HICAPS and Medicare Integration

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1 HICAPS and Medicare Integration Visual Outcomes now includes integration of HICAPS and Medicare payment methods for clients. Setting up your HICAPS Terminal Please call HICAPS and organise for a terminal to be connected to your PC, then go to our website to download and install HICAPS Connect software: open zip file and run HicapsConnect_1_0_2_61.exe. Once the HICAPS terminal is connected to your PC: press the function key and press 9 on the keypad. Confirm software upgrade on terminal (this will take about 30 minutes to download). Once both actions are complete: go to Start > Programs > HICAPS Connect > HICAPSConnectServiceController.

2 Program will run in the background and will show in your Windows tray. Right click on HICAPSConnect icon > Configure Configuration window should show port to which terminal is connected: Save and Close. To test your connections: Start > Programs > HICAPS Connect > HICAPSConnectClient. Please test connections with Terminal Test, All Providers, All Merchants. They should all return an OK connection and display providers and merchants listing.

3 HICAPS - User Guide for Visual Outcomes (VO) Setup Log on to Visual Outcomes: User ID: Password: ceo CEO HICAPS Requirements You must have a HICAPS enabled terminal installed. You must have the Use HICAPS setting set to true.

4 You must have configured the HICAPS terminal with the appropriate Provider Numbers. You must ensure that the Practitioners have the Provider Numbers setup in the Personnel Wizard (Practitioner Tab) the same as configured on the HICAPS terminal. You must ensure that the Services have the Health Fund codes setup in the Services Wizard (Service Tab). Click on... in Health Code field, select the HICAPS Item Code

5 Select code and OK. The Till must be opened when you log on to VO for the first time each day. To open the till: Navigator > Front Desk > Banking Wizard. Select Open till for the day, then Next > Next > Finish. The HICAPS terminal must be synchronised. This can be done at the same time as opening the till: On the Till Status window of the Banking Wizard, below Till Float Value, is the Activate HICAPS row. Click on the HICAPS Interface button and the HICAPS Interface window appears. Click on the Sync button to synchronise with the HICAPS terminal.

6 CLAIM - Invoicing a PHI transaction Generate Invoice An invoice is generated either automatically from an appointment; or manually through the Invoice Manager located in the Front Desk tab in the Navigator. From the appointment: right click on the appointment and from the menu select Arrive and View Invoice or Arrive and FastPay. The former will display the invoice. The latter will create the invoice but not display it. You will see a further menu showing payment types: Select HICAPS Transaction.

7 Taking Payment If the invoice to be paid is not already open on the screen, right click on the appointment and select Invoice then View Invoice. Once the invoice is showing: select HICAPS ; Process; Gap amount, which will be displayed, is paid through the invoice manager. Select Add receipt, select payment type in Receipt form, then Save. CANCEL cancel a HICAPS transaction Navigate from the invoice to the HICAPS interface Select Transactions Today > select HICAPS Claims and Quotes > identify the valid HICAPS transaction > select Remove.

8 SALE - Invoicing EFTPOS Generate Invoice An invoice is generated either automatically from an appointment; or manually through the Invoice Manager located in the Front Desk tab in the Navigator. From the appointment: Right click on the appointment and from the menu select Arrive and View Invoice or Arrive and FastPay. The former will display the invoice. The latter will create the invoice but not display it. You will see a further menu showing payment types: Select EFTPOS. Taking Payment If the invoice to be paid is not already open on the screen, right click on the appointment and select Invoice then View Invoice. Once the invoice is showing: Select Add Receipt > Select payment type in Receipt form > Save. REFUND Refund an EFTPOS Transaction Navigate from the invoice to the HICAPS interface Select Financial > Enter the relevant amount > Select Refund QUOTE Obtain a Quote for a Claim Navigate from the invoice to the HICAPS interface Ensure HICAPS tab is selected > Select HICAPS quote and process. HICAPS Report Navigator > Management > HICAPS Transactions Select date range Configure report to suit using grid functionality Preview/Print/Export through File Menu Print Preview.

9 How to Process a Claim from a Plan Appointment To process a plan appointment under HICAPS: Arrive > Start > right click on the appointment Select Invoice > View Invoice Check client health fund ID and click Send Swipe card through the terminal. On completion, Visual Outcomes will add back the HICAPS benefit to the plan. When an invoice is opened (even one fully paid by a plan), then HICAPS is run, the benefit amount applied will automatically detach the equivalent dollars from the receipt attached to the plan. This way, the appointment remains fully paid and the unused plan money total goes up by that amount.

10 Visual Outcomes (VO) Medicare Easyclaim User Guide Introduction When an applicable appointment is made that is eligible for a Medicare Easyclaim, VO provides an easy to use process that benefits the practice and client. Medicare Easyclaim Requirements You must have a HICAPS enabled terminal installed. You must have the Use HICAPS setting set to true You must have configured the HICAPS terminal with the appropriate Provider Numbers You must ensure that the Practitioners have the Provider Numbers setup in the Personnel Wizard (Practitioner Tab) the same as configured on the HICAPS terminal. The services that are eligible for Medicare Easyclaim must have a valid MBS code. This can be setup for each service in the Service Wizard and is stored in the Health Code data field. The Till must be opened. The HICAPS terminal must be synchronised. Please refer to HICAPS Requirements for instructions on how to set up any of the above mentioned requirements. Usage When an appointment has generated an Invoice, navigate to the Invoice Manager and click the HICAPS button. An invoice is generated from an appointment by a right click on the appointment and selecting Create Invoice or View Invoice. The HICAPS/Easyclaim Interface will load.

11 The Medicare Easyclaim Interface When actioning an Easyclaim request, ensure that the Medicare Tab is selected and the HICAPS system is synchronised. There are 5 main components to the interface: 1. Provider Details 2. Client Details 3. Referral Details 4. Claim Items 5. Actions

12 Provider Details This section provides data fields to add the Service Provider Number, the Paying Provider Number and the Claim and Service types as well as the Concession Request field if required (Bulk Bill Only). The Service Provider Number MUST be entered. It will be automatically populated based on the Practitioner who performed the appointment. If no value appears, then the chosen practitioner s Provider Number is not recognised by the terminal. Without a valid Provider Number, the transaction will fail. There are 4 Claim Types: Fully Paid The Appointment has been fully paid Partially Paid The Appointment has been partially Paid Bulk Bill No payment has been made. When selected the Concession Request data field will be displayed and must contain either the Yes (Y) or No (N) indicator Not Paid No payment has been made. VO supports 2 Service Types: General Practitioner Specialist You must select the appropriate Claim and Service Type before proceeding. Client Details

13 The Patient Medicare Number and Patient IRN relate to the actual person who received the service. The Claimant Medicare Number and IRN are related to the person claiming the benefit. This becomes significant in the case of children with parents and guardians. You can choose to leave the Patient Medicare Number blank as the system will prompt you to swipe the Medicare card when required. You must ensure that the correct IRN is selected prior to sending the request. Please note, that the Claimant Medicare Number and IRN are not eligible for swiping and must be entered manually if applicable. Referral Details For a Specialist Service Type, Referral details MUST be entered. When the Specialist Service Type is selected, the Referral Details will expand and be ready for entry. Referral Date is the date of referral from a Practitioner. Referring Provider is the Provider Number of the referring Practitioner. There a 2 options for the Referral Type: Standard (S) Indefinite (I)

14 If the referral data is not available, you MUST set the Referral Override Code to one of the following 3 choices. Lost Emergency Not Needed. Claim Items This section provides a list of all services that will be claimed against for the Patient. Each Claim Item must follow the selected Claim Type, Service Type, Service Provider and Referral Details. A separate Claim Line must be made for each instance of a service. I.e. If 2 identical services are being claimed, then 2 separate Claim lines must be filled in. By default, the system will populate the Claim Lines with details from the Appointment. You can add a new claim item by clicking into the new item row and filling in the required details. You can delete a claim by clicking the cross button at the bottom of the Claim Items. Claim Item Fields: Item# - The MBS Item Code for the service. Date The date the service was performed Override Code Provides you the ability to set the override reason for the item. LSP Number Location Specific Practice Number Fee The Total Amount for the service. (Only valid for Fully paid and Not Paid) Patient Amount The amount paid by the Patient (Only valid for partially Paid) Benefit Amount The amount of benefit paid. This is a read only field and will be populated after the transaction has occurred.

15 Actions Clear Clears all Claim Items Send Send the Easyclaim to Medicare MBS Search Link A hyperlink to the MBS search facility to help you identify MBS codes. Sending a Claim When all details have been entered into the interface, simply click Send and follow the instructions from the terminal graphic. It most cases, the client will be asked to swipe their Medicare card. Before being sent, VO will perform basic checks to ensure that you have completed the appropriate data fields correctly. The system will wait for the transaction to complete and present you with a description of the response. If successful, the terminal will print out the transaction details for the client and provider. You cannot send more than 14 Claim Items.

16 Process Diagram Setup VO and HICAPS terminal Create Appointment Perform Appointment Activate HICAPS Connect choosing Medicare Easyclaim Generate Invoice Enter and validate Claim Items Send Claim Verify Response

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