Overview

An Assistant is a clinician who assists the practitioner with a procedure. The practitioner can then bill the patient for the assistant services on behalf of the assistant, or an assistant can bill for their own services independently to the practitioner’s claim (using assistant items 51300 or 51303). If the assistant bills independently, they submit to Medicare as a separate claim so that the appropriate payments can be received separately.

Prior to billing for any Assistant Services, setup of both assistants and Assistant Items are required in Bluechip.

o      Assistants; with name and provider number

o      Assistant items; with a tick to determine it is an Assistant Item and the percentage requirement

Assistant Record Setup

1.      From the Bluechip main window, select Setup > Lists > Assistants . The Setup Assistants window appears.

 

2.      Perform any of the following actions:

o      Create a new assistant by clicking  A blank record is created in which you can enter the assistant's Name and Provider Number.

o      Delete an existing assistant by selecting them from the list and clicking  You cannot delete an Assistant with historical financial records.

o      Deactivate an assistant by selecting them from the list, and clicking  Deactivated records appear in italics, as shown in the example below. Note also that you can reactivate a deactivated record, by selecting it and clicking

 

 

3.      Click to save your the changes and close this window.

Assistant Service Items Setup

You must specify which Service Items qualify as 'Assistant Items' for the purposes of billing. Once enabled, if you add these items to an invoice, the associated percentage fee will be calculated automatically for you. If a Health Fund Assistant Percentage differs from the usual 20%, you are required to amend the percentage amount to include the additional percentage in each Health Fund Fee List.

Example: Original default percentage 20% + HCF quoted additional 1.407% = 21.407%. Therefore you would enter 21.407 into the % field and it will automatically round up or down appropriately (21.40).

Procedure

1.      From the Bluechip main window select Lists > Service Items. The Service Item List window appears.

 

2.      Select the Medicare/Health Fund you wish to modify fees for, and click  The Service Items window appears.

 

3.      In the Filter by Item field, enter the Assistant Service Item you wish to modify. Some examples are shown in the image above.

4.      For each item you wish to associate with assistant billing, tick the Assistant Item check box, and enter the require percentage in the % field.

 

5.      To save changes click back onto the item number within the list.

Practitioner Record Setup

Before billing for Assistant Items, you need to ensure that the associated practitioner has been configured correctly;

o      If the practitioner is not already in your database, you must create a record for them.

o      Ensure the practitioner has a Provider Number recorded.

Invoicing For Assistant Items

1.      Create the invoice for the principal provider first. This invoice should consist only of Service Items for the principal provider. Do not add Assistant Service Items to this invoice.

2.      Submit the principal provider's claim to Medicare. It is advisable that you wait for the claim to be processed completely before invoicing for the assistant, to allow for any rejections that may occur.

3.      Then, create a new invoice for the Assistant, invoicing for any of the assistant items you configured above (in our example, we have used item 51300).

 

4.      Upon pressing the Tab key, the Assistant Item window appears.

 

5.      Via the Billing Type section, indicate whether in this instance the Assistant Item is being billed for by;

o      A Surgeon, billing for Assistant items on behalf of the Assistant.

If you select this option, you must also specify which Assistant the surgeon is billing on behalf of.

 

o      An Assistant, billing for themselves.

If you select this option, you must specify the Assistant's surgeon.

 

 

6.      The Invoiced Items section lists all the Service Items you are invoicing for. You may also list non-invoiced items by entering them in the Non Invoiced Items section. You may wish to do this if the fee you wish to charge is a percentage of one or more other Service Items.

7.      If you wish to apply Multiple Procedure Scaling for non-invoiced items selected for Assistant Item fee calculation, tick the Multiple Procedure Scaling check box. Note that the Non-Invoiced Items section of this window will display a Fee column and a Scale column when this check box is ticked, and fees will be calculated using Multiple Procedure Scaling for applicable service items.

8.      Indicate whether you will charge an overall Fixed Fee or a Percentage of specific Service Items; within the Calculate Fee as a section, select either the Percentage of Fees option, or the Fixed Fee option.

o      If you choose the Fixed Fee option, you must specify the fee amount in the field provided. It is recommended that you also indicate which Service Items the fixed fee is associated with. Failure to do so may result in Medicare rejecting the claim.

o      If you choose the Percentage of Fees option, you must also specify the percentage rate (e.g. 20%) in the field provided, and then indicate which Service Items you will charge the rate against, by ticking each item's associated fee check box. This option is selected in the example above. Note that if you have added items to the Non Invoiced Items section, it is assumed that each will be considered when your % fee is calculated. If you wish to remove an item from the Non Serviced Items section, select the item and click press CTRL + Delete on your keyboard.
 

 

9.      Click to confirm. You will be returned to the New Invoice window. Note the Assistant Item, along with its fee. Note also the Service Text description - this can be accessed by clicking within the Service Text field and pressing SPACE + ENTER on your keyboard.

 

10.   Click to issue the invoice.

11.   (optional) You may be prompted to select an associated referral.

 

12.   The Issue Invoice window appears. Enter the date on which the invoice was issued, The default is today's date, but you can back-date it if you wish.

 

13.   Click  You will be prompted to print the invoice. The Invoices tab displays the Assistant Item.