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Jun
28
ACC Clinical Services - payment changes effective 1st July
Posted by Sinclair Hughes on 28 June 2018 09:57 PM

Pricing Changes for Clinical Service Assessments 

ACC have increased the fees payable for Clinical Service Assessments by 1.53%, effective from 1 July 2018.

Before you make any changes to your invoice fees, if you do NOT have a contract directly  with ACC then you must use the prices provided by your contract holder e.g. Southern Cross, HBOG etc.

Please ensure that you have entered all claims with a service date up to and including 30 June 2018, before updating your prices.  You will need to do this before you start entering claims with a service date of 1 July 2018. 

Your Clinical Services codes can be set up as either:

  •  Invoice Items
    • SPM Classic:          Setup > Charges > Invoice Items
    • SPM Integrated:     Setup > Financial > Charges > Invoice Items, or;

  • Third Party Schedule Claim Items
    • SPM Classic:          Setup > Claims > Third Party Schedule Claim Items
    • SPM Integrated:     Setup > Financial > Charges > Schedules > Third Party Schedule .    

If you are using Third Party Schedule Claim Items, and are in a group practice database, please consult with the other secretaries to ensure they have completed their June invoicing before amending any prices, as these codes are normally shared.

Third Party Schedule Claim Items are set GST Inclusive .  Invoice items can either be set GST Inclusive or GST Exclusive depending on the configuration (SPMi: Setup > Provider > Config. 2 > Edit  or  SPMc: Setup > User > User Config. > Edit ).

Please ensure that the 'Short code for eBilling' (see table below) is entered in the Item# field for the appropriate Billing Type (if using Invoice Codes) or the Item# field for the 3rd Party Schedule Code.

Here are some of the more commonly used clinical service items, with ACC's prices.  Refer to either ACC's or your contract holder's price schedule for other service items.

Service Item Code

Short code for ebilling

Service Item Definition

2018/19 Prices    (Ex GST)

2018/19 Prices (Inc. GST)

CS100

CS10

Simple Assessment (Initial)

170.71

196.32

CS200

CS20

Complex Assessment (Initial)

261.56

300.79

CS400

CS40

Second Opinion Assessment

170.71

196.32

CS500

CS50

Reassessment

170.71

196.32

CS61

CS61

Subsequent Assessment (Simple)

115.62

132.96

CS62

CS62

Subsequent Assessment (Complex)

170.71

196.32

CS900

CS90

Second Opinion Assessment (Complex)

261.56

300.79

 

ARTP codes update

As ACC have replaced or added many Elective Surgery billing codes, you will need to update the list of procedure codes (and related MBSE codes) that are used in the ARTP. 

You can download and import a file provided by Incisive to complete this update procedure for you.  This only needs to be done once for all the specialists in the practice.

  1. Click on this link to download a file  with all the ARTP Codes in it (ARTPwMBSEcodes_July2018.txt).  Note the location where you have saved it (it probably saved into your Downloads folder).
  2. In SPM, go to Utilities > Import > ARTP > ARTP Procedure Codes
  3. Use the 'Set' button to select the ARTP Codes file you downloaded
  4. Click on the 'Import Codes' button to import and update the ARTP. (Cancel to close)