Creating Estimates

 

The following information explains how to create a basic estimate. There are also examples for No Gap, Known Gap (Scheme) and Standard Gap estimates, along with instructions for creating estimates for In-Hospital Claiming.

1.     For convenience, ensure you have done the following first;

o       Created a Fee List.

o       Configured your various Company Groups with their appropriate Address Types, an example of which is shown in the following image.

 

 

2.     Open the patient's record.

3.     From within a patient's record, select the Estimates menu item.

4.     Click  The New Estimate of Fees window appears.


This window may vary slightly depending on whether you have enabled Quantity / Equipment ID items for Medicare or non-Medicare estimation and invoicing. In this Bulk Bill example, the option has been enabled, as indicated by the presence of the Quantity column. Note that Medicare and non-Medicare items cannot appear on the same estimate together - they must be added to separate estimates.

 

5.     Enter information as necessary (see examples of Gap/No Known Gap Estimates). Points of interest about this window:

o       Be aware that if after adding items to this window you then make a new selection from any of the Practitioner, Class or Issue To drop-down boxes, the grid will refresh, and all items will be removed.

o       The 'H/F Rebate Based On' drop-down box to the right appears only after you have enabled the corresponding 'Health Fund' check box to the left, and the selectable items include 'Medicare'. If this option is selected, then the health fund benefit (and therefore the patient gap) will be calculated correctly in those situations where the practitioner does not opt into the health fund's 'no gap' or 'known gap' scheme.

o       Upon enabling the Multiple Procedure Scaling check box, a Scaling column becomes available. This column displays scaled fee amounts, generated automatically as you enter additional items.

o       To include an Invoice Message, enable the associated check box and then select an available message from the drop-down box provided. This list is managed via Setup > Practice > Messages.

o       You can indicate that this estimate is associated with an Assistant, by including an Assistant Service Item. After adding the Assistant Service Item, you will be prompted to provide details such as whether the estimate is being prepared by a surgeon on behalf of their assistant, or whether the assistant is creating their own estimate. See Invoicing for Assistants for more information about recording this information.

 

6.     Enter an Estimate Name in the field provided.

7.     Click to confirm and close this window. You will be returned to the patient's list of estimates

o       Click to display the details of a selected estimate.

o       Click to duplicate a selected estimate, opening the duplicate ready for additions/edits.

o       Click to print the estimate.

o       Click to create a new invoice for this estimate. Please ensure you have correctly setup your accounts.

 

This concludes the steps necessary for creating an estimate. If you wish, you can now validate this estimate with Medicare, by performing an Online Eligibility Check.

Once you have generated an Estimate, you cannot edit it or delete it. However, you can clone it and then edit the clone. If it is necessary for you to add items to an existing estimate, you can always do this at the point where you issue the invoice for the estimate.