Funders in Halaxy

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In Halaxy, a funder is the overarching framework 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.

Each funder has a funder type which determines the required claiming information. A patient's claim under a funder specifies their identification (such as their employee number or membership number), the payer and paying organisation, referral information and other required claim details as determined by the funder type.

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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".

Adding funders and default funder information

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

Using Funders for Third Party Billing - Example

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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