Billing Questions

Newborns require special handling for billing because they don't have a PHN/ULI. We currently do not have anything related to newborns in our user interface. Do you anticipate support for newborns being required in the initial release?
- don't worry about it. Off the list.
Dental procedures require special handling for billing. Do you anticipate any dental procedures being performed in the IH clinics any time soon?
- off the list.
Incoming Referrals – that is, when an IH doctor is a specialist and receives a referral from another practitioner – require special handling for billing and for keeping track of the incoming referrals (e.g., need to keep track of the referring practitioner's PRACID). Do you anticipate IH practitioners receiving referrals such that this functionality is needed for initial release?
- occasional one GP will refer to another GP
- we need this
- we will need user interface for this (add to SOAP note)
- extend appointment data model with referring doctor and ID
Something called a “provider skill code” is needed. It's an attribute of the practitioner. Do you know what this would be? (Jackson: we will need to have UI for entering this data about a practitioner.)
- GP
- Same skill code all the time.
When I submit a billing transaction, I have to indicate to whom it will be paid. This could be the “service provider” (I guess this means the individual practitioner in the clinic) but the documentation I found suggests this is more likely to be a “business arrangement” identified by a “business arrangement number”. Do you have any idea what we're going to do?
- Business arrangement. Different for each clinic. Physicians assigned to clinic.
“Good Faith” claims require special handling. Is this a priority for first release?)
- Yes.
Service provided at “home” – I guess this means the patient's home – require special handling. Priority for first release?
There is field that indicates a claim requires “confidentiality” – I guess this is over and above the normal level of confidentiality that is afforded all claims. How should I handle this?
- No. Ignore.
There is the ability to claim an amount less than “usual”. This requires special handling. Is it a priority for the first release?
- Don't worry about it.
Finally, there are additional fields called the Facility Code, Facility Number & Functional Centre. Do you have any idea how these get assigned?
- facility number is attribute of clinic
  - will usually be same facility code and centre 99% of time
  - Functional centre / code: working out of hospital, nursing home, clinics etc.
    - paper slip from doctor
- data model needs to be extended