How to set up line item modifiers

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.

Before you start

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:

  1. Go to Settings > Team members
  2. Open the team member's profile
  3. In the Categories field, check that the right category is selected, or select one
  4. Save your changes

Note: If you chose categories during the claims setup, they're already saved to each team member's profile.

Add a modifier to an invoice line item

You add a modifier to the line item it applies to. Bookem then adjusts the amount based on the modifier type

Follow these steps:

  1. Open the invoice
  2. Find the line item the modifier applies to
  3. Select the modifier from the list
  4. Check the line item total
  5. Click Save

Note: You only see the modifiers for your own category. If you don't see the modifier you need, check the category on your team member profile.

Update line item groups that use codes in brackets

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:

  1. Go to your line item groups
  2. Open a line item group that requires a modifier
  3. Add a modifier to the line item(s)
  4. Save the line item group
  5. Repeat for each line item and line item group that uses bracketed codes.

Tip: Work through all your line item groups in one go, so every invoice you create from them is ready to claim.

How modifiers appear on a 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.

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