Set up patient claim details

Claim information allows funding bodies — a company or organisation that subsidises or pays for a service you provide — to identify a patient and determine their eligibility for services to be covered.

On Halaxy, a patient's claim details can include their identification number, the default payer, paying organisation, and other details required by each funding body.

By storing this information, Halaxy can automatically enter and manage claim details based on the fee you select for an appointment.

Add patient claim details

  1. Open the patient profile and click the Funding tab.

  2. At the top right, click New Claim.

  3. For Funder, enter the funding body's name and select it in the dropdown. If it is new, click Add 'Funding Body Name' as a new funder.

    Patient-Claim-02.png
  4. Complete the claim information form. (Required details may differ for each funding body.)

    Patient-Claim-01.png
  5. Click Next or Submit.

The patient's claim information for this funding body is saved to their profile and appears on their appointments and invoices with fees linked to this funding body.

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

To edit the claim details, click the Icon-Edit.svg edit icon.

Set the payer for third-party funder claims

If you are creating a patient claim for a third-party funder, you must also set some additional options, such as the default payer for this patient's invoices.

Patient-Claim-06.png

The options may include:

  • Paying organisation: The default organisation that is billed and receives the invoice. If you don't want to set a default organisation (due to changing organisations), 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.

  • (Optional)Anonymise patient details on invoice: Tick this checkbox to not display the patient details on invoices. When ticked, the patient appears on the invoice in the format HX 123456.

  • 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.

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