions to amend these dates)
  5. The End of Current Fee date indicates the date that the Current Fees will expire. Users will still be able to create IFC’s for admissions after the End of Current Fee date. However, the system will prohibit billing for episodes that fall after this date. (This date isn’t mandatory. However, it is a good way to ensure accounts aren’t accidentally billed at old prices)
  6. Select the Overnight Accommodation Fees tab
  7. Select the required Accommodation Type from the drop down. (Accommodation Categories can be added or amended in Settings > Accommodation Categories)
  8. Click Edit
  9. If adding amended fees, use the More Actions dropdown to select Click to move all Current Fees to Old Fees
  10. If the fees are required to mirror the Minimum Benefits fees (Entered in Settings > Minimum Benefits), use the More Actions drop down & select Copy Rates from Minimum Benefits
  11. A pop up will appear to give all required options regarding copying the Minimum Benefits Rates into the Health Fund Contract rates
  12. Full Cover Fees can be added to the first section of the screen
  13. Basic Cover Fees can be added to the second section of the screen
  14. When entering fees, use the   to adjust the Day that the fees apply to. This will automatically adjust the following line to continue on.
  15. Add the relevant fees into the Shared, Private & Rebate columns
  16. Click Save
  17. The user is then able to select the next Accom Type that they require & follow the same process again

For further information on how to set up fees please visit our pages:

Other Settings
Casebase Fees
Casebase Multi Fees
Hospital Health Fund Fees – DRG Fees




IFC for an Episode that is partially covered by the Health Fund

There will be some instances where insured patients need to pay for part of their procedure.
Maybe some of the procedures is classified as a cosmetic procedure, maybe they have restrictions on their level of cover & the hospital is able to raise a charge to the patient for those extra procedures.
Maybe the hospital is contracted for 2nd Tier rates and can charge a patient gap or they want to charge a credit card surcharge to the patient.
Whatever the case may be, FYDO accommodates this split method of billing the health fund AND the patient seamlessly.

The first step in this process is to ensure the patient is entered with their Health Fund Details for the episode. And then adding the items to the Edit Appointment Screen.

As seen below, FYDO gives the option to Send Invoice To the Health Fund or the Patient. This allows the user to select certain items that will be billed to the patient.

Each facility is able to add their own “codes” to the Other Services list in FYDO. This can be done by following the instructions for Adding Other Services Codes (Hospital) and then adding the corresponding fees by following the instructions for Adding Fees for Other Service Codes (Hospitals)

After all required information is entered, the user can click Save. They will then be prompted to review the information, as FYDO wants to be sure that the items are being bill correctly.

Therefore click Ignore and Save.

From here, the user is able to proceed to creating the IFC. This is where we will be able to see that the items being billed to the health fund will attract a rebate. And the items being billed to the patient will not attract a rebate.

Once the IFC is produced the patient will be able to clearly see which items attract a health fund rebate & which items do not.

For information in receipting payments for these types of episodes visit these instructions for




Receipting for an Episode that is partially covered by the Health Fund

There will be some instances where insured patients need to pay for part of their procedure.
Maybe some of the procedures is classified as a cosmetic procedure, maybe they have restrictions on their level of cover & the hospital is able to raise a charge to the patient for those extra procedures.
Maybe the hospital is contracted for 2nd Tier rates and can charge a patient gap or they want to charge a credit card surcharge to the patient.
Whatever the case may be, FYDO accommodates this split method of billing the health fund AND the patient seamlessly.

To create an IFC for a patient whose admission is only partially covered by the health fund, see instructions on Creating an IFC for an Episode that is Partially Covered by the Health Fund

To receipt the patient for their Insured & Uninsured portions of their payment at the same time navigate to the appointments screen, right click on the episode & select Excess/Deposit.

Then use the Fund Excess section to receipt the payment that is required to go towards the Insured Fund Invoice and use the Patient Account Deposit section to receipt the payment that is required to go towards the Uninsured Patient Invoice.

Click Save & Print to produce a copy of the receipts for the patient.

If you navigate to the History/Episodes screen you will be able to see that there has been an Insured Invoice Number raised, along with an Uninsured Invoice Number raise.