A funder is the organisation or funding body that pays for or subsidises a patient’s service. Whilst some funders are wholly responsible for setting and managing the rules of the program, deciding the fees and paying for the treatment, others will run the program but not make payments. For example:
- A Government organisation that may pay for all of the service or they may pay part of the service and the patient may pay part of the service.
- Other funders control and manage the program, including the fees, rules and regulations, and they make the payments.
- Other organisations, control and manage the program, however they are not responsible for making payments. Instead they outsource this responsibility to a panel of insurers.
- A school may be a funder. If each school that you charge has the same fee structure (such as initial consultation, ongoing etc,), instead of listing every school you bill as a separate funder, you can have one generic funder such as “school service” listed, as your funder. This way, your fee applies no matter which school you provide the service to. You only need to set up the specific school as a funder if you charge that school a different fee.
If the patient is paying for the service, the funder is considered to be "private".
Many practitioners provide services funded by a variety of different funding bodies, all of which have different requirements for invoices, fees, rebates and clinical reports. Adding your funders to your Funders List and adding your identifications helps to ensure your invoices and clinical reports meet the requirements of the funding body, so that invoices and claims are paid on time.
The vast majority of practitioners add their funding bodies to their Funder List when they add fees to their Fee List; however, you can also add funders directly into your Funder List.
When making an appointment or adding a new fee
Start typing the name of the new fee in Fee field when making an appointment, on an invoice or in the Lookup field when adding a new fee directly into your Fee List. If the new fee is already listed in the Halaxy fee database, it is shown in grey and you can "import" the fee to your own Fee List by selecting the fee - the funder listed for the fee is automatically added to your Funder List.
If the fee is not in your Fee List and not listed in the Halaxy fee database, select that you want to add the fee to your Fee List, and add the fee details, including the funder. If the funder is listed in the Halaxy funder database it is shown in grey and you can "import" the funder to your Funder List; if not, add the details of the funding body, and it will be listed in your Funder List.
Directly into your Funders List
You can also add a new funding body directly into the Funders List. Go to your Funders List by going to the Finance tab, selecting the Fee page, and clicking the Add Funder button. Add the required information about the funding body, including:
- Name: the name of the funding body
- Funder Type: every funder comes under a funder type. Select the type of funding body - there are 4 types of funding bodies:
- Patient self-funded: where the patient fully pays for the appointment;
- Membership based: where patients must be a member for rebates/subsidies to be claimed - most government insurers or health funds/HMOs fall into this category;
- Accident: where the ability to claim rebates or bill the funder is based on the patient having had a traffic, work or other accident; and
- Program: where fees are claimed through a special program for which the patient is eligible - e.g. Employee Assistance Programs.
- Description: your own description of the funding body (e.g. for WorkCover Victoria - the workers compensation scheme for people injured at work in Victoria)
- Identification (Primary): how the funding body identifies you as a practitioner who is eligible to provide services through the funding body for which invoices can be billed and / or rebates can be claimed (e.g. Provider number, NPI etc) - do not enter the actual number itself as this is added on the Identification page
- Identification (Secondary) - optional: add any secondary identification that the funding body uses to identify practitioners, if relevant; if not required, leave this field blank. This may be useful for funders for example schools, where each school has different eligibility requirements such as teacher or enrollment date
- Identification - optional: add any other identifications that the funding body uses to identify practitioners if relevant; if not required, leave this field blank
Click Save to add the funding body to your Funders List.
When the same funding body has been entered multiple times into your Funders List, you can merge each entry into the one listing (which avoids confusion between the listings). Click on the funder (the "source funder") in your Funders List that you want to merge into another listing, and then click the Merge button that appears at the top right of the screen next to the Login toggle. In the Funder Search field, start typing the name of the funder into which the listing is to be merged, select the funder (the "destination funder") from the list of funding bodies shown and click the Next button.
You are then shown a summary of the information to be merged from the source funder into the destination funder listing, including:
- The name of the funding bodies and identification types;
- The number of fees, patient claims and referral types that will be merged into the target funder listing; and
- Specific practitioner identifications (e.g. provider numbers) for each practitioner in your practice that will be merged into the target funder listing.
Click the Merge button to confirm that you want to merge the listings. As there is no way to undo merging of funders, please make sure you do want to merge the funders before you click the Merge button.
Adding funder payment details
You can choose how often funding bodies and other third parties are invoiced for patient treatments, who the paying organisation is and whether these invoices are grouped together or not.
You can choose the following options for producing invoices for third party funding bodies:
- Patient: an invoice is created each time for the patient and you have the option to create a separate invoice made out to the organisation. Where the payer can change, for example, sometimes the plan manager pays, sometimes the patient pays and sometimes the funder pays (such as in the case of the NDIS), leave the Paying organisation field blank and you can update this on the invoice;
- Organisation (new invoice): a new invoice is created for the funding body every time you use that fee;
- Organisation (existing invoice, same patient): all fees for this patient for this funding body are grouped together onto the one invoice;
- Organisation (existing invoice, any patient): all fees for any patients for this funding body are grouped together onto the one invoice;
When you know who the paying organisation is, and the organisation does not change between invoices, you can enter the details in the Paying organisation field.
Creating an Invoice Schedule
Halaxy makes it even easier to manage and track your payments by creating an invoice schedule. If you selected Organisation (existing invoice, same patient) or Organisation (existing invoice, any patient), you can nominate the frequency for sending the invoices to the funding body. Enter in a name and if it is new you can create the schedule, selecting how often to send the invoices such as weekly, fortnightly, every three weeks etc.
As Halaxy automatically groups fees onto an invoice according to a schedule (when it has been set up), when a schedule has not been set up, charges will keep accumulating on an ongoing basis, even though the appointment has not yet occurred. For example, if a patient has booked one appointment per week for the next two months, these eight appointments keep appearing on your invoices if you schedule your invoices weekly, or fortnight etc. To prevent this, when you send the invoices off to the third-party, you can mark the invoices as "issued", which has the effect of locking the invoices. You can do this from the top right-hand side of the screen.
Your Funders List
The funding bodies that you have added from which you (or your patients) are eligible to bill or claim rebates are listed in your Funders List. The Funders List page allows you to view all the funding bodies that you have listed. To access the Funders List page, click the Finance tab and the Fees page, then select the Funders page.
You can search and filter columns to find the information you need, and also change the view to suit your preferences as shown below.
Use the Search function at the top left to search for anything including funder name, funder type and description. The list of funders is then limited to show only funding bodies that meet your criteria.
Sorting and filtering fee records
Funding bodies are automatically listed in the order that you first entered them. You can click each of the column headings to re-order the funders, for example, in alphabetical order.
Scrolling through pages
Changing the view
You can change how this page appears in a number of ways and Halaxy dynamically remembers your view preferences based on the computer you are using. Click Choose Columns to add or remove columns shown. Click the Results per Page picker to select the maximum number of funding bodies that you would like to see per page. Move columns by clicking on the column and dragging it to where you want the column to be.
Adding your identifications
Your identifications are listed by funding body that you have added on your Funder List. To view your Identification page, click the Finance tab and click Fees, then select the Identification page. To add identifications, click the Edit button and add the required information to your identifications for each funder. Click the Save Identifications button.
Only add multiple provider numbers for the same location.
I have the same funding body listed twice on my Funders List and both of the listings have been used for invoices - how do I merge duplicate funding body listings?
Click the duplicate funding body on the Funders list, then click the Merge button and follow the prompts.
How do I add provider numbers for my locations and invoices in my practice?
Go to your Identifications page which is on your Fees page under your Finances tab, and click the Edit button to add your provider numbers which appear on your invoices. You can also add the provider number directly on an invoice and the provider number is saved to your Identifications page and to all other invoices for that funding body and that location.
What is a Payee Provider Number and how do I add one?
A Payee Provider Number is the number that is linked with Medicare for payment when you have multiple practitioners working in the one practice but payment only goes to one bank account.
To add a Payee Provider Number, go to the Finance tab, select Fees then Funders. Click on Medicare and in the Identification (Secondary) field, enter "Payee Provider Number" then Save. You can now go to your Identifications page and add your Payee Provider Number.