In Halaxy, a funder is the overarching framework which governs how fees, claims and referrals work. All fees are linked to funders, and all claims and referrals are set up under a funder.
Funders are not necessarily paying organisations. You can bill different organisations under the same funder - for example, you can create a funder named "School Services" to bill different schools. Rather, the funder simply determines shared settings, the required claiming information (such as the patients' student number) and the fees and referrals that can be used.
Each funder can be configured to ask for different practitioner identification, such as provider number. This will appear on the invoice.
Each funder also has a "funder type", which determines the required claiming information for the patient and who can be set as the payer (patient or third-party organisation). Based on the funder type, a patient's claim under a funder may specify their identification (such as their employee number or membership number), the payer and paying organisation, referral information and other required claim details.
All referrals are also linked to a patient's claim for a particular funder.
For example, Medicare fees are linked to the funder "Medicare"; based on this, invoices that use Medicare fees have the option to process rebates or bulk billing. The patient's claim details under the funder "Medicare" in their patient profile will then determine what information appears on the invoice, such as their Medicare number and referral details.
Similarly, National Disability Insurance Scheme (NDIS) fees are linked to the funder "National Disability Insurance Scheme (NDIS)", which by default is configured to allow for third-party billing. You can then set up a patient's claim 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.
Tip
If a patient pays for the full amount of a fee without being able to claim a rebate or subsidy, set the funder to "Private".
You can access your Funder List by clicking Finances > Fees, then clicking the Funders tab.
To add a new funder:
Click Finances > Fees, then click the Funders tab.
Click Add Funder in the top-right.
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Type the name of the funder in the Lookup field. 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 default funder information manually:
Name: The name of the funder in Halaxy
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Funder Type: The funder type determines how claims work for this funder, as well as what information appears on invoices. 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.
If you would like to edit a funder type's settings, including what claim information to ask for and what information appears on invoices, click the Edit (pencil) icon next to the Funder Type field. You can also select Add New in the drop-down menu to create your own funder type.
Image: Editing required claim information for a Funder Type (expand image)
Description: The description of the funder for your own records
Identification: Enter the label used to identify eligibility to claim, such as "Provider Number". Do not type your actual provider number; this is just a label (you can enter your actual provider number in the Identifications tab).
Create default patient claim (checkbox): Tick to automatically create a claim for this funder using these details whenever you create a new patient profile. If unticked, claims will only be automatically created when the patient has an appointment using a fee under this funder.
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Fill out the Payment Details section. If you do not see this section, edit the Funder Type above by clicking the Edit (pencil) icon (see Step 3) and set the Payer to "Third party" instead of "Patient only". Choose from the following options:
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Patient: the patient pays for the invoice
Organisation (new invoice): each time you use a fee associated with this funder, a new invoice billed to the paying organisation will be created
Organisation (existing invoice, same patient): all fees for this patient associated with this funder will be sent as a single collated invoice to the paying organisation for the invoice schedule period
Organisation (existing invoice, any patient): all fees for all patients associated with this funder will be sent as a single collated invoice to the paying organisation for the invoice schedule period
Paying organisation: The default organisation that will be billed. If you do not want to set a default organisation, leave this field blank - this is useful if the paying organisation changes (for example, NDIS claims where different organisations may pay for the patient or if you provide the same service to different schools or employers)
Invoice Schedule: how often invoices are sent when the payer is set to "Organisation (existing invoice, same patient)" or "Organisation (Existing invoice, any patient)". For example, you could choose to send collated daily invoices, weekly invoices or monthly invoices.
(Optional) Tick the "Anonymise patient details on invoice" checkbox to anonymise the patient details. If ticked, the patient will appear as an anonymised ID such as "HK 123456".
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Click Save.
Mary performs treatment services for various schools around her area. Her patients are various students at the different schools, and the service is wholly paid for by the student's particular school.
To manage this in Halaxy, Mary sets up a funder called "School Services" and sets the funder type to "Third-party body". Because the school pays, she sets the default payer to "Organisation" instead of "Patient", but because the paying organisation is different for each student, she does not set a default paying organisation.
She then creates a $75 fee under this funder. Because the school pays for the full amount, she also sets the rebate amount to $75.
When Mary makes an appointment with a student using this fee, the student's claim under the funder "School Services" is automatically created in their Halaxy patient profile. For each student, she edits their individual claim information and sets the paying organisation to the student's school.
Now whenever Mary makes an appointment for a student, the invoice is automatically billed to the student's school.
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