Patient Claim Details

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Claim information is information that a funding body (i.e. the body that pays or subsidises a service you provide) uses to be able to identify a patient and determine their eligibility for services by a particular practitioner, paid for by the funding body.

For example, a government healthcare system may identify eligible patients by a patient number, a claim number, the details of a particular event (such as the date of an accident for accident compensation schemes) or a combination of these.

The claim information required differs for each funding body, which Halaxy automatically manages for you based on the fee type you select for a particular appointment.

Once you have added a patient's claim information, you can also add referrals.

Adding and editing claim details on a patient's profile

A patient's claim information can be found in the Funding page of their patient profile:

PatientProfile_Funding.png

You can access this page by clicking the patient's name in the Patient List, then clicking the Funding tab.

To add a new claim:

  1. Go to a patient's profile and click the Funding tab.

  2. Click New Claim in the top-right of the page.

  3. In the Funder field, type part of the funding body's name and select it from the drop-down menu.

  4. Complete the claim information form (depending on the funder, you will be asked for different claiming information):

    ClaimMedicareDetails.png
  5. Click Next/Submit.

RESULT: The patient's claim information for the funder is now saved to their profile and will appear on their appointments and invoices linked to this funder. You can now also add referrals by clicking Add Referral under the claim in their Funding page:

ClaimAddReferral.png

To edit the claim details, click the Edit (pencil) icon under the claim.

Adding claim details from an appointment or invoice

Alternatively, if a patient has been booked for an appointment covered by a particular funding body, you can add or edit a patient's claim information in other ways:

  1. From an appointment: after you have made an appointment, click the appointment on the calendar and click the Edit (pencil) icon next to the claim field.

  2. On an invoice: go to the invoice and click the Edit (pencil) icon in the Claim and Referral section of the invoice.

The claim details are recorded on the patient's Funding page, on relevant invoices and on the appointment listing in your calendar.

Third parties that pay for a patient's treatment are also listed on the patient's Funding page.

Merging multiple claims into the one claim details record

Duplicate records of the same claiming information can occur when you accidentally add the information multiple times, when you merge patient profiles or when you have a particular funding body entered multiple times on your Funders List.

If a patient's claim information has been entered on their Funding page multiple times, you can merge the claiming information listings into the one listing. When this happens, a Merge icon (two arrows pointing to each other) appears next to the relevant listings.

Click this link for instructions on how to merge claims.

Deleting and archiving a claim

You can delete claims that have been added in error (e.g. for the wrong patient, or added as a duplicate) and archive claims that have been used but are not required anymore.

Deleting a claim removes its information entirely and cannot be reversed. You can only delete claims that have no appointments. referrals or invoices linked to the claim.

Archiving a claim will retain the associated information but will render it inactive so it cannot be used; this is appropriate if there are appointments and invoices linked to the claim.

To delete or archive a claim:

  1. Click the Delete (trash) icon to the right of the claim information on the patient's Funding page.

  2. Select whether you want to delete or archive the claim, then click Submit.

NOTE: When you archive a claim, a new active claim with the same details (but not linked to any existing appointments, invoices or referrals) is created. This allows you to use the new claim easily and automatically. You can edit the claim details by clicking the Edit (pencil) icon.

Restoring (un-archiving) an archived claim

You can un-archive a claim by clicking the Delete (trash) icon next to an archived claim and selecting Restore:

ClaimRestore.gif
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