Billing and Claiming

Follow

Getting claiming right is important because it ensures that you can claim a subsidy/rebate/claim if available to you and your patients, and it links to invoicing, payments processing and clinical reports.

Funders

In Halaxy, funders are the overarching schemes and frameworks which govern how fees, claims and referrals work. All fees are linked to funders, and all claims and referrals are set up under a funder. A funder is not necessarily the paying organisation, although in many cases this is true.

For example, Medicare fees have the funder set to "Medicare"; based on this, invoices that use Medicare fees have the option to process rebates or bulk billing. Setting up the patient's Medicare claim on their funding page will determine what information will appear on the invoice.

Similarly, National Disability Insurance Scheme (NDIS) fees will have the funder set to "National Disability Insurance Scheme (NDIS)", which by default is configured to allow for third-party billing. You can then set up patient claims under the funder "National Disability Insurance Scheme (NDIS)" in the patient's Funding page. The information set up in the patient's NDIS claim will determine whether to bill the patient, the National Disability Insurance Agency, or a different third-party organisation on the invoice.

You can add a funder in a number ways: from your calendar, when adding a New Fee (Adding Fees) to your Fee List, on an existing invoice or when adding a patient's claim.

Adding Funders from your calendar

When adding an appointment and adding a new fee, add the funder on the New Fee page.

Adding Funders from your Funder List

You can access your Funder List by clicking Finances > Fees, then clicking the Funders tab.

From the Funder List, click Add Funder at the top-right of the page to add a new funder to your Funder List. Type the name of the funder in the Lookup field, and if the funder is listed in Halaxy's database, you can select it from the drop-down menu to automatically import all the funder details.

If the funder is not in Halaxy's database, you can enter the funder information manually:

  • Name: The name of the funder in Halaxy

  • Funder Type: The funder type determines how claims work for this funder. Select the most relevant funder type; if the patient pays for everything without being able to claim a rebate or subsidy from a funding body, select Private.

  • Description: Add a description of the funder for your own records

  • Identification: Enter the label used to identify eligibility to claim. This is just a label, such as "Provider Number" - do not enter your actual provider number here (you can enter your actual provider number in the Identifications tab).

  • Payer: Choose whether to bill the patient or organisation by default. If you are billing the organisation, you can specify who the default paying organisation is as well as whether you wish to create a new invoice for each service or collate the invoices.

0 out of 0 found this helpful

Comments

0 comments

Article is closed for comments.