Processing radiation oncology 011-43010150
This document details how to process radiation oncology claims in a timely and efficient manner to make sure national consistency is maintained.
From 1 July 2024
On this page:
Process kilovoltage accounts/invoices for multiple sites
Process claims for multiple sites
Note: if the account/invoice has:
- only one item and is over $9,999.99, see the relevant table in Charges $10,000 or more (greater than $9,999.99) for Medicare patient claims
- outpatient items both over and under $9,999.99, see Table 6 in Charges $10,000 or more (greater than $9,999.99) for Medicare patient claims
Table 1: this table describes how to pay a radiation oncology claim with multiple planning or treatment sites with a date of service from 1 July 2024.
Step |
Action |
1 |
Check date of service + Read more ... From 1 July 2024, separate processes apply when processing radiation oncology claims depending on the date of service. Service Officers must follow the process relevant to the date of service they are processing. If the date of service is:
|
2 |
Start processing claim + Read more ... For:
|
3 |
Identify sites + Read more ... Identify:
Note: this information is populated by the health professional for online claims. The Resources page has a list of items. |
4 |
Read claim text and/or supporting information + Read more ... Read any text or annotation provided by the health professional to confirm each anatomical site being claimed. |
5 |
Assess claim + Read more ... Check and read all return messages in full:
The Resources page includes radiation oncology return messages and resolutions. |
6 |
Finalise claim + Read more ...
|
Before 1 July 2024
On this page:
Key the amount charged from the account/invoice
Process accounts/invoices
Note: if an individual charge is over $9,999.99, see the relevant table in Charges $10,000 or more (greater than $9,999.99) for Medicare patient claims.
Table 1: this table describes how to pay a radiation oncology claim with 2 or more fields for accounts/invoices with a date of service before 1 July 2024.
Step |
Action |
1 |
Check date of service + Read more ... From 1 July 2024, separate processes apply when processing radiation oncology claims depending on the date of service. Service Officers must follow the process relevant to the date of service they are processing. If the date of service is:
|
2 |
Identify fields + Read more ... Identify the:
Note: this information is populated by the health professional for online claims. The Resources page has a list of items. |
2 |
Key details + Read more ... Key the:
Note: Service Officers must key multiple treatments on the same day, in separate claims. Manual claims Service Officers must key a:
Electronic claims For electronic claims, the first base and derived fee items must be paid, and subsequent items rejected. See the Resources page for the rejection codes. Health professionals must resubmit a separate claim. Repeat this step for the remainder of items. For:
|
3 |
Key LSPN and equipment number + Read more ...
Note: this information will be populated by the health professional for online claims. |
4 |
Return messages + Read more ... Check all return messages in full:
The Resources page includes radiotherapy return messages and resolutions. |
Key the amount charged from the account/invoice
Table 2: this table lists the actions taken to record the amount charged.
Step |
Action |
1 |
Identify charge type + Read more ... Check the amount charged on the account/invoice:
|
2 |
Single amount charged for each item + Read more ... Key each amount in the charge field against each item. |
3 |
One amount charged for combined single field base item and matching additional field derived fee item + Read more ... Key:
The Resources page has a list of items. |
4 |
One amount charged for the combination of all items on the account/invoice + Read more ... Key:
|