-WA Government Dental Subsidy Service

In Western Australia, subsidised emergency and general dental care for adult concession cardholders is available through public dental clinics or private dental clinics participating in the Government Subsidised Dental Health Care Scheme.

Holders of a current Health Care Card or Pension Concession Card are eligible for emergency and general dental care at the basic rate of subsidy. This rate is currently 50 per cent of the cost of treatment.

The purpose of this document is to explain how to manage invoices for the Dental Services Subsidy for all eligible patients by setting up the Responsible Parties for the Insurances correctly.  This will allow for the Government invoices to be managed according to one responsible group and payments can be receipted from one group.

Setup Insurance

1. Setup the Insurance Fund

   1. Go to Insurance > Insurances tab 

   2. Operations menu > Select New Record

   3. Name: Government Dental Service Subsidy

   4. Abbreviation: GDSS
      

2. Setup Insurance Plan 1

   1. While in the GDSS Insurance Fund, click Add
      

   2. Plan code: DS50

   3. Plan name: Dental Subsidy Rebates 50%

   4. Tick Co-payment is allowed

   5. Click to edit the plan period and set the effective date to 01/01/1900
      

   6. Enter the rebates of 50% in the Benefit Schedule section

   7. Click OK

3. Setup Insurance Plan 2

   1. While in the GDSS Insurance Fund, click Add
      

   2. Plan code: DS75

   3. Plan name: Dental Subsidy Rebates 75%

   4. Tick Co-payment is allowed

   5. Click to edit the plan period and set the effective date to 01/01/1900
      
      

   6. Enter the rebates of 75% in the Benefit Schedule section

   7. Click OK

4. After both plans are setup they will appear in the GDSS Insurance Plans section
   
   

5. New Insurance Plans

   1. When new rebates are to be setup, click to create a new period with the date from the commencement of the new schedule. Once this new period has been created the new rebates can be entered for this period.
      

Setup Fee Level 

A new fee level needs to be created to match the WA Scheme Insurance plan created above.

For Scheme:

1. Create a Scheme fee level

2. Populate the fees with the values from the Scheme fee schedule

Setup Patient Fee Level and Insurance

1. Go to Patient Records > Patients tab > Insurance/Various sub tab

2. Fee Level: Select GDSS Fee Level

3. Insurance Level: DS50 or DS75
   

Process Invoice

1. This process should only be followed after the patient is setup with the correct Fee Level and Insurance Fund.

2. Go to Patient Records > Treatment tab

3. Enter treatment items as required

4. Press F2 to create a New Invoice

5. Tick Show Extended Attributes > Tick Auto Allocation
   
   

6. A window will appear explaining how much is to be paid by the patient and the insurance
   

7. Click OK
   

8. Click Receive Payment and enter the patient's payment details.

9. Untick Autoallocate Payments and enter the amount against the patient's amount outstanding.
   

Debtors

1. Payments outstanding for GDSS should be put on hold in the Debtors tab to ensure no letters or calls are made following up the amounts.

2. Go to Debtors & Marketing > Debtors tab

3. Highlight the Invoice/s and click Hold Rem 1, 2, 3, 4

Receive Payments

1. When the payments are received, the amounts need to be entered into D4W so they are no longer outstanding.

2. Go to Patient Records > Receipts tab

3. Create a New Receipt

4. Change the Payment from to Insurance > Government Dental Subsidy Services

5. A list of all patients with an invoice outstanding to GDSS will appear in the Invoices list

6. Enter the total amount of the payment received

7. Untick Autoallocate Payments and enter the amount paid per patient against their outstanding amounts
   

8. Click Create