This article describes how to configure Bp Allied to submit claims to Health Funds through Tyro HealthPoint Claiming.
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Before you begin
Tyro HealthPoint Claiming allows access to lodging claims and requesting quotes from multiple Health Funds via one system. The details of supported funds by modality can be accessed on the Tyro website. Please contact Tyro Support to sign up for Tyro HealthPoint on 02 8907 1700 or 1300 966 639. A practitioner may need to be registered with a Health Fund to process claims. Please contact the relevant Health Fund for details on whether this is required.
Download a copy of the Health Fund IDs table from here.
Payments
As soon as the Claim is accepted by your Client, Tyro guarantees payment to you, the merchant. Tyro directly pays the merchant a single sum on a daily basis for all claims lodged and accepted on a +2 day schedule. If you require any additional information regarding their merchant payment system and HealthPoint Settlement Reports, please contact Tyro directly.
Pre-requisites for lodgement
There are several pre-requisites required for a claim to be lodged. A claim can only be for:
- one practitioner
- one modality (e.g. psychology or speech, not both)
- one service (appointment) date
- Multiple appointments or items that occur on the same day can be sent on the same invoice
Updating Health Fund table
Practices must enter each Health Fund into Data Maintenance > Health Fund using the downloaded HealthFund IDs table in order to submit claims to through Tyro HeathPoint. The details to be entered are:
- Health Fund – an identifying name for the Health Fund. Will appear in all the drop-down lists
- Enabled – Must be checked to allow a claim to be made against it
- HealthFund ID – The identifying ID for the Health Fund
- HealthFund Digits - The identifying digits for the Health Fund (this relates to the client’s HF card)
NOTE CSS Settlement has been deprecated. This was previously used to identify how the payments related to the Health Fund claims are settled with Tyro. This is longer applicable to merchants claiming via Tyro HealthPoint.
Please contact the Bp Allied support team for a list of this information.
Updating Products and Services table
Each Health Fund has its own series of Item Codes that can be claimed against. There are also some common claim Item Codes. When creating a Quote or an Invoice against which a claim request is sent, the Item Code is used to determine which Item is being claimed for and therefore what rebate is received. These Items need to be created in Products and Services. There are two fields that are required for a valid claim to be sent:
- Item Code – relevant for each specialty (modality) and service performed
- Service Type – which specialty or modality the service relates to. E.g. E = Dietitian, P = Physio and Y = Psychology.
ServiceType can be selected from the drop down list of values available.
Update Provider
Each Health Fund that a provider requires claims to be submitted for needs an entry in their user information. This is entered into System > Options > User Administration > Provider IDs. The details required are:
- Health Fund – a line for each fund to be claimed for
- Location – If the provider number is the same for each location then the <ALL> location can be selected, otherwise a line for each Fund / Location combination is required.
- Provider Number – Relevant provider number for the Fund / Location combination
- Auth Group – only relevant for Medicare Online Claiming and not to be selected for HealthPoint claiming
- Active – To be checked if the line is to be used.
Update Client
Clients whose claims will be processed on their behalf must provide the following information:
- Health Fund – select from the drop-down list. Determines which Health fund the claim is submitted to.
- HF Family Number – manually enter in the two digit code. This is not transmitted when the magnetic strip of the HF card is swiped so must be manually sent with the claim.
The currently available field called Health Fund Number or HealthFund / DVA Number is not used in processing a HealthPoint Claim. The client MUST provide and swipe their Health Fund card to have a claim submitted via Tyro HealthPoint.
The client’s HF Family Number can be saved in the Client record. See the Adding more Client Details section on how to update / add these fields to a Client’s record.
Pair the Tyro Terminal
This is carried out in the same way as for Tyro Eftpos. Discuss with Tyro Support whether the terminal will need re-pairing or rebooting if adding HealthPoint to an existing Eftpos setup.
Reporting
Run financial reports to manage the functions available using Tyro HealthPoint from the Reports tab.
- HealthPoint Claims Report – The Tyro HealthPoint Claims report displays all claims lodged by Bp Allied during the period of time selected. This does not include an quotes lodged as this information is not saved.
- Quote Summary - The Quote Summary report is designed to allow management of outstanding quotes. It enables a view of all the quotes created within a period of time and includes details on which ones have had appointments associated with them and which ones haven’t.
- Transaction Summary – has been updated to show the Health Fund against any claims that are displayed in this view. The grouping and filtering options can be used to view Health Fund related invoices and payments.
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