Who can do this?
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All users and access levels
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Practice groups with Tyro Health integration
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Requires Halaxy credits*
*Credits will only be charged for successful transactions.
Practitioners based in New South Wales can use Halaxy's integration with Tyro Health (formerly Medipass) to process icare workers insurance claims (formerly covered by WorkCover NSW). Any invoice with a fee under the funder WorkCover NSW - SIRA can be processed for icare.
Claims are usually processed in 24 hours. All your patients need is their claim number, so the process is quick and convenient.
To prepare for processing icare claims, you must:
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Sign up for a Tyro Health account and register for icare claiming.
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Connect your Tyro Health account to Halaxy.
Processing an insurance claim with Tyro Health in Halaxy costs 1 credit per successful transaction.
Note
Only worker insurance claims with a claim number greater than 2000000 (7 digits) are supported. Invoices for other schemes (Dust Disease, LifetimeCare, Insurance for NSW, Sporting Injuries, HBCF) are not yet supported. Older legacy icare claims (claim numbers below 2000000) are not supported.
To successfully process an icare claim via Halaxy, ensure you have the following details in place:
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Funder / Fees: Only fees under the funder WorkCover NSW - SIRA can be processed for icare. You can quickly set up fees under this funder by importing them from Halaxy's presets. Alternatively, you can just import the funder and create your own fees under it.
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Item number: The fee has the correct SIRA item number in Halaxy so icare can identify the service being claimed. You can refer to SIRA's list of publications for the correct item numbers. (Tip: Look up the most recent "Fees and rates orders")
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Rebate amount: The fee has a rebate amount greater (and no higher than the maximum in SIRA's fee schedule) than $0.00, which is the rebate amount is the amount paid by the insurer. By default, fees imported from Halaxy's database are set to the maximum allowable. If the rebate amount is higher than SIRA's maximum, the claim will be rejected. You can refer to SIRA's list of publications for the scheduled fee amount. (Tip: Look up the most recent "Fees and rates orders")
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SIRA Workers Compensation Approval Number: You have entered this number under the funder WorkCover NSW - SIRA in your identifications. This number must be registered with Tyro Health. (Tip: You can also add this number on the invoice.)
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Provider number: You have entered your Medicare provider number under the Private funder in your identifications. This provider number must also be registered with Tyro Health. (Note: Even if you have entered your provider number for the Medicare funder, you still need to add it again for the Private funder.)
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Patient claim details: Set up your patient's claim for WorkCover NSW - SIRA on their patient funding page. You must include the patient's claim number, set the paying organisation is to icare, and set the payer to bill the organisation rather than the patient.
Image: A patient's "WorkCover NSW - SIRA" claim on their funding page.
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Patient details: The patient must have a valid date of birth and mobile phone number on their patient profile.
Note
You do not need to know which insurer provides funding to your patient. This is handled by Medipass when you submit the claim.
After you set up an appropriate fee and entered your SIRA approval number for the funder WorkCover NSW - SIRA, you can now process the claim from the invoice, similar to processing a private health claim with Tyro Health.
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Open the invoice. (The fee added must be under the funder WorkCover NSW - SIRA.)
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Under Payments, click Process icare.
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In the pop-up, tick the checkbox for the rebates you want to claim, then click Process. (Note: Rebates that cannot be claimed yet are not included.)
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In the Tyro Health confirmation pop-up, click Continue to Payment.
When payment is approved, the Halaxy invoice is updated with the rebate marked as paid.
You can view the claim history and a Tyro Health statement by clicking the claim status link on the invoice. After the funds are transferred, you can log into your Tyro Health portal to access remittance advice and to refund the payment if required.
Image: Viewing the Tyro Health claim history and statement (expand image)
Note
If there is a gap amount remaining (i.e. the fee total was higher than the rebate amount paid by icare), Halaxy creates a linked invoice billing the patient for the gap. The link to the patient invoice appears on the icare invoice, and you can then process payment for the remaining gap amount.
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