For private in-patient hospital claims via ECLIPSE, please refer to our article: Set up ECLIPSE online claiming
With private billing, a patient may pay for their own treatment or they may submit their claim themselves through private health insurers. In other cases, the patient is fully covered by their health fund, whom you will need to bill.
There are two ways to set up private billing on Halaxy:
See the sections below for step-by-step instructions on how to set up billing for each way.
Tip
With our Tyro Health and Tyro terminal integrations, you can process your payment and your patient's private health claim at the same time - straight from a Halaxy invoice.
In this setup, the patient is paying the full amount of their appointment invoice and is billed on the invoice.
Click the arrows to see all the steps.
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Step 1: Create an appointment and set up the fee
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On the calendar, click on a timeslot to create a patient appointment.
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For Fees, enter the name of the service you are providing, then click it in the dropdown to add it as a new fee.
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In the pop-up, configure the fee:
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Funder: Type Private, then click Import Private in the dropdown. (Note: You'll only need to import this funder once. If you've already imported the Private funder, you can just select it in the dropdown.)
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Amount: Set how much you charge for this service.
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Rebate: Leave the value at 0.00.
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(Optional) Configure any other details for your fee as needed. (For a complete guide to fee details, see this article.)
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Click Add Fee. This service has now been saved to your practice and can be reused in new appointments.
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In the appointment panel, click Save to create the appointment and automatically generate the invoice. (In the newly created appointment, click Invoice to open it.)
You have successfully imported your fee - and also created an appointment, clinical note and invoice.
Note
You can create as many private fees as needed and follow this same process. If the fee is fully paid by the patient, make sure to set it up under the Private funder.
Tip
If you want to set up all your fees and services without needing to create appointments, you can also import them from the Fees List.
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Step 2: Add your identification (if required)
If you need to include any identification on invoices (such as a provider number), you can add this information in the Identifications page. This step is optional.
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From the patient's appointment on the calendar, click Invoice.
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Under the Practitioner Details section, under Identification, click the
pencil icon.
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In the pop-up, enter your identification.
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Click Save.
Your identification number/s now display in any invoice that contains your Private fees.
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Step 3: Process the invoice payment
If you have already set up Halaxy electronic payments, you can process payment and charge the patient's credit card directly on the invoice.
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Under the Payments section, click Process Now. (If you have not yet stored the patient's payment information yet, click Add Payment Details and enter their card details.)
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In the pop-up, configure the following:
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Amount: Enter the payment you are receiving for the invoice.
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Assign processing fees to the patient: Select if you want to charge the processing fees to the patient. If you select No, the processing fees are deducted from the payment when it is transferred to your bank account.
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Yes: The patient pays the processing fees, which are added on top of the invoice payment.
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No: The practice pays the processing fees, which are deducted from the payment before it is transferred to your bank account.
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Payment approval (recommended): Tick the checkbox to require SMS payment authorisation from the payer.
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Notes (optional): Enter any notes for this this payment.
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Click Process.
You have successfully billed and processed payment for this patient.
Alternatively, you can also process payment outside of Halaxy and manually mark the invoice as paid.
Note
Only users with verified profiles can process Halaxy electronic payments.
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In this setup, the patient's private health fund is paying for the appointment and is the billed organisation on the invoice, which contains the patient's claim details.
Click the arrows to see all the steps.
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Step 1: Create an appointment and set up the fee
-
On the calendar, click on a timeslot to create a patient appointment.
-
For Fees, enter the name of the service you are providing, then click it in the dropdown to add it as a new fee.
-
In the pop-up, configure the fee:
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Funder: Type Private Health Insurance, then click Import Private Health Insurance in the dropdown. (Note: You'll only need to import this funder once. If you've already imported this funder, you can just select it in the dropdown.)
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Item code (optional): If the health fund has a specific number for the service, enter it here.
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Amount: Set how much you charge for this service.
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Rebate: Enter the rebate amount you receive for this service. (If you charge a gap fee for this service, Amount must be greater than Rebate.)
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(Optional) Configure any other details for your fee as needed. (For a complete guide to fee details, see this article.)
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Click Add Fee. This service has now been saved to your practice and can be reused in new appointments.
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In the appointment panel, click Save to create the appointment and automatically generate the invoice. (In the newly created appointment, click Invoice to open it.)
You have successfully imported your fee - and also created an appointment, clinical note and invoice.
Note
You can create as many fees as needed and follow this same process. If the fee is billed to the health fund, make sure to set it up under the Private Health Insurance funder.
Caution
If you charge a gap fee for a service, Amount must be greater than Rebate. This creates another invoice billed to the patient to charge the gap.
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Step 2: Enter the patient's claim details
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From the patient's appointment on the calendar, under the claim section, click the
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In the pop-up, enter the patient's details for their claim:
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Paying Organisation: Enter the name of the health fund.
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Member Number: Enter the patient's policy number or member number at their health fund.
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Member Reference Number / Expiry (optional): Enter these details if necessary.
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Payer: Select Organisation (new invoice).
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Click Save.
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If required, click Add Referral to enter the patient's referral details.
You have successfully added the patient's claim details for their health fund. This is also stored in their patient profile. Whenever you book this patient for an appointment using a Private Health Insurance fee (not Private), these details are automatically added to their appointment and invoice.
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Step 3: Add your practitioner identification (if required)
If you need to include any identification on invoices (such as a provider number), you can add this information in the Identifications page. This step is optional.
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From the patient's appointment on the calendar, click Invoice.
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Under the Practitioner Details section, under Identification, click the
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In the pop-up, enter your identification.
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Click Save.
Your identification number/s now display in any invoice that contains your Private Health Insurance fees.
This invoice can now be billed and submitted to the health fund for processing.
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If you have different identification numbers for different private health funds, you can add multiple IDs to the Private Health Insurance funder, which allows you to switch IDs on an invoice.
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Click Finances > Fees, then click the Identifications tab.
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In the Private Health Insurance row, click Add another identification.
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Enter the ID for the new health fund. Make sure to enter the health fund's name in the Description.
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If you have multiple locations, repeat steps 2 and 3 for every location.
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Click Save.
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On the invoice, under the Practitioner Details section, next to Provider Number, click the
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Under Available Funder Identifications, select the ID you want to use for this invoice and click Save.
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