Invoicing
Adding alerts to invoices and patients
Introduction Invoice Notes and Patient Notes can be flagged with an Alert status. Alerts may be used for medical purposes such as significant allergies, previous anaesthetic issues etc, or for admin/financial purposes such a bad debtors, important ...
Two Way Claims
From time to time you may be advised by health funds to submit a claim as a "two way claim". Cutting Edge is not able to submit two-way claims on behalf of patients or providers. Strictly speaking a two way claim can only be submitted by a patient. ...
DVA Prior Financial Approval Items
DVA may sometimes approve charges above those listed in the Repatriation Medical Fee Schedule if there are exceptional circumstances justifying the payment of a higher fee for a particular patient. They will issue the provider (e.g the surgeon) with ...
Adding Alternate Contact Details
For most invoices, the Address, Email and Phone details on the 'Contact' tab in the 'Contact Details' section are sufficient for claiming and receipting. However in some situations you may need to address invoices to a third party, such as a parent, ...
Adding passwords to PDFs
In general, modern emails are considered secure in transit as they use Transport Layer Security (TLS). Almost all modern email providers now support TLS for encryption, but some older systems, regional Internet Service Providers (ISPs), or specific ...
MBS Items that require number of patients seen
Some professional attendance items for nursing home or inpatient attendance require you to specify the number of patients that were seen the same day. This is so that CE can calculate the correct fee, as Medicare pays a reduced fee where more than ...
Setting up Surgery Connect billing
For Surgery Connect work where the invoices need to be sent to the hospital, you may first need to register with the hospital and confirm what address they want invoices sent to. Then in CE, set up a new entry in your Databases > Funds page for each ...
Unpaid Gap
On the invoice screen: Cutting Edge Software includes a field to see the remaining fee owed by the patient on an invoice at a glance: This will allow users to determine if a patient has paid their Gap in full or in part, or if follow up is required. ...
Emailing Directly to Fund from Cutting Edge
Purpose: Resubmitting a claim - ie the fund has asked you to resubmit this claim manually (if the fund requires a batch header you will need to email directly from your email) Submitting a claim to Workcover or TAC Open the invoice you are wanting to ...
Gaps and out-of-pocket charges
Here are some tips on when you can and can't charge gaps and out-of-pocket expenses with Cutting Edge. It is important to note that under current legislation, both the practitioner providing the services and the person who manages their billing and ...
DVA Claims
In Cutting Edge you can submit DVA claims electronically, much like any other claim. Simply create a new invoice, enter the patient name and DOB then select DVA as the fund. In most cases CE will look up the Veteran's File Number for you, but if not ...
Claiming for transoesophageal echocardiography (TOE) on anaesthetic invoices
Medicare benefits for transoesophageal echocardiography (TOE) by anaesthetists are payable with Item 22051, but not in association with items 55130, 55135 or 21936. Anaesthetic claims should not include item 55130, no benefit will be payable. From ...
Patient Notes & Invoice Notes
On an invoice there are two tabs PATIENT NOTES and INVOICE NOTES. Invoice Notes will only appear on that invoice - these notes could be used for when you call the patient etc. any notes that you would want relevant to that episode of care. The Notes ...
Anaesthetic items for abandoned surgical procedures (21990)
Where a surgical procedure is abandoned, the anaesthetist should use item 21990, worth 3 units, plus the item for the actual anaesthetic time. See http://www9.health.gov.au/mbs/fullDisplay.cfm?type=note&q=TN.10.12&qt=noteID&criteria=21990
Multiple operation rules
For surgeons and assistant surgeons, where there are several billable surgical items on an invoice the appropriate Multiple Operation Rule will apply. Surgical items are all items in Group T8 of the CMBS. CESoft will apply the appropriate rule when ...
Anaesthetic Age Modifier
The Relative Value Guide (RVG) has an age modifier for anaesthesia on children and the elderly. Prior to 1 November 2019 there was a single MBS item 25015 which was applicable for patients under 1 year of age and 70+ years. It had a value of 1 basic ...
Assistant Surgeon Invoices
The Invoices screen for Surgeons has an Assist check box which should be ticked for Assistant claims. Uncheck the Assist box for other claims, such as consultations and non-surgical procedures, or if you are the primary surgeon. NOTE: You don't need ...
Abandoned Surgical Procedures
In some cases Medicare allows providers to make a claim when a surgical procedure is abandoned for medical or other reasons. For surgeons, the fee in this case is calculated at 50% of the fee which would have applied had the procedure not been ...
WAGMSS billing
WAGMSS is the Western Australian Government Medical Services Schedule. It's used in WA for Contracted Medical Practitioners working in government hospitals engaged under a Fee for Service Medical Services Agreement. See this link for more details ...
Workers compensation claims
Workers compensation claims cannot be submitted via ECLIPSE electronically, they can be emailed via CE8 - click on the email box in the Contact Details box and tick the Use Fund Address in the bottom left corner. Cutting Edge offers the schedules and ...
Creating epidural items
Epidural items can be sent with or without other items on the invoice. Cutting Edge prompts you for duration in minutes when entering long epidural items(18219/18227) to automatically calculate the correct fee and set the Service Text on the Extra ...
How to provide discounts for early payment
Offering discounts for early payment can be done by entering the amount of the discount using the small wheel with the "$" symbol that is located in the Fee Calculation Box: A box will pop up and you can enter the amount and the expiry date of the ...
Working with LSPNs
Diagnostic items involving ultrasound require that you enter a Location Specific Provider Number (LSPN) in the Facilities database before the claim can be sent. To assist you to find the correct LSPN there's a link on the Facilities page, which can ...
Entering Referral Details
Specialists A referral is required for most specialist services. A referral can be Standard, Non-Standard or Indefinite A standard referral by default is for a period of 12 months from a GP or 3 months from another specialist, unless it’s for an ...
Overseas claims (OVS) including Overseas student health cover (OSHC), Overseas Visitors Health Cover (OVHC) and Reciprocal health care agreements (RHCA)
OVS - Overseas Claims Students from overseas on a temporary student visa are not usually eligible for a Medicare card. To comply with visa requirements, they may have to purchase Overseas Student Health Cover (OSHC) to meet the costs of medical and ...
Claiming for newborns
An electronic claim can't be transmitted without a Medicare number for the individual receiving treatment. Claims for treatment of the infant can't be transmitted under a parent's Medicare number. If the infant doesn't have a card number the only ...