HSP Claims via HSP Wizard (Australia) |
  
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The HSP Wizard simplifies the HSP Claim entry process by pre-populating as much information as possible in a screen presentation that only shows the user one screen at a time. The Wizard then populates the standard claim screen with all the information selected by the user. To turn on the HSP Wizard, go to HSP Parameters . Check the field ENABLE HSP WIZARD to utilize this tool.
After checking ENABLE HSP WIZARD, when adding a new HSP Claim within HSP CLAIMS, the HSP CLAIM WIZARD WINDOW will display. Enter the Patient Number and confirm or select the Document Location. If your company has been flagged in HSP Parameters to allow HSP Quoting, then check this flag. (Quote HSP Claims cannot be printed.)
When ready to continue, press NEXT.
If the VALIDATE HSP VOUCHER NUMBER inHSP Parameters flag has been enabled, the system will confirm that the patient selected has a valid HSP Voucher number and valid expiry. If the Voucher doesn't not have the correct Voucher Number format or if it is expired, a warning will appear (if the VALIDATE HSP VOUCHER NUMBER is enabled.) The warning will prompt you to return to the previous screen and the Patient's Voucher information will need to be corrected before being allowed to create a new claim. Pressing CANCEL at any point in the HSP Wizard will close the HSP Wizard and return you to the original HSP CLAIMS screen.
Click NEXT to display a screen confirming the PRACTITIONER (otherwise known as the SPECIALIST flagged on the Patient file), the most recent 3FAHL results and the last Audiogram date. If the 3FAHL information and date has been saved in the ADDITIONAL INFORMATION screen of PATIENT INFORMATION for this patient, it will appear here. The system will also review the Audiogram history for this patient to find the most recent 3FHAL results and audiogram date. The system will populate the most recent 3FAHL results and Audiogram date.
The user can return to the previous screen by pressing PREVIOUS. Edit the information presented or press NEXT to continue to be presented with the next screen.
Next the HSP ITEM selection screen will appear. Users can select either NON-FITTING or FITTING as the Claim Type (at the top of the screen).
When selecting either Claim Type, the HSP items shown will populate based on their set-up. Under HSP Items (Australia only) each HSP item can be assigned a fitting type of NON-FITTING (N) or FITTING (F). This TYPE determines whether an HSP item appears in the Fitting or Non-Fitting portion of an HSP Claim.
Select the NON-FITTING or FITTING item by double-clicking on the item and making the SELECTED check mark appear to the right of the selected HSP Item number.
After selecting the NON-FITTING or FITTING HSP Item, press NEXT to continue to the next screen. In this screen, users can choose left and right devices for this claim. Either enter the product number for each side or use the search tool to find the product to add. The rest of the product information will appear based on how the product has been set up. If a product that has device options or suggested sales lists associated to it has been selected, then users will be prompted to select those options. If choosing a serialized product, users will be able to select from the available serial numbers at the selected location in the drop-down list for SERIAL NUMBER. If the selected product has DEVICE OPTIONS or SUGGESTED SALES LISTS associated to it, users can review that information here as well after it has been entered. Add the products to left and right as needed.
When ready to continue, (or if you are not adding any product to this HSP Claim) press FILL CLAIM to populate the standard HSP CLAIM screen with all the information previously selected.
The full standard HSP CLAIMS screen will appear. The NON-FITTING items selected will appear in the upper Non-Fitting section. If a FITTING item was selected, it will appear in the middle Fitting Item section of the claim. Any devices sold on this HSP Claim will appear under the product section of the HSP Claim.
Edits or changes that are necessary can be made at this point. To remove a NON-FITTING item , FITTING item or PRODUCT, simply uncheck the box to the left of the item. This will remove it from the claim. To add a new item to the claim, re-check the box at the left of the line and manually add or search for the item or product you wish to add to any section.
**If VALIDATION RULES in HSP Parameters indicate that specific HSP ITEMS require date matching on either NON-FITTING or FITTING items, the system will ensure that the claim date, various HSP ITEMS, product dates and signature dates all match.
If this claim is a Battery & Maintenance claim or a fitting claim with a Battery & Maintenance fee (and the patient is not DVA exempt), then be sure to check the "I have/ will pay the provider for services" tick box under CERTIFICATION BY CLIENT . The HS Card amount will populate.
Under CERTIFICATION BY SERVICE PROVIDER, be sure to allocate the correct "Authorized Person" from the drop-down list of Specialists. The TOTAL COST TO CLIENT will populate based on the products select minus any HSP benefit portion.
Make sure the SIGNED box is checked and dated to indicate when the Specialist signed the document.
If another Funder is paying for any portion of this HSP Claim, then access the Funder window and allocate the portion to the 3rd Party Funder as required. This will alter the balance by the patient.
If the Patient owes any portion of the claim, a payment can be made against this claim by accessing the PAYMENT AMOUNT window and entering the payment method and amount.
If this is a manual claim, then click the MANUAL CLAIM box at the top right. This will prevent this claim from being included in the e-Claim file export to HSP.
If this claim is complete and ready to be sent via the e-Claim file export, then click READY at the top right.
If your clinic requires that claims be confirmed by a user (with permissions/authority), then that user will need to click CONFIRMED to include this claim in the e-Claim export file.
The SENT flag will be checked after the HSP CLAIM has been included in a 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, a user is 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.