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Ethical invoicing for medical professionals

This article will show how medical professionals can use AppointmentGuru to easily create ethical invoices that meet the criteria of South African medical aid providers like Discovery Health.

Disclaimer:

This information is correct to the best of our knowledge at the time of writing (April 2019). We do our best to ensure that our invoicing software remains up to date. We will also work to keep this information current and post updates as requirements change. If you have any questions or comments, please let us know by emailing us at [email protected].

What needs to be on the invoice:

The following information should be displayed on your invoice if possible:

  • Name of practice: The AppointmentGuru will automatically add your practice name and number as configured in your settings (Settings -> Profile).
  • Practice address and contact information: AppointmentGuru will automatically add this information based on the settings under invoice settings. See: Add your invoice settings.
  • Medical aid details including patient name and ID number: Capture this information under the client's contact information. See: Adding personal and medical aid information.
  • Referring doctor/practitioner and their practice number: You can add a referring practitioner under the clients contact information. See: Add a referring practitioner to your invoices.
  • List of ICD-10 codes: AppointmentGuru will automatically generate and add a list of all the unique ICD-10 codes used in an invoice.
  • Your banking details (so you can get paid).

Complete invoice header information: Complete invoice header information as generated by AppointmentGuru

On top of this, each session/appointment should be listed and should include the following information:

Appointment information:

  • Treatment date and time.
  • Treating practitioner, their registration number and where the patient was treated. e.g.: Treated by Joe Soap (BK: 12345) at The Hub Note: You won't be able to activate this setting in your AppointmentGuru account yet, but we can do it for you. Please contact us if you would like your invoices to reflect these changes.
  • Price.

Line item information:

An appointment can have multiple line items (essentially a line item is a therapy code). Each line item must display the following information:

  • Patient name and surname.
  • ICD-10 codes used.
    • It is now recommended to add multiple ICD-10 codes per therapy code (you need to have causal codes in addition to the pathology)
    • The recommendation is to separate codes with a /. eg: M54.47/M25.60/M51.37
  • Tariff / process codes.
  • Line item price.

Note: All this information needs to be on the same line

An example of how the line items on your appointments should look: The appointments section of your invoice as generated by AppointmentGuru

ICD-10 and Therapy codes:

  • ICD-10 codes are a means to identify the diagnosis of the patient.
  • Tariff or therapy codes signify what treatment was done to treat the diagnosed issue. See: Adding medical coding to your invoices.

Some basic rules around coding:

  • The same ICD-10 code can be used for up to 3 therapy codes.
  • A therapy code can only be used once per appointment.
  • Some South African medical aid providers only accept a subset of the global set of ICD-10 codes. This subset is call the MIT (Master Index Table) list. We are working on sourcing this list and including it in our ICD-10 code search.
  • It is recommended to provide multiple ICD-10 codes per therapy code. See: Adding medical coding to your invoices.

Other useful information to add to your invoice:

In addition to the information above, AppointmentGuru will automatically add the following information to your invoices if configured to do so:

  • Invoice date and due date (automatically added based on what you choose when creating an invoice).
  • Invoice number (autogenerated for you).
  • Logo (settings -> media).
  • SnapScan code for payment (if your account is integrated with SnapScan). See How does the SnapScan integration work.
  • Notes that can be automatically added to invoices and receipts (Click on the cog on the top right of the Invoices page).

Automatic notes with AppointmentGuru:

AppointmentGuru can automatically add notes to you invoices and receipts respectively.

For example, you might put:

  • "Please use invoice number as reference when paying" on your invoices
  • and something like: "Invoice paid in full, please reimburse client" on your receipts

Example of a complete invoice:

A complete invoice

Invoicing