Modifiers adjust or add information to a line item on an invoice, for example to reduce the fee for a second procedure or to record extra treatment time. Medical aids use modifiers to calculate the amount payable, so adding the right modifier helps your claims go through correctly. Modifiers are linked to discipline categories, such as Physiotherapist or Occupational Therapist.
Every team member who uses modifiers needs a category on their profile. This usually includes physiotherapists, doctors and specialists. Without a category, a team member won't see any modifiers on their invoices.
Follow these steps:
Note: If you chose categories during the claims setup, they're already saved to each team member's profile.
You add a modifier to the line item it applies to. Bookem then adjusts the amount based on the modifier type
Follow these steps:
Note: If you previously added modifiers in brackets directly in your line items, they should be removed as medical aids only accepts this format.
Some practices added modifiers to their line items by putting a code in brackets after the item, for example in the description or tariff code. Medical aids can't read modifiers added this way, so these line items need to be updated to use the modifier instead.
Follow these steps:
Tip: Work through all your line item groups in one go, so every invoice you create from them is ready to claim.
When you submit a claim, each modifier is sent with the line item it belongs to.
If a modifier reduces an amount, the modifier line is sent to the medical aid as R0. You may also see a system message about this when you submit. The message is expected and doesn't affect your claim.