Introduction

Before you add the 2022 Ministry of Health (MOH) fee updates to your EXACT database, you need to process any current MOH claims.
The MOH claim bundles you create will include:

1. Any patient who has had a treatment visit prior to the end of business 30th June 2022

2. For whom a claim has not yet been sent.

The Exception to the Rule

As a rule, claims are sent once MOH patients have completed all of the planned treatments and visits.
However, before you update your 2022/23 fees, you need to claim any unclaimed visits. This will ensure these visits are claimed based on the 2021/ 2022 fee schedule before the new fees take effect.
It is therefore likely you will be sending claims for patients who have not yet completed all of the planned treatment.

Step 1: Confirm the Patients

To confirm which patients have unclaimed visits open the Payor transactions section on each MOH Payor file.

1. Click to select the File menu

2. Click to select Payor from the File list

3. Click the List button

4. Click to highlight the Payor Code OHSA

5. Click the OK button to open the OHSA Payor file

6. Click the transactions icon

7. Take note of the Patient names with a COT icon

Step 2: Treatment Complete

Once you have confirmed the names of the relevant patients, you need to update their Treatment Plans using the TC (Treatment Complete) button.
This is important to do this for each patient with a visit prior to the end of business 30th June 2022, for which a claim has not been sent.

How to Treatment Complete

1. Open the Chart tab on the relevant Patient file

2. If the Treatment Plan includes Planned Treatment

(a). select and cut the planned MOH items codes from the Treatment Plan
(b). paste the selected items codes to the Misc. tab
(c). remove the second appointment line from the Treatment Plan

1. Click the TC button for completed MOH treatment items

2. Respond to the MOH Claim prompt (select Completion or Non-Completion)

Completion = no MOH treatment is planned for this patient
Non-Completion = the patient needs to return for planned MOH treatment

How to enable the TC button

1. Click to select the Configure menu

2. Click to select User Settings from the list

3. Untick Auto TC when course charged

4. Click the save icon to save the user setting update

5. Update all relevant users

Step 3: Create Claim Bundles

The claims you create before you update the 2022 MOH fees, will confirm and "close off" claims based on the fees from 1st July 2021.

How to create a Claim Bundle

1. Open the OHSA Payor file from the Payor list

2. Click the Claim button

3. Update the 'Date From' field and 'Date To' field

4. Select a Provider

5. Click the OK button

6. Print the OHSA Individual Treatment Report

7. Click the Close button to continue

8. Print the OHSA Claim Summary Form

9. Click the Close button

10. Repeat these steps for each Provider for each active MOH Payor File

In Summary | Update #2

Remember, before you update the 2022 MOH fees you need to close off claims based on the fees from 1st July 2021.