Guide to funders

In Halaxy, a funder is the billing and claiming settings for all fees linked to it.

With every patient you treat, there can be a variety of scenarios on how the appointment invoice is billed and the required information to include for claims. Each invoice contains a fee that is linked to a funder, which in turn configures the invoice requirements and populates it with the correct information.

You can import funders from Halaxy's preset database or you can create your own funder.

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Image: Examples of different applications of funders. When a fee is added to an invoice, its linked funder settings automatically configure the billing and claiming details to display on the invoice.

Overview

Every fee is linked to a funder.

When added to an invoice, the fee's linked funder settings customise the invoice according to:

  • Who is paying for this fee (the patient or an organisation)

  • If an organisation is paying, which organisation is billed

  • If an organisation is paying, how they are billed

  • The required practitioner identification details

  • The patient's eligibility requirements for any claims needed

You can use a funder specifically for an authority or funding body, but you can also set up a funder for a general service you provide paid by different organisations.

Tip

If your funder requires patients' eligibility identification (e.g. member ID, employee number, or card number and expiry) on invoices, make sure to set up each patient's claim information under the funder. You only need to do this once for each patient, then Halaxy automatically fills it out for you every time!

Import a preset funder

Halaxy's global preset database includes ready-made funders for funding bodies, authorities and organisations specific to your country and region, with all the required settings are pre-configured for you.

Note: If you cannot find a suitable preset funder in the database, you can create your own funder.

  1. Click Finances > Fees, then click the Funders tab.

  2. In the top right, click Add Funder.

  3. For Lookup, enter the name of the funding body, authority or organisation. Select the name in the dropdown to import it and its settings.

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  4. Click Save.

The funder is now imported into your Halaxy. If needed, you can edit your imported funder's settings anytime. This only affects the funder in your Halaxy, and does not affect the source preset in Halaxy's database.

Tip

Import on the go - you can quickly import preset funders and fees while creating appointments.

Note

If you have patients who pay for the full amount of a fee without being able to claim a rebate or subsidy, import the Private funder.

Add a funder

If the funder you are looking for is not in Halaxy's database, you can add your own and manually set up the funder settings.

  1. Click Finances > Fees, then click the Funders tab.

  2. In the top right, click Add Funder.

  3. Under the New Funder section, configure the following:

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    • Name: Enter a title for your funder. This can be specifically for an organisation or a general label.

    • Funder Type: Select the relevant type for your funder, which configures which payment and claim details to include in invoices. Halaxy has preset funder types that you can import and edit, but you can also create your own. Click the Icon-Edit.svg edit icon to configure your funder type.

      • Patient claim details: Enter the field labels for any patient information required on the invoice for their claim eligibility. The actual information is added in the patient's funding page.

      • Payment: Select who can pay for this invoice. Select Third party to allow billing to both patients and organisations. Select Patient only to allow only patients to be billed.

    • Description: Enter a short description of your funder to appear in the Funder list.

    • Identification: Enter the labels (not the actual identification number) for the practitioner identification/s to display on the invoice. (For example: Provider Number, Licence Number) You must then add the actual identification number in your Identifications page.

    • Create default patient claim (optional): Tick this checkbox to automatically create a patient claim under this funder whenever you create a new patient profile. If unticked, claims are only automatically created when a patient has an appointment using a fee under this funder.

  4. Under the Payment Details section, configure the following:

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    • Payer: Select who will be the default payer for fees booked under this funder. (If you need to make a one-off change, you can still change the payer on the invoice.)

      • Patient: The patient pays for the invoice.

      • Organisation (new invoice): The organisation pays for the invoice. A new invoice is created each time you use a fee associated with this funder.

      • Organisation (existing invoice, same patient): The organisation pays for the invoice. All fees associated with this funder for this patient are grouped into a single invoice. The invoice is sent to the paying organisation according to the Invoice Schedule you set.

      • Organisation (existing invoice, any patient): The organisation pays for the invoice. All fees associated with this funder for all patients are grouped into a single invoice. The invoice is sent to the paying organisation according to the Invoice Schedule you set.

    • Invoice Merging: Select your preference for which fees under this funder are allowed to be merged into an invoice.

      • Same practitioner / same clinic: Allow merging only for fees by the same practitioner from the same location (default)

      • Same practitioner / any clinic: Allow merging only for fees by the same practitioner from any location in your practice group

      • Any practitioner / same clinic: Allow merging only for fees by any practitioner but from the same location

      • Any practitioner / any clinic: Allow merging for fees by any practitioner from any location in your practice group

    • Paying organisation: The default organisation that is billed and receives the invoice. If the paying organisation constantly changes, you can leave this field blank.

    • Invoice Schedule: The frequency of when invoices are sent. This schedule is followed when Payer is set to Organisation (existing invoice, same patient) or Organisation (existing invoice, any patient). See related article: Set up an invoice schedule.

    Note: If you cannot see this section, that means the Funder Type payment settings is set to Patient only, so all invoices for this funder type are automatically billed to the patient.

  5. Click Save.

You have successfully created a funder. This funder's settings apply to all invoices that contain fees linked to this funder.

You must now add fees under this funder to be used in appointments and invoices.

Tip

If you have fees and services billed to various organisations with their own specific requirements, you might need to set up your funder and fees for third party billing.

Updated

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