Set up third party billing once. Every invoice then reaches the right payer, with no rework.
A third party is an organisation, such as an employer or a funding body, that pays for a patient's treatment instead of the patient. Set up third party billing once, and Halaxy bills each invoice to the right paying organisation, even when it changes from patient to patient.
GIF: 1) Practitioner treats the patient, 2) Practitioner invoices the third party, 3) The third party pays for the patient's treatment
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Right payer billed. The paying organisation in your patient's claim details is the one billed for that funder's fees. No guessing who should pay.
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Invoices grouped on your schedule. Choose an existing invoice payer option and the funder's fees land on one invoice, collated on the Invoice Schedule you set. Fewer invoices to chase.
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Ready to send. Invoices arrive complete, with the paying organisation's details already on them and ready to email or process for payment.
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Gap amounts split. A gap amount no longer means extra admin. Halaxy creates two invoices: one billed to the paying organisation for the rebate and one billed to your patient for the gap.
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Reports stay linked. Your invoice and your financial reports stay connected to the third party funder and its settings, keeping your numbers consistent.
There are four elements to set up for third party billing:
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Funder: When you create a third party funder, select the correct funder type. The funder type sets the default settings for who is billed, how claims work for the funder and how information appears on invoices.
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Fees: Set up third party fees linked to the funder, to use in appointments.
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Patient's claim information: Add your patient's correct claim information under this funder on the Funding tab of their profile.
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Paying organisation: Check that the paying organisation's details are correct.
After you set up these four elements, manage your calendar as usual and Halaxy bills the invoices to the right third party.
Alex is a sports physician who treats student athletes at different universities. The students' universities pay for the treatments in full. The university is the paying organisation (third party), and it changes from student to student. With third party billing, Halaxy bills the correct university for each student, without Alex entering the details on every invoice.
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Step 1: set up the third party funder
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Click Finances > Fees, then click Funders.
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In the top right, click Add Funder.
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On the New Funder screen, first set up the funder:
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Name: Enter the name of the funder. If it already exists in Halaxy's database, select its name to import it. In the example, the funder is University Services. Because the paying organisation changes, the funder's name can be a general label.
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Funder Type: Select what kind of funder this is, which sets how Halaxy uses billing and claim information on invoices. In the example, select Third-party body. Note: Set this to a third party funder type, such as Workers Compensation, Employee Assistance Program (EAP) or Third-party body.
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Description (optional): Enter a brief description of this funder.
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Identification/s: Enter the label for any identification that appears on the third party invoice and is required for claiming with the paying organisation. In the example, the primary identification is Provider Number, and the secondary identification is an external contractor ID that a university may assign. Note: Enter the label only, then add the actual number on your Identifications page.
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Create default patient claim (optional): Tick to create a claim for this funder, using these details, whenever you create a new patient profile. If you leave it unticked, Halaxy creates claims only when a patient has an appointment using a fee under this funder.
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Set up the payment details, which are the default settings for how and when Halaxy bills the invoice:
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Payer: Select the default payer for fees booked under this funder. You can still change the payer on an invoice for a one-off change.
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Organisation (new invoice): The organisation pays for the invoice. Halaxy creates a new invoice each time you use a fee associated with this funder.
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Organisation (existing invoice, same patient): The organisation pays for the invoice. Halaxy groups all fees for this funder for this patient into a single invoice, collated according to the Invoice Schedule you set.
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Organisation (existing invoice, any patient): The organisation pays for the invoice. Halaxy groups all fees for this funder for all patients into a single invoice, collated according to the Invoice Schedule you set.
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Invoice Merging: Select which fees under this funder Halaxy can merge into an invoice.
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Same practitioner / same clinic: Merge only fees by the same practitioner from the same practice location (default).
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Same practitioner / any clinic: Merge only fees by the same practitioner from any practice location in your practice group.
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Any practitioner / same clinic: Merge only fees by any practitioner from the same practice location.
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Any practitioner / any clinic: Merge fees by any practitioner from any practice location in your practice group.
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Paying organisation: The default organisation that is billed and receives the invoice. If the paying organisation changes often, leave this field blank.
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Invoice Schedule: How often Halaxy collates invoices. Halaxy follows this schedule when Payer is set to Organisation (existing invoice, same patient) or Organisation (existing invoice, any patient).
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Click Save.
You have set up the funder. Next, create the fees to use for appointments with this funder.
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Step 2: set up fees for the third party funder
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Click Finances > Fees.
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In the top right, click New Fee.
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On the New Fee screen, set the following:
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Funder: Enter the name of the funder from step 1 and select it. In the example, the funder is University Services.
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Fee Name: Enter the name of the service you provide. In the example, the fee name is Student athlete consultation.
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Item Number (optional): Enter the item code that identifies the fee, if required.
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Duration (optional): Enter the number of minutes for each appointment using this fee.
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Amount / Rebate: If the third party pays for the service in full, Amount and Rebate have the same value, above 0.00. If the patient pays a partial gap amount, Amount is higher than Rebate, and the difference is what the patient pays.
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Click Save Fee.
Whenever you use this fee for an appointment, the invoice and financial reports link to the third party funder and its settings from step 1.
Note
If a patient pays a gap amount, i.e. the Amount and Rebate values are different, Halaxy creates two invoices: one billed to the paying organisation for the rebate and one billed to the patient for the gap.
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Step 3: set up patient claim information
Every patient treated under third party billing needs the right claim information on their Funding page. Individual patient settings override the default funder settings, so each patient can have their own paying organisation.
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Open the patient profile and click Funding.
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In the top right, click New Claim.
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For Funder, enter the name of the funder from step 1 and select it. In the example, the funder is University Services.
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In the form, set the following:
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Paying Organisation: Enter the name of the third party that is billed and receives the invoice. If it is a new organisation, select the option to add it to your organisations list. In the example, the paying organisation is the student's university.
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Invoice Schedule / Payer: You can customise these fields for each patient to override the default funder settings.
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Reference Number (optional): Enter a reference number that identifies this patient as eligible for third party billing. In the example, the reference number is the student's Student ID at their university.
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Anonymise patient details on invoice (optional): Tick to hide the patient's name on the invoice and show it in the format HK 123456.
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Click Next.
Whenever you book this patient for an appointment with the third party fee from step 2, Halaxy bills the paying organisation in the patient's claim for this funder.
Tip
Patient names can be anonymised on third party invoices. Turn this on in the individual patient's claim details.
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Step 4: set up the paying organisation details
Add the paying organisation's information so their details appear on the invoice. If they give you payment details, you can also add them for automatic payment processing.
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Click Contacts > Organisations.
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In the list, click the name of the paying organisation to open their profile.
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To edit their details, click Edit, enter the required information, then click Save.
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(Optional) To add card payment details, click Add Card. In the pop-up, enter the card details, then click Save.
The paying organisation's details now appear on invoices billed to them, ready to email or process for payment. From this page, you can also view their invoices and current fee balance.
Tip
To make sure billing succeeds, add the paying organisation's ABN and address.
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Use third party billing in appointments
After you set up all four elements, create appointments as you normally do and Halaxy creates each invoice with the correct information.
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Open the calendar.
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Create an appointment for the patient you entered claim information for in step 3.
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In the appointment panel, add the third party fee from step 2, then click Save.
Image: By booking this patient, their claim details for the added fee's funder are automatically displayed in the appointment.
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Click Invoice to open the appointment invoice.
Halaxy bills the invoice to the paying organisation in the patient's claim details for the fee's funder.
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Third party billing builds on funders and invoice schedules, so Halaxy bills the right organisation on the right cycle.
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See how funders work. The Guide to funders explains every funder setting.
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Send the invoice. Send an invoice to the paying organisation in a few clicks.
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Bill NDIS plan managers. The Guide to National Disability Insurance Scheme (NDIS) billing shows how.
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