Under 13

Disclaimer: Please note that the fee amounts, codes and service names on the screenshots are for demonstration purpose only as they may vary for each practice, and not be used as a reference unless directly specified in this manual.

Under 13 Co-Payment Fees

From 1 July 2015 practices that opt-in to the zero fees for under 13 funding scheme are required to charge their patient’s ages six to twelve years zero co-payments.

  1. Accounts – > Account Setup and click on Fees tab.
  2. Search for consultation fee to filter out the rest of fees as displayed on the screenshot.
  3. There should be at 4 services needing to be changed.
  4. First, we change the patient’s minimum age range from 5 to 12 for a free consultation.
  5. Expand Consultation Fee for patients under 6 (should be $0.00 amount) and then change number 5 to 12 as displayed on the screenshot.
  6. Second, please edit the other 3 services that are applicable to patients from the age of 6. Change minimum age number from 6 to 13 in the field Between Ages as displayed on the following screen shots.
  7. Please click FINISH to save the changes.
  8.  Next step is to update GMS services.

Under 13 GMS Fees

2015-05-27 13_51_13-UNDER 13 ACCOUNT SETUP MANUAL.docx - Word

From 1 July 2015, the age groups will change for the category and a new category C will be added, and all GMS claims will attach the corresponding patient category codes, as per Table 1 below.

  1. Accounts – > Account Setup and click on Fees tab.
  2. Search for gms to filter out the rest of the services as displayed on the screenshot.
  3. First is to update existing J group of services to change the minimum age from 6 to 13.
    Please do the following change for all 3 services that have codes JZ, J1, and J3:
    Change the number for patient’s minimum age to number 13 as displayed on the screenshot.

  4. Second is to create 3 new services for the group of patients aged 6-12 with the following codes CZ, C1, and C3.
  5. Click on the greyed-out line to add new service.
  6. In the new window, search for gms and then double click on GMS Subsidy to add the service.
  7. In the new line, enter CZ for code and 20.45 for the fee.
  8. Click on ‘+’ to expand the service settings
  9. Please enter the next 4 conditions for code CZ exactly as displayed on the image.
  10. Repeat steps 6 and 7 to create a new GMS Subsidy service and add code C1 and fee 20.45 including 5 conditions exactly as displayed on the image
  11. Repeat steps 6 and 7 to create a new GMS Subsidy service and add code C3 and fee 15.33 including 5 conditions exactly as displayed on the image
  12. Now you should have
    a.  3 new GMS Subsidy services:
    i.  CZ $20.45 for ages 6 to 12
    ii.  C1 $20.45 for ages 6 to 12
    iii.  C3 $15.33 for ages 6 to 12
    b.  and 3 updated:
    i.  JZ $20.45 for ages 13 to 17
    ii.  J1 $20.45 for ages 13 to 17
    iii.  J3 $15.33 for ages 13 to 17

Under 13 ACC Contract update

Cost of Treatment regulations:

Changes align with the Government’s new policy to encourage free GP and nurse visits for children under 13 years.  There are new codes and rates for under 13s’ consultations by GPs, nurses and nurse practitioners. Note that the new under 13s codes are replacing the old under 6s codes. The rates for children under 6 are retired from 1 July 2015.

CodeDescriptionFlat rate $ (GST excl.)Flat rate $ (GST incl.)
NCONNurse consultation if the client is 13 years old or over14.4516.62
NC13Nurse consultation if the client is under 13 years old19.4522.37
NUP1Nurse practitioner consultations if the client is 13 years old or over26.4530.42
NU13Nurse practitioner consultations if the client is under 13 years old50.4558.02
GPNNurse and GP consultation if the client is 13 years or older33.7338.79
GN13Nurse and GP consultation if the client is under 13 years old57.7366.39
GP1GP consultation if the client is 13 years old or over (also known as CON)30.8535.48
GP13GP consultation if the client is under 13 years old54.8563.08

  1. The goal is to create the next 4 services:
    a. Consultation under 13yrs
    b. Consultation under 13yrs Nurse+GP
    c. Consultation under 13yrs Nurse only
    d. Consultation under 13yrs Nurse Practitioner
  2. Accounts – > Account Setup and click on Service Type tab.
  3. Search for under to filter out the rest of the fees as displayed on the screenshot. There should be at least two services, may be more depending on each practice.
  4. Rename existing Consultation under 6yrs by clicking on the name of the service and replacing number 6 by number 13.
  5. Create two new services by clicking on click here to add item line and
    a.  typing one for every new service:
    i.  Consultation under 13yrs Nurse Practitioner
    ii.  Consultation under 13yrs Nurse only
    b. Set the same values for columns Class, Fund, Organisation, Inv Type, Rules, and Duplicate€™ in the new services as they are in existing ACC services.
  6. Now it’s time to add the fees to these services.
  7. Click on Fees tab and type under in the Service column.
  8. Click on the grey line and search for created service Consultation under 13yrs Nurse Only. Then add this service by double-clicking on it.
  9. After the service is added, type its code NC13 and GST Inc amount 22.37
  10. Click on the grey line and search for created service Consultation under 13yrs Nurse Practitioner. Then add this service by double clicking on it.
  11. After the service is added, type its code NU13 and GST Inc amount 58.02
  12. Next step is to change fees and codes for Consultation under 13 and Consultation under 13 Nurse+GP :
    a. Consultation under 13 code is GP13 and its GST Inc amount is 63.08
    b. Consultation under 13 Nurse+GP code is GN13 and its GST Inc amount is 66.39
  13. The services names, their fees and codes should be exactly as displayed on the following screenshot:
  14. Next, we need to set these services to be applicable only for patients who are under 13 years.
  15. For that please expand all the 4 services by clicking on the + sign next on the left of every line.
  16. Then change number 5 to number 12 in the line that has Between Ages parameter.
  17. For the services that were created please add Between Ages parameter and set it to 12.
  18. The end result should look exactly as on the following image:
  19. The last step is to add 2 new services in the Accident service group.
  20. Click on Services tab.
  21. Select Accident in the group column.
  22. There should be only two services for under 13yrs.
  23. Click on Services in Group button.
  24. Locate two new services in the list and tick the check box next to them. Then click OK.
  25. All 4 services should be in the Accident group.
  26. Please click the FINISH button to save these changes.

13 years and over ACC Contract update

The new rates are to be used for invoicing from 1 July 2015.

2015-05-28 10_36_14-UNDER 13 ACCOUNT SETUP MANUAL.docx - Word
  1. Accounts – > Account Setup and click on Fees tab.
  2. Search for CON or GP1 code to filter out the rest of fees as displayed on the screenshot.
  3. To limit this service only for patients 13 years and over, change Between Ages number 6 by 13.
  4. For GPN code, search for GPN code and limit this service only for patients 13 years and over, by changing Between Ages number 6 with 13 
  5. Repeat the same steps for other the two codes NCON and NUP1 if necessary.
  6. Click Finish to save the changes.