HSP Claims (Australia) |
  
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In Australia, many patients qualify for the country's HSP plan. Before processing a sale for an Australia HSP patient, first ensure that the patient has been correctly set up in the PATIENT INFORMATION file.
The patient's HSP information needs to be correct in the PATIENT INFORMATION file in order for HSP Claims to work properly.
Step 1 - Select ADD to create a new claim by clicking ADD. To find an existing claim, use the search tool (magnifying glass icon) to search for the customer name relating to the claim.
Step 2- Tab across to the PATIENT NUMBER. Click the search tool (magnifying glass icon) to search for the patient's name. Claim Date and Location information will set automatically when you tab across and both can be edited. If accessing a previously saved HSP Claim and the user changes the location, the user will be asked if they wish to edit the SITE LOCATION for any items already on the invoice to the new location.
The Posting Date will default to today's date (the posting date is also the date that the transaction will post to in your Daily Close 3 or accounting extraction). **This "POSTING DATE" field will only show for Clinics that have had this Company parameter set by Auditdata. The MANUAL CLAIM option can be selected if needed and will exclude this claim from being exported in the E-Claim process to HSP.
The READY check box is only to be checked once all the information on this HSP Claim is complete and correct. Until a claim has been marked "READY", the claim will be excluded from the E-CLAIM export to HSP. An appointment for this patient can be selected and tied to this invoice by clicking the
icon to see a list of appointments. From the list of appointments, users have the option to highlight and select which appointment should be tied to this invoice. If selecting an appointment is mandatory parameter, then an appointment must be selected in order to save the invoice. If there is no such appointment, the user can select the "No Associated Appointment" option that appears at the bottom of the list. After assigning an appointment to this invoice, users can view the appointment by clicking the
icon. This appointment information will be stored and can be displayed at any time. This information is also tracked on the Appointment Booking Report (REPORTS & INQUIRIES > MARKETING & CRM > APPOINTMENT BOOKING REPORT) when exported to Excel. If the original appointment is edited or changed after associating it to an invoice, the invoice will NOT be updated with the new appointment details. If your clinic produces HSP Claim Quotations, then the QUOTE flag can be checked, designating that this claim is actually a Quotation. (**Note; Quote HSP Claims cannot be printed.) Once you check the READY check box, any HSP Validation Rules will be checked and if a validation rule has been broken, you will not be able to continue until corrections are made and the validation can pass. Based on the patient's information, the Voucher Number will appear. (If this number is RED then the patient's voucher number has expired and should be updated.) The CONFIRMED check box is only shown for those clinics who have set up that they wish to CONFIRM HSP Claims prior to them being processed through the E-Claim process. If confirmation of claims is required, a user will need permission to confirm HSP Claims within APPLICATION USERS. The REPLACEMENT option when checked will make this document treated as a replacement sale. Product Categories can be configured to auto apply "replacement discounts" and those specified discounts will be applied only on invoices that are flagged as "Replacement" invoices.
Step 3 - Enter the information on Non-Fitted items. Tick the box for the Non-Fitted Item claim area and use the search tool to choose the claim code. The date, site and practitioner fields will fill in automatically based on this patient's file information and the date of the claim (this information can be edited). If the HSP Item selected has been flagged as using Appointment History (in HSP Items (Australia only), then accessing the DATE search will launch a Patient Appointment History window so that the appropriate appointment and date and can be tied to this claim. Note that only HSP Items that have been designated (in HSP ITEMS) as "Non-Fitting" (or have a BLANK fitting type) can be added to this section of the HSP Claim.
Step 4- Enter the information for claiming a Fitting item. Tick the box for the Fitting Item claim area and use the search tool to choose the claim code. The date, site and practitioner fields will fill in automatically based on this patient's file information and the date of the claim (this information can be edited). If the HSP item selected has been flagged as using Appointment History (in HSP Items (Australia only)), then accessing the DATE search will launch a Patient Appointment History window so that the appropriate appointment and date and can tied to this claim. Note that only HSP Items that have been designated (in HSP ITEMS) as "Fitting" (or have a BLANK fitting type) will be able to be added to this section of the HSP Claim.
Step 5 - If the claim is for hearing aids, tick the Left and/or Right boxes. Next, choose the correct devices by typing in the PRODUCT NUMBER or using the search tool. Use the PRODUCT NUMBER window button to select or view device options. (If using a bar code scanner, scan the bar code while the cursor is in this field. The associated product number to the scanned bar code will populate. When using a scanning device, make sure the device setting "carriage return" or "line feed" has been turned ON. This allows the assumption of the ENTER KEY to be applied after scanning a bar code.) Note that if a serialized product added has a warranty date, it will be calculated off the CLAIM DATE. That is, unless your clinic has turned on "Use Receiving Date for Serialized Warranty" turned on within CONFIGURE SYSTEM SETTINGS > SYSTEM > Document Parameters which will always assign a warranty date for a device based on the receiving date.
The DEVICE CODE will fill in automatically. Window in on this field to enter/view the serial number and warranty date. If the aids are checked as "Top Up", an invoice will be created automatically. Click on the CLIENT COST window to enter or view DISCOUNT information.
Step 6 - If applicable, add any accessories that the Patient will be purchasing by clicking the ACCESSORIES window to add products or services to the HSP Claim that will be paid for by the Patient.
You can use the
box to see additional information.
The unit price is displayed, and a discount can be applied (based on your user privileges and product settings).
There are two options: accepting the default Category selection, or editing it as needed. A check box will appear when you save the claim to print the invoice.
Step 7 - 3FAHLS will auto generate if the audiogram has been entered into Manage or if you have previously created an HSP Claim with either a 600 or 800 code and had 3FAHL values entered. If the 3FAHL information in the patient's "ADDITIONAL INFORMATION" screen has a date that is newer than the last audiogram, then this is the 3FAHL information that will auto populate on the HSP Claim. The follow-up date is only required for 670 and 680 claim code items.
Step 8 - If a client is paying a Battery and Maintenance portion, tick the box. Note that the HS Card/ Battery & Maintenance Plan amount that populates when selected is based on that which has been set up in HS CARD INFORMATION for both Standard or Top Up HS card amounts and effective date. Patients flagged as Top Up type plan will see the Top Up HS Card amount show here. Also tick the 'Eligible for Services' box. The amount will fill in automatically, based on the claim date. Choose the authorized person from the drop-down box and tick to indicate that the claim has been signed.
Step 9- You can indicate the Authorized Person and check the "signed" field to have the signed date populate. This signed date should match the Claim Date and the Dates of any services provided on this claim according the validation rules set up. If you have selected to allow "3rd Party Funder" on HSP Claims then this window will appear, allowing you to allocate a portion of the patient's receivable to the 3rd Party Funder.
If your HSP Claim is marked as a QUOTATION, the CONVERT QUOTE TO ORDER flag appears. (This only appears on documents flagged as a Quote and the user has permissions to the "Convert Quote to Orders" menu option.) When this "Convert Quote to Order" flag is checked and the quotation is saved, the system will automatically redirect the user to the CONVERT QUOTE TO ORDER screen (if the user has permissions to the "Convert Quote to Order" menu option.)
Step 10 - Deposits and Payments can be entered here.
If your HSP Claim is a Quotation, the DEPOSIT field can be used (if your company has been set up to accept deposits on HSP Quotes). Enter the AMOUNT, DATE, DEPOSIT REFERENCE and PAYMENT METHOD to account for a deposit held on this Quotation.
When an HSP Quotation becomes an HSP Claim, the Accounts Receivable will be immediately affected, just as in the case of a regular sales invoice in INVOICES & QUOTES. If an HSP Quote needs to have the deposit returned, then the simplest way to handle this is to delete all the products and services from the Quote, and then convert the Quote to a Claim by UN checking the "QUOTE" flag. This will give the claim a credit due back to the patient, which can be done by entering a negative payment within the PAYMENTS window.
If your HSP Claim is not a Quotation, then you will be able to enter a payment within the PAYMENT field. Enter the AMOUNT, DATE and PAYMENT METHOD for each type of payment received.
If the claim is now ready to be included in the next HSP Export Batch, tick the READY flag at the upper right of the screen and press CONTINUE. You will be prompted with the option to print your claim, the client invoice, the 3rd Party Funder invoice or all of the above. (* An HSP Claim quote cannot be printed.)
If viewing a previously exported HSP claim, the EXP TRX# field will show the batch or transaction number on which the claim was exported. If the claim was rejected, the TRX# will be prefixed with the word REJECT.
The SENT flag will be checked after the HSP CLAIM has been included in an HSP Batch. When a claim has been included in a batch, it is important to NOT remove the SENT flag. (Within Security Roles (CONFIGURE SYSTEM SETTINGS > SYSTEM > SECURITY ROLES) a user can be given permission to uncheck the SENT flag). Once a claim has been returned from HSP with a status of REJECTED, users are able to mark the claim as UNSENT so that edits can be made to the claim and the revised claim resubmitted in a later batch to HSP.