CAPÍTULO 3. Sentido de Comunidad
3. Sentido de comunidad en el ámbito educativo
Markup Group
Markup Groups allows quick and precise changes to be made to the markup percentage used by different groups of items. See Appendix 4: Updating Sale Prices on page 71.
Rationalizing Fees
Many practices end up with their fees in some disarray, particularly in practices that have converted data from an older software system. Rationalizing fees is advantageous for usability, accurate billing, better reporting and better stock control. The process weeds out unused fees and implements time saving options, puts fees into logical Service Headings and into meaningful groups for reporting.
Ultimately you will have to step through the fees one by one, fine tuning and culling as needed. Before you begin this task some groundwork needs covering. This includes:
Setting up Income Groups, Service Headings and Categories
• • • • • • • • • • •
Learning how to add and remove fees Planning what you want to achieve
Income Groups
Income Groups are set independently for the fixed and variable fee on each item. They are only used for reporting and while they can be setup in
retrospect it is actually good to set them up before anything else so they can be applied as you go. See page 10 for details including an example report.
A prime purpose of income group reports is for your tax records so it may be worth discussing requirements with your accountant.
A common basic set of income groups is: Fees
Drugs Traveling
A more complex set might be: Drugs
Professional Fees Other Fees Merchandising Traveling
Income Groups are setup in Options > Items > Income Groups. Take a look and consider if your income groups need attention.
Figure 31 Configure Income Groups dialog
The Configure Income Groups dialog will allow you to edit names, add new names and merge items in one group to another.
For example, if you chose to delete Food as an Income Group the Update Field Values dialog (Figure 32) will automatically open giving you the opportunity to select another Income Group to move Food items into.
Figure 32 Update Field Values dialog
Checking every actual item in the Fees module for its income group is quite tedious! A far more efficient method of checking and setting Income Groups is to use the Item Miscellaneous Data Wizard. See Appendix 5: Data Wizards on page 74.
Service Headings
Principally Service Headings are used as headings on the invoice but they are also used as a grouping for statistical analysis. See page 5 for details.
Service Headings are configured in Options > Items > Service Headings. Take a look and consider if your list of Service Headings needs attention.
Managing Service Headings
Do you need more Service Headings? Many practices in earlier days sold all inventory items under the heading Medication. The trend now is to have only true medications sold under that heading. This requires headings for other inventory items. Some extra headings you might consider include:
Diet
Pet Care
•
Service Headings have a number of options, demonstrated in Figure 33. Some of these are default values for fee items you may add to the service at a future time. As such, changes you make to these options do not affect existing fee items.
Other options do immediately effect existing items and the way your invoicing flows. In fact, it would be worth reviewing these settings for existing services as well as setting them up correctly for new services.
Which of these apply will be explained as each field is discussed.
Figure 33 Configure Services dialog
Fields that are default values for future items
Fixed Fee Income Group and Variable Fee Income Group (see notes on Income Groups, page 28). These are default values for new items you add to the service.
Fixed Tax Rate and Variable Tax Rate are default values for new items you add to the service.
Fields that have immediate effect on your system
Invoice Order controls the relative position of the heading on the invoice. If invoice order for Consultation was 1 and Medication was 2, Medication will be second on the invoice if Consultation is used but first if Consultation is not used.
Estimate Range is a variation that will be added to estimates created in the Visits screen. An estimate takes into account the Estimate Range value for each service and puts a final value on the estimate of “Between $X and $Y” where $X is the value of the items you included in the estimate and $Y is $X plus the aggregated Estimate Range.
Group on Invoice will show the service heading but no item details on the invoice. For most services this would not be used. See page 5 for more details.
Apply Discount and Apply Service Ratio allow you to be selective about which services permit these processes.
Select Apply Discount if discounts are permissible on items in the service. (Note: Insurance Discount will apply even if Apply Discount is not selected.) Select Apply Service Ratio if it is to be allowed on items in this service.
Close on Charging is an option suitable for services where you only ever make one choice in charging, such as Consultation. It makes the highlight jump back to the service list after you choose an item from that service.
Allow Tax Exemption works in conjunction with the optional Tax Status
field on the Client screen. If Allow Tax Exemption isselected and the client Tax Status is Tax Exempt or Dutch Export then the client will be exempted from tax on items within the service.
General Ledger Accounts allows you to setup Income, Expense and Stock accounts for the RxWorks QuickBooks interface. If these are set for a service they will apply to all items within the service unless the item has its own account settings.
Deleting Service Headings
Do you have superfluous Service Headings? For example, you might have Pathology and Laboratory as headings and decide they could be merged.
Figure 34 Deleting a Service Heading
If you choose to delete a Service that has items in it, you have the opportunity to name another Service for the items to be moved to. Just choose a Service from the New Value list. In Figure 34 Radiology is being deleted and radiology items are being moved to Diagnostic Imaging.
Changing an Item’s Service Heading
Find the item and on the Fees page choose another Service Heading from the Service Heading list.
Duplicated Items
For accurate stock control, inventory items must not be duplicated. This may take some reorganization for items such as vaccinations (page 39) or drugs that are in the system as a bottle and per ml (page 37).
On the other hand, duplicating fees for professional service items can be very useful. For example, you can have an item called Boarding and set the species
When invoicing for boarding you will then just see the correct boarding charge for the species of the current patient. The benefit is twofold: less clutter in pricelists and more accurate billing.
Deleting Items
The program will not allow an item to be deleted if it has been used in an invoice.
To prevent an item being invoiced in future you can set a deactivated date on the Fees page. To hide from staff you can rename it to something like
zPilocarpine or zDeactivated Pilocarpine. Some practices actually have a Service Heading called zDeactivated and move all deactivated items into that heading.
Typical Fee Setups
This section shows samples of different fee types and demonstrates how they would typically be setup.
Professional Service Item (Consultation)
Although Standard Consultation is probably your most commonly used fee it is quite simple in its setup.
It will probably be under the service heading Consultation so there is no need to duplicate Consultation in the Printed Name.
Figure 35 Fee setup for Standard Consultation
The Default Value of 1 is important, as is selecting Charge Default. Together they mean you do not have to enter a quantity when invoicing this item.
Merchandise Item (Frontline)
Charge Default is again selected so it will automatically bill for 1 pack and this is rarely incorrect for many merchandise items.
Figure 36 Fee setup for Frontline, a merchandise item
Merchandise items can be sold at a set price or marked up price. However, the asterisk on Markup for this example indicates this item is sold at a set price not by a markup percentage.
If the cost price alters for this item, the sale price will not change.
On the Attachments page you may wish to select appropriate update fields.
Prescription Tablet (Clavulox 250mg Tab)
The fixed fee is derived from a Standard Fee called Dispensing Fee. On the attachments page you would select Print Label and choose Standard Header as the Label Header Text.
Discount
The Discount item is one of several protected items. It is usually item number 999998 and it cannot be deleted or renamed.
When applied to an invoice it calculates a discount that shows on the invoice and deducts from the total. It can be linked automatically to invoices for selected clients such as pensioners or it can be manually added to an invoice.
Figure 38 Fee setup for the Discount item
In the lower left corner you can add as many different discounts as you need. “Markup” is actually the discount percentage.
Figure 39 Adding a discount 'fee'
These discounts will be available in the Discount Type field on the client screen to allow particular clients to be setup for automatic discounting. To apply a discount to an invoice manually, during the process of creating the invoice you ‘charge’ the discount.
Items added to the invoice after the discount will not automatically be
discounted. When you save the invoice, a message asks if you wish the discount to be recalculated. You can take advantage of this if you would like to discount
Discounts (except insurance discounts) can be completely blocked on certain services (Service Headings section of Options > Items) and they are limited by the Maximum Discount set for any particular item.
Standard Fees (Injection Fees)
Standard fees can be the fixed component of other fees. Injection fee is a typical example and Dispensing fee is essentially the same. The tick in the Standard Fee box makes it shareable.
Updating the standard fee automatically updates all those fees referring to it.
Figure 40 Injection Fee as a Standard Fee
Some injectable medications may need an option to invoice without an injection fee. Medications you sell to farmers are a good example. A special standard fee can be added for these with options for Injection Fee and OTC Sale.
Some injectables have more than one route of administration and may need different fees. A special standard fee can be used to provide these options.
Figure 42 Injection Fee Choices as a Standard Fee
You would only use the more complicated Standard fees on items that really required it. For normal items it creates an unnecessary step when invoicing.
Injectable Medication (Baytril Injectable)
This example shows an injectable medication using the simple Injection Fee.
Figure 43 Baytril Injectable using an injection fee
Figure 44 Procaine Pen G with OTC option and quantity break
When invoicing for an injection you can charge by the ml and select the injection fee. For the sale of a whole bottle over the counter you can invoice 250ml (the bottle size) which automatically uses a lower price and as well you could choose the OTC Sale fee.
Notice the default quantity has been set to 250 ml as this helps prevent inexperienced staff selling a whole bottle for the price of 1 ml.
Figure 45 Charging Procaine Pen G with an OTC option
Multi-route Injectable (ACP Injection)
This example shows an injectable that may be given IV, IM or SC. At the time of invoicing you can make the choice.
Figure 46 ACP Injection using Injection Fee Choices
Vaccinations (C5 Vaccination)
Traditionally, vaccinations were charged as a flat fee incorporating an
examination and the medication cost. This works effectively but misrepresents income reporting. It makes the vaccine look spectacularly profitable and does not recognize the large professional component.
Figure 47 Vaccination as a simple fee
This could be rectified by splitting the fee into a fixed component and a variable component shown in Figure 48.
Figure 48 Vaccination split into professional and drug components
For reduced prices on multiple pet vaccinations or litters you can apply a discount manually or build a reducing structure into the fixed fee.
This could be done for each vaccine but would preferably be based on a Standard Fee for easier maintenance. This can then be used as the Fixed Fee component for all your vaccinations.
The variable fee can differ between vaccinations to account for different drug cost. With a little juggling of the values most practices find this very
satisfactory.
Figure 49 Creating a Standard Fee for vaccinations
The full list of fees could include options for litter vaccinations. Figure 50 takes artistic license. It shows the full list of fees you could add though you would never see the whole of this list displayed at one time in the RxWorks interface.
Figure 50 Fees including litter vaccinations
Having set up the standard fee for the examination component of vaccinations you can then deploy it on your vaccine fees.
Figure 51 Vaccination Standard Fee attached to the C5 Vaccination
This works well and is easy to use when invoicing. You just select the appropriate fixed fee option from the dropdown list seen in Figure 52.
Figure 52 C5 Vaccination charging choices
As it defaults to Single Animal Visit, in many cases you just press ENTER twice for the correct fee.
With multiple patient vaccinations each needs a separate invoice for correct history, certificates and reminders. Say you were invoicing one of 3 patients you would use DOWN-ARROW twice then ENTER twice for the correct fee. For litters the number of doses must be changed. With a litter of 6, you would select A: Litter 6 from the list (using DOWN-ARROW or by pressing A on the keyboard), then press Tab and enter 6 as the number of doses.
Figure 53 Charging C4 vaccination for a litter of 6 pups
Note: Vaccinations are also highly amenable to using procedures for multiple pets and litters. See the RxWorks Procedures Manual for setting up
vaccinations as procedures.
Items with Non-linear Pricing (Proheart SR12)
Where the fee is based on price bands rather than a unit such as tablet or ml the fixed fee can be used for price choices and the variable fee, while priced at 0.00, can still be charged per unit for the benefit of stock control.
Figure 54 Fixed fee component price bands
When charging this item, choose the price band from the list then enter the number of mls used.
Figure 55 Selecting the price band when invoicing
Quantity Break
Quantity breaks allow the price to change depending on the quantity sold. There are two variations: sliding scale and fixed scale.
The first example (Figure 56) uses sliding scale quantity discount. The first fee was edited for a quantity of 9 then another fee was added for quantities up to 999999.
Figure 56 Sliding Scale quantity break
With sliding scale, if the client purchases 20 tables they will all be charged at the lesser price. The second example shows quantity break with stepped scale (Figure 57).
Figure 57 Stepped Scale quantity break reducing price
With Stepped Scale, units below the break point are always charged at full price and only those units above the break are charged at the break price. In the case of the example in Figure 57, for a quantity of 3, the charge would be 1 unit at the full price and 2 units at the break price. Stepped scale is often used for items like radiology, fluids and pregnancy testing in large animals. Quantity breaks are not restricted to reduced prices!
Some practices have setup X-Ray charges with a large fixed fee plus a variable charge per plate that was priced at zero for the first 2 units and some value thereafter. The effect is that the fixed charge includes the first 2 plates and extra plates are additional.
Adding New Fees
To add a new fee item you have 3 choices: Copy another item
• • • • • • Use a template
Add the fee filling in every field on a blank new item screen.
An experienced user can add a fee using the first two methods in a comfortable 20 seconds. The third method takes around 2½ minutes! This becomes
significant if you have hundreds of items to add to a new system. A template is a typical fee of a certain type…antibiotic tablet, worming
product, flea treatment etc. Templates will be available in new systems but not for practices converting from another program.
Converted practices already have plenty of fees in the system and a fee similar to a fee you are adding is a better template than a template!
Using a Template or Copy Current Item
If you intend copying an existing item then first find the item to copy. Use the Add button on the Fees page to begin creating the new fee. The New Item dialog appears which allows you to choose a method:
(no template) Template
Copy Current Item.
Practices who have converted from another program will not have the templates listed in this example (Figure 59).
Figure 59 New Item dialog
Figure 60 Copy Item Details dialog
In the Copy Items Details dialog, replace the item name with the new item name then work through each of the fields:
Cost price must NOT include tax.
• • •
Enter a Markup or Sale Price but not both.
If you set the Markup percentage then the Sale Price including tax will be calculated for you.
If you set the Sale Price yourself the program assumes you want a fixed price that does not change if the cost price changes. Make sure you DO include tax in the Sale Price if you are setting it yourself!
Figure 61 The new item details added
Note that the pricing information here is for the variable fee. The fixed fee cannot be set until after the item is added.
The On-Hand Level is the number of selling units you have. Pack Size is the