Creating a 90 Day Gap Scheme Invoice

Brief Overview

This article explores how to specially create a 90 Day Gap Scheme invoice. This type of invoice will allow the patient to just pay the Gap amount and when this claim is submitted to Medicare, the patient will receive a cheque which is then provided back to the practice. If the cheque is not received within 90 days Medicare will send the payment to the practice via EFT. 


The Short Version

  • Click on the patient appointment
  • Select the invoice icon
  • Select the 90 Day Gap option
  • Add the item number
  • Take gap payment
  • Save & Claim 
  • Receipt payment once Cheque/EFT received from Medicare



From the scheduler

(invoice icon is located on the top right side of the scheduler page) 

With an appointment 

1. If the patient has an appointment on the scheduler you can click their appointment once to highlight it (it will show a blue line around the appointment if it is highlighted) then click the invoice icon (shown above) PROCEED TO STEP 2


Without an appointment 

1. Click the invoice icon and type the name of the patient

Choose the Doctor and Location PROCEED TO STEP 2

 2. The below pop-up will appear. Ensure that the correct Doctor and Location is selected and select 90 Day Gap as the type of invoice. 

Note: This option will only show if the patient has Medicare Card details in their patient demographics. 


3. All of the relevant information will pull into the invoice from the appointment/patient demographics.

4. The referral can be changed if required by clicking the Drop Down Arrow or if there is no referral you can click the Plus icon next to the Referral section to add the referral details.


5. Imaging Machine only needs to be completed if you are billing for an LSPN related item number.



6. Type in the Item Number.

Note: If the doctor has entered this when finishing the consult, the item number will automatically be added to the invoice. 


7. The payment type will default to the 90 Day Gap amount entered in the provider settings. This will show the total amount and the Out of Pocket for the patient. This field can be changed as required. 


8. Complete the relevant details for the item:
- You have the ability to add or change the Date of Service. You can also add multiple dates onto one invoice.
- Choose the Payment Type (If you select Private, you have the ability to change the price or add a discount) 
- Add Duration time if relevant
- Tick the Not related Care Plan or Not Standard Aftercare if relevant
- Add Notes to this item number if relevant 

9. Click Add Item 
- The item will fill into the invoice
- Items to be added one by one as per instructions above
- Remove any item by clicking the Trash Can icon

10. Take the Out of Pocket payment from the patient and add this to the Out of Pocket Payment section into the relevant payment type (for example: If the patient pays via Cash you would type the amount next to cash). 


11. If you are using the Patient Portal and would like this invoice to be visible to the patient, leave the Publish this Invoice radio button selected.


12. To send the claim to Medicare for the remaining amount click Save & Claim. This will submit the claim to Medicare and they will either send a Cheque to the patient to be returned to the practice, or after 90 days will send an EFT payment directly to the practice.  


Once you do this a new tab will open with the Statement of Claim.


13. Click the Save & Print option to print the invoice.



Further Reading

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