ACC Claim Management

This article explains how use the ACC Claims screen in Bp Omni.

Download Quick Reference Guide PDF

All claims are searchable from the ACC Claims screen. When a Condition with a type of Claim is linked to an appointment, a new claim is created in this screen with a status of Incomplete.

From this screen users can lodge ready claims, edit incomplete or claims with an Error status, delete claims or change a claim to private. An ACC45 online form can be sent to the patient and the claim form and summary can be printed.

To locate and manage claims, use the search and filter options. The ACC Claims screen can be accessed from

  • Admin > ACC Claims .
  • Finance > Find an ACC Claim.

ACC Claims screen

  • Name - Only one patient can be selected.
  • Claim number - Bp Omni will return all results that match the characters entered in the search field.

    • Filter by claim number

  • Provider and Insurer - Search or select an option from the dropdown list.
  • Status - Select one or more options from the drop-down list. Not Ready and Ready statuses are located at the top of the drop-down. See ACC Claim Statuses below for the full list.
  • Date(s) - Enter a date range manually, select dates on the calendar or use the Standard ranges.
  • The Action Required button will display all claims with a status of Accredited employer, Error, Declined, Not Verified, Ready, and Incomplete. This filter button excludes private claims.

    • ACC Claims filters

Filters can be useful when lodging claims as an end of day procedure. To send all ACC claims in Ready Status to ACC for today:

  • Search for ACC - Accident Compensation Corporation in the Insurer filter
  • Select the Ready checkbox in the Status filter options.
  • Select today's date in the Date(s) filter.

    • Filter for Ready ACC Claims for Today's date

Select the ellipses [...] button to view a menu of quick actions. The menu options available are dependant on the claim status.

  • Summary - Opens the ACC45 Summary.
  • ACC 45 >

    • Action

    Description

    View

    Opens the ACC45 claim form in view-only mode.

    Edit

    Opens the ACC45 claim form to edit.

    Lodge

    Lodges the selected ACC45 claim.

    Print claim form

    Prints the claim form.

    Print completed ACC45

    Prints the completed ACC45 claim form.

    Email to client

    Opens the Email window. Enter the email address and click Send now.

    Send a form

    Sends a link to an online form for the patient to complete via email or SMS. See Understanding Online Forms for more information.

    Display a QR code

    Generates a QR code for online forms for the patient to complete via email or SMS. See Understanding Online Forms for more information.

    Lodge a claim from the actions button

  • Change to Private - If no consultations or invoices are attached to the ACC Claim it can be changed to a private claim.
  • New ACC32 - A new ACC32 can be created for claims with a status of Discharged, Accepted, Accredited or Not available. SeeACC32 Requests for more information.

TIP The menu will display the number of ACC32 requests in parentheses ( ) when one or more ACC32 requests exist for a claim.

ACC45 Claims can be lodged in Bp Omni from the ACC Claims screen accessed from the Admin menu, or from the claim itself.

  1. Go to Admin > ACC Claims.
  2. Use the filters to find claims with a status of Ready.
  3. Once all desired filters are set, select the top checkbox in the column heading to select all filtered claims.

    4. Lodge Claims

  4. Click Lodge to send claims.

The ACC45 Claim screen can be accessed from many areas of Bp Omni.

  • From the Clinical Record > Select Conditions > Select the claim > Click the Open icon.
  • From ACC Billing > Click on the claim link > Select Go to claim.
  • From ACC Claims > Click on the claim link > Select the ACC45 tab.

The claim can be lodged and printed from the top toolbar options. The Lodge button is also available from the Summary tab.

Lodge or Print Claim

From the Summary tab of the ACC45 claim, consultation details for each ACC contract or provider type are recorded in the Consults card.

The Consults card will display for each provider type the number of:

  • Consults remaining.
  • Allocated consultations as per the provider contract.
  • Consultation Extensions permitted for the claim.
  • Total Booked consultations linked to the claim.
  • Total Billed consultations linked to the claim.

Consults card in the ACC45 Summary

To remove a contract or provider type, select the trash can trash can delete button button. This option is disabled when booked or billed consultations are linked to the claim.

  1. Go to Admin > ACC Claim.
  2. Use the search fields to find the claim or use the Status filter to see all claims with an Error or Status Error status.

    3. Filter by error

  3. Select the Actions button for the claim and click Summary.
  4. View the error details in the Overview card.
    • An Error is a message returned by Bp Omni before the claim is lodged.
    • A Status Error message is an error returned from the ACC API after the claim has been lodged from Bp Omni.

    Overview error details

  5. Once the error has been resolved the claim can be lodged again.

To email a PDF copy of the ACC45 form to the patient:

  • From the ACC Claims screen, click the ellipses [...] button and select ACC45 > Email to client.
  • From the ACC45 claim form, select Print > Email to client.
  • From the Appointment information screen, click the ellipses [...] button and select Email to client.

Selecting one of these options will open the Email window. Enter an email address to Send ACC45 to and click Send now.

Email a copy of the ACC45 to the patient

An incomplete ACC claim can be deleted from the Conditions card in the patient profile before it has been lodged from Bp Omni.

  1. From the ACC Claim screen, click the Patient name to open the patient profile.
  2. Scroll down to the Conditions card.
  3. Select the ellipses [...] button and click Delete.

    4. Delete an ACC claim from the Conditions card of the patient profile.

Enter additional details about a referred claim from the Referral Information card.

  1. Open the ACC Claims screen.
  2. Click on the Claim link. Referred claims will have the referred icon next to the claim number.

    3. Referred claims will have the referred icon next to the claim number.

  3. Expand the Referral Information tab from the claim Summary screen.
  4. Type in the name of the provider that lodged the claim.
  5. Select the date that the claim was created.
  6. Enter the Injury date.

    7. Referral information card for a referred ACC claim.

  7. Enter the Primary diagnosis information including a Description, Side and Status of the claim.
  8. Add Additional diagnoses and Equipment & orthotics if required.
  9. Click Save at the top of the screen.

ACC Specialist Treatment Provider (STP) contracts require that allocated treatments must be completed within 12 months from the initial consultation date, or 12 months from the latest ACC32 approval date.

To help you comply with ACC rules and prevent invoices being declined, Bp Omni will flag a patient condition as “On Hold” when the patient treatment expiry date is met. Bp Omni calculates this as 12 months from the service date on the initial consult appointment invoice.

On hold claims from the Current conditions.

If a claim is showing in Bp Omni as On hold, create a new ACC32 request for approval to use the claim. Once you add the approval date to the ACC32 record in Omni the treatment expiry date will be recalculated to 12 months from the approval date.

If you have completed your treatments, discharging the patient claim will also clear the on-hold warning.

On hold icon in ACC Claims screen.

NOTE The ACC45 Summary and New Invoice screen will display a warning message if the claim is on hold. Bp Omni will not stop the user from invoicing an on hold claim.

ACC claim statuses

Status

Description

Available Actions

Next Steps

Accepted

Claim has been accepted by ACC.

Create ACC32.

 

Accredited

Claim is managed by an ACC Accredited Employer. See ACC Accredited Employers for further details.

Create ACC32.

 

Declined

Claim has been declined by ACC.

Edit, Lodge, Change to private.

Lodge claim again if decline reason resolved with ACC. Claim can also be changed to private.

Discharged

Internal to Bp Omni, claim has been discharged.

Create ACC32. Claim discharge can be reversed from the Clinical Record.

Reverse discharge if claim is relevant.

Error

Internal to Bp Omni. ACC API cannot be reached. View error details from the claim summary.

Edit, Lodge.

Lodge claim when services are restored.

Held

Claim has been received by ACC and is awaiting decision.

Edit, Lodge.

 

Incomplete Invoice

Internal to Bp Omni. Claim is incomplete and has not been sent to ACC.

Edit, Lodge, Delete, Change to private.

Complete all required fields.

Not Available

ACC Sensitive Claim.

Create ACC32.

Discharge claim.

Not Verified

Internal to Bp Omni, for referred claims only. Awaiting status confirmation from ACC.

Change to private

Awaiting status from ACC.

Pending

Claim has been sent to ACC and is awaiting approval.

 

 

Queued

Internal to Bp Omni. Claim is in the process of being lodged from Bp Omni.

 

 

Ready

Internal to Bp Omni. Claim is complete and ready to be sent to ACC.

Edit, Lodge, Delete, Change to private.

Lodge claim.

Status Error ACC Claim badge displayed when an error is returned from the ACC API.

Error returned from the ACC API. See the Overview card of the ACC45 Summary for more details.

 

Resolve claim error and resubmit.

What do I do next? | Related topics

Last updated: 12 September 2024