Billing Rules - Multiple Procedure Rule

What is the context?

Whenever multiple Procedures are consumed during or outside of an appointment in Meddbase, you can apply automatic discounts on Procedure bundles.

What is the purpose of the article?

This article outlines:

• How you can configure the Multiple Procedure Rule and add it to relevant Charge Band(s)
• 2 different ways of applying a discount on a procedure bundle:

1. 1. 1. Highest value
      2. Service Price %

• Adding the Multiple Procedure Rule to Charge Band(s)

Service Types in Meddbase are configured in Admin > Service Management. There are different types of services you can configure, e.g. Tests, Products, Vaccines etc. The billing rule described in this article only applies to the Procedure service type.

What are the pre-requisites of using the Multiple Procedure Rule?

There are configuration activity that needs to take place before this rule can be used effectively, and these are:

• Procedure(s) configured in Admin > Service Management (the Multiple Procedure Rule applies only to this Service Type)
• Configured Procedures available on Charge Band(s) via either:

1. 1. A Price List with 'Provide Services with Prices?' box ticked and prices for Procedures set as positive integers*.
   2. A Provide Services Rule (if the aforementioned Price List has the 'Provide Services with Prices' box unticked*).
   3. A Service Credits Rule (if the aforementioned Price List has the 'Provide Services with Prices' box unticked*).
   4. A Pricelist Modifier Rule (modifies prices on an existing Price List, if the aforementioned Price List has the 'Provide Services with Prices' box ticked*).

*The above configuration pre-requisites are based on the assumption that you intend to charge patients' preferred payers for consuming Procedures. If the intention is for Procedures to be offered free of charge, this rule is obsolete.  

Configuring the Multiple Procedure Rule and adding it to a Charge Band

To configure the Multiple Procedure Rule:

1. From the Start Page navigate to Admin > Billing Rules.

2. Expand the company icon where you wish to store the rule* and click +Add rule.

*You can configure any billing rule (except Charge Band) under any given entity's icon, and that entity will not own the rule. This means you can configure 1 rule, e.g. under your chamber company, and add it to multiple Charge Bands irrespective of which entity a given Charge Band belongs to, saving you the trouble of creating the same rule multiple times.

3. Select Multiple Procedure Rule.

4. Name the rule accordingly.

Adding a Folder name / in front of the rule name will create a folder (if it doesn't exist already) and move the rule to that folder

5. Select the Rule for Multiple Procedure discount from the dropdown menu.

Discounts for patients receiving multiple procedures can be calculated in one of two ways:

Highest value

When the 'Highest Value Service Percentage' rule is selected in the Multiple Procedure Rule Details dialog, the amount charged on the invoice will be based purely on the highest priced (the most expensive) Procedure out of the many booked, with a percentage supplement applied.

The supplement is decided by the number of Procedures on the invoice. If one Procedure is invoiced, it will be charged in full with a 0% supplement.

If two Procedures are invoiced, the supplement will increase according to the setup. If three or more Procedures are invoiced the supplement will increase once more.

Let's use an example of a 10% supplement when 2 Procedures are booked and a 20% supplement when three or more Procedures booked.

Service Price %

When the 'Highest Value Service Percentage' rule is selected in the Multiple Procedure Rule Details dialog, the total value of the invoice will be calculated based on a percentage of each Procedure price.

The highest value Procedure (the most expensive) will be charged at 100%.

The 2nd highest value Procedure will be charged at a reduced percentage, as per the setup, then all lower value Procedures will be charged at a further reduced rate.

It does not matter in which order you select the Procedures, as the system takes the hierarchy of prices (from highest) into account not the order of selection

Let's use an example of 80% charged for the 2nd most expensive Procedure booked and 50% for further less expensive Procedures booked. Let's use the Procedures from the previous example again here:

• • • Procedure 1 - £1000
    • Procedure 2 - £500
    • Procedure 3 - £10
    • Procedure 4 - £5

Adding the Multiple Procedure Rule to Charge Band(s)

As with any billing rule, the Multiple Procedure Rule must be added to relevant Charge Band(s) to perform the desired action and apply discounts on Procedure bundles.

To add the rule to a relevant Charge Band:

1. From the Start Page navigate to Admin > Billing Rules.

2. Expand the icon of the entity (company) to which you wish to apply the rule. If the relevant entity is not visible, you can add it to the view via the Add Companies field.

3. Click on the relevant Charge Band(s) you wish to apply the rule on.

Every entity (company) can have as many Charge Bands configured as needed, e.g. an Employer having multiple Charge Bands for different groups of employees or an Insurer having multiple Charge Bands for different insurance tiers.

4. in the Charge Band Rules section click +Add rule.

5. In the Add Rules To Set dialog window, expand the entity where you created/stored the rule.

6. Click the rule and it will be added to the Charge Band.

Review date

This article was last reviewed on 1st November 2024.