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HSP Parameters

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(Only visible for Australian clinics.)

 

If your company processes HSP Claims, then the following HSP Parameters need to be set up.

 

The screen prompts are:

 

HSP Claim Funding Source - Enter the funding source that will be assigned to HSP.  The program has been hard-coded to look use funder "HSP" as the funding source, so be sure a funding source called "HSP" has been created within Funding Sources (Co-Payers).

 

HSP Number - Enter the official HSP number for your organization.

 

File Directory - Indicate the directory where the HSP E-Claim batches will be saved.

 

Minor Customer ID - Enter your Organization's Minor Customer ID. If your locations each use their own Minor Customer ID, that can be entered per location under Location Information (CONFIGURE SYSTEM SETTINGS > SYSTEM > LOCATION INFORMATION.)

 

Address Information to Print - Check which address to print on HSP letters.

 

HSP Renewal Letter - Indicate which Patient Letter (from within your database) is to be the HSP Renewal Letter.

 

DVA Renewal Letter -  Indicate which Patient Letter (from within your database) is to be the DVA Renewal Letter.

 

HSP Payment Reminder Letter -  Indicate which Patient Letter (from within your database)  is to be the HSP Payment Reminder Letter.

 

DVA Payment Reminder Letter -  Indicate which Patient Letter (from within your database )  is to be the DVA Payment Reminder Letter.

 

 

 

Process Return Voucher Requests Centrally - Indicate if RVR's are to be run out of one central location. (Otherwise, each location would run their own RVR's.)

 

Use Details From Location - If running the RVR's out of one central location, indicate that location here.

 

Process HSP Claims Centrally - Check this box if ALL claims are to be processed through a single assigned location. An Australian change for standard clinics allowing HSP claims to be sent centralized by region. Similar to the "centralized by location" HSP toggle in CONF SYS SETTINGS > SYSTEM > HSP PARAMETERS but allow it to be centralized by region now. Selecting to run all claims centrally through a single location will create one e-claim batch file using a single minor customer ID.

 

Use Details From Location - If ALL claims are to be processed through a single location, select which location details will be used for all locations claims.

 

Process Payments By Location - If ALL claims are to be processed through a single location, check this box if payments received will be allocated to each individual location based on the claim being received.  Leave this box Unchecked if all payments received will come into the location identified as the Central Location, no matter which clinic the claim belongs to.

 

Claim Generation By - Select to generate Claims by either Region, Location or one Central Location.

 

HSP Claims Require Confirmation - Check this field to indicate that a HSP Claim must be marked as "READY" prior to adding to the "SEND HSP CLAIM" queue.

 

Suppress HSP Details On Client Invoice - Checking this field will remove the HSP payable portion from the printed Client Invoice.

 

Reset Fitting Date Upon Quote Convert - Select either Yes to automatically reset the Fitting Date when Converting the Quote to an Invoice to match the Claim Date. Select NO to automatically resetting the Fitting Date to the Claim date when converting a Quote to an Invoice. Select Prompt to be prompted to reset the Fitting Date when converting a Quote to an Invoice.

 

 

 

 

 

HSP Validation Rules - Validation rules may be set up.  This Validation cross checks that the right HSP Item number is used within an HSP Claim in the correct way.

 

Available HSP Claim Validation Rules:

  • REQUIRING AN ADDITIONAL ITEM 777, IF CLIENT IS DVA - Assign which HSP Item numbers will require the HSP Claim to contain HSP Item 777 when the client is a DVA patient.
  • REQUIRING AN ADDITIONAL ITEM 888, IF CLIENT IS DVA - Assign which HSP Item numbers will require the HSP Claim to contain HSP Item 888 when the client is a DVA patient.
  • REQUIRING A 3FAHL - Assign which HSP Item numbers will require 3FAHL values on an HSP Claim.
  • MONAURAL FITTING ITEM - Assign which HSP Item numbers are for Monaural fittings only on an HSP Claim.
  • BINAURAL FITTING ITEM - Assign which HSP Item numbers are for Binaural fittings only on an HSP Claim. If a HSP claim is approved for a patient without a FITTING TYPE set on their PATIENT INFORMATION screen, and the claim sets the patient's LEFT/RIGHT FITTING DATE field then the patient's FITTING TYPE will be automatically updated to BINAURAL.
  • REQUIRING A MAINTENANCE PAYMENT, IF CLIENT IS NOT DVA - Assign which HSP Item numbers require a maintenance payment on the HSP Claim, when the patient is not DVA.
  • ITEMS REQUIRING THE B&M FLAG CHECKED, IF CLIENT IS NOT DVA - Assign which HSP Items require the B&M Flag to be checked on an HSP Claim when the patient is not DVA.
  • DATE MATCH FOR NON-FITTING ITEMS - Assign which HSP Items require the CLAIM DATE to match the item DATE for non-fitting items on an HSP Claim.
  • DATE MATCH FOR FITTING ITEMS - Assign which HSP Items require the CLAIM DATE to match the item DATE for fitting items on an HSP Claim.
  • LAST CLIENT REVIEW ITEMS - Assign which HSP Items on an HSP Claim will update the patients LAST CLIENT REVIEW date on their patient record.
  • MANUAL ITEMS - Assign which HSP Items on an HSP Claim will indicate that the claim is to be processed manually and not submitted via the SEND CLAIMS function. When assigning an item marked as a "Manual Claim" the user will be reminded on saving the claim to not forget to remit it manually.
  • ITEMS REQUIRING FINALIZATION DATE 7+ DAYS AFTER FITTING - Assign which HSP items will require that the FINALIZATION DATE is 7+ days after the FITTING DATE.
  • ITEMS REQUIRING DATE OF FOLLOW-UP - Assign which HSP Items will require the DATE OF FOLLOW-UP field to be completed on an HSP Claim.
  • ITEMS TO BE EXPORTED IN PRIORITY ORDER - Assign which HSP Items will require that they are the FIRST HSP Item listed in an HSP Export file in order for HSP to approve the claim.
  • ITEMS REQUIRING 3FAHL VALUES WITHIN A RANGE - Assign which HSP Items will require 3FAHL values populated with the pre-determined range. (3FAHL value ranges are defined within HSP Parameters.)
  • INITIAL FITTING ITEMS - Assign which HSP Items will only be considered as initial fitting items.
  • INITIAL ASSESSMENT ITEMS - Assign which HSP Items will only be considered as initial assessment items.
  • MAINTENANCE PLAN EXPIRY DATE SET BASED ON ITEM DATE - Assign which HSP Items will update the patient's Maintenance Plan Expiry Date on the patient record when they are added to an HSP Claim.
  • ITEMS EXCEPT FROM HSP VOUCHER VALIDATION - Assign which HSP Items will be exempt from HSP Voucher Validation when added to an HSP Claim.
  • ITEMS WHICH CAN ONLY BE CLAIMED ONCE - Assign which HSP Items can only be claimed once.
  • ITEMS WHICH PRINT A MAINTENANCE AGREEMENT - Assign which HSP Items will need to print a Maintenance Agreement.
  • SUBSEQUENT BINAURAL FITTING ITEMS - Assign which HSP Items should also be considered a subsequent binaural fitting items. Works in conjunction with Binaural Fitting Items above.
  • REPLACEMENT FITTING ITEMS - Assign which HSP Items should be considered as replacement fitting items on an HSP Claim.
  • ITEMS EXEMPT FROM HSP VOUCHER VALIDATION - Assign which HSP Items are exempt from the Voucher Validation process on an HSP Claim.
  • CAN ONLY BE CLAIMED ONCE EVERY 12 MONTHS (GROUP 1) - Assign which items cannot be claimed from GROUP 1 within 12 months of the last time it was claimed. (This will check archived claims as well.)
  • CAN ONLY BE CLAIMED ONCE EVERY 12 MONTHS (GROUP 2) - Assign which items cannot be claimed from GROUP 2 within 12 months of the last time it was claimed. (This will check archived claims as well.)

 

To itemize which item numbers are applicable to each rule, click the ... button in the right corner of the ITEM NUMBERS field.

 

Each ITEM NUMBER is added one at a time using the ADD button.  There can be multiple item numbers assigned to each rule.  To remove an item number, highlight the line and click DELETE.

 

Click CONTINUE to save when all item numbers have been added to this specific validation rule (the rule titled "ITEMS EXEMPT FROM HSP VOUCHER VALIDATION" allows the user to add HSP Items that will never use any validation rules).

 

Clicking the EXP/CON button will allow the user to customize a message that will appear when users violate the validation rule.

 

 

When entering DATE MATCH FOR NON-FITTING ITEMS and DATE MATCH FOR FITTING ITEMS, any HSP Item numbers associated to these validation rules will force the CLAIM DATE, NON-FITTING DATES/FITTING DATES, DATE SIGNED and CERTIFICATION SIGNED dates all to match. If one date changes, they will ALL change to match automatically.

 

The user is returned to the HSP INFORMATION screen:

 

 

HSP Voucher Number is Required - Check this field to indicate an HSP Voucher Number is required (mandatory) on an HSP Claim. Users will be allowed to enter an HSP Voucher number directly on the HSP Claim, and that Voucher Number will be stored on the Patient file with the Funding Source "HSP" upon saving the HSP Claim.

 

Validate HSP Voucher Number - When this box is checked, the system will prevent the user from creating any HSP Claims when the Voucher Number on the patient profile is not formatted properly or when a patient Voucher has expired. (Note that if you turn on HSP VOUCHER NUMBER VALIDATION, the patient's voucher number must be 10 alpha numeric characters, followed by a dash, followed by 8 digits for the month, day, year. For example "123456789X-06042016".)

 

Practitioner Number is Required - Check this field to indicate that a Practitioner Number is required for the Practitioner listed on an HSP Claim. (Maintaining Practitioner Numbers is located within Specialists CONFIGURE SYSTEM SETTINGS > SCHEDULING > SPECIALISTS.)

 

3FAHL Must Be Less Than: Within HSP Validation rules, HSP Items can be assigned to "Items requiring 3FAHL values within a range. This "must be less than" value can be specified to be respected on an HSP Claim using an HSP Item assigned to this HSP Validation rule.

 

3FAHL Must Be Greater Than: Within HSP Validation rules, HSP Items can be assigned to "Items requiring 3FAHL values within a range. This "must be greater than" value can be specified to be respected on an HSP Claim using an HSP Item assigned to this HSP Validation rule.

 

HSP Claims Require Confirmation - Check this box to indicate that an additional step to be completed that confirms the claim is ready to be sent. Permissions on which users can confirm a claim is ready for submission is also assignable.

 

Suppress HSP Details on Client Invoice - Check this box to have the HSP funder information and details hidden from the client copy of the invoice.

 

Income Tax Exempt - Check this box to indicate that your organization is Income Tax Exempt.

 

GST Registered - Check this box if your organization is GST registered.

 

Min. to Complete Form - Indicate how many minutes will print on the HSP Claim form as being needed to complete the HSP form.

 

Sell Accessories on HSP Claims - Check this box to have the option of selling accessories on HSP claims that are payable by the client.

 

Validate HSP Claim Has A Benefit Value - select this option to prevent any zero dollar HSP claims from being processed.

 

Enable Multiple Funding Sources - Check this box to allow other funders (other the HSP) as receivables on HSP Claims.

 

ENABLE HSP WIZARD - Check this box to enable the HSP Wizard which prompts the user to enter through an HSP Claim in a formatted and easy structure. There is additional configuration options located within the settings configuration symbol.

 

Steps to configure the HSP Wizard:

1) HSP WIZARD ACTIVITIES - Use the ADD icon to add each of the activities that a HSP Claim can include. (IE: Hearing Assessment, Fitting, Annual Review, Battery Maintenance, Other Claim Items or Manual Claims.) To edit an existing Activity, highlight the activity and click the CHANGE icon. To delete an existing activity, highlight the activity and click the DELETE icon.

 

2) Once an HSP ACTIVITY has been created, click into the CLAIM TYPES window. This is where the HSP ACTIVITY TYPES can be created. (IE: the Activity FITTING may need the ACTIVITY TYPES "INITIAL FITTING" and "SUBSEQUENT FITTING" and "REFITTING".) To edit an existing ACTIVITY TYPE, highlight that type and click the CHANGE item to make edits. To delete an ACTIVITY TYPE, highlight the item line and click the DELETE icon. To save your changes, click the CONTINUE icon.

 

3) Once the HSP ACTIVITY TYPES have been created, each HSP ACTIVITY TYPE can have it's own HSP ITEM NUMBERS associated to each by clicking in the ITEM NUMBERS window. Use the ADD icon to add each HSP ITEM NUMBER associated to this ACTIVITY TYPE. A note about the HSP ITEM and how it can be applied for the user can be configured here as well. To edit an existing HSP ITEM NUMBER, highlight that number and click the CHANGE item to make edits. To delete an HSP ITEM NUMBER from an ACTIVITY TYPE, highlight the item line and click the DELETE icon. To save your changes, click the CONTINUE icon.

 

When finished all Wizard configuration, the sorting order (which is the presentation order the user will see when using the HSP WIZARD tool) can be designed via the SORT icon at the top of the screen.

 

To save your WIZARD ACTIVITIES click the SAVE icon and to return to the previous screen click the EXIT icon.

 

(Note: to enable the HSP WIZARD at the user level, permissions to the WIZARD must be granted within CONFIGURE SYSTEM SETTINGS > SYSTEM > Security Roles. When a user has permissions to use the HSP Wizard they will be presented the opportunity to utilize the Wizard when entering an HSP Claim.)

 

 

Enable HSP Quoting - Check this box to enable HSP Claim Quotes.  Claims designated as a Quote will not be included in the E-Claim export to HSP, nor will it be included in any Daily Close process (unless there is a deposit on the Quote.) *NOTE if you have date range controls turned on and edit an HSP Quote from a closed date period, then the CLAIM DATE will immediately change to today's date. If you have additional HSP CLAIM POSTING DATE functionality turned on (ask Auditdata Support if you are unsure if you have this functionality turned on) then the POSTING DATE will not be editable.  Thus you will need to create a new HSP Quote. HSP Claim Quotations also have the ability to record DEPOSITS taken if the company parameter has been turned on. To inquire about turning on the HSP DEPOSIT functionality, please contact Auditdata (Client Services Department).

 

HSP Quote Default - Check this box to default new HSP Claims are to be flagged as Quotes.

 

Generate B&M Claims as Quotes - Check this box to default that all B&M Claims generated via HSP CLAIM GENERATION are created as Quotes.  B&M Claims generated as a Quote will not be included in the E-Claim export to HSP or included in any Daily Close process.  Users will have to later edit them and mark them as READY in order to be included in the E-Claim export to HSP.

 

 

HS Card Information:

 

 

Two Types of HS Card plans are available.

 

HS CARD - Enter the applicable HS Card cost and the GST amount; the total will auto-calculate. If the price for the HS Card will change in the future, enter the new cost effective date, cost and GST.  The totals will auto-calculate based on the date of the Claim.

 

HS CARD (Top Up) - Enter the applicable HS Card Cost for Top Up plans, as well as the GST amount.  The total will auto-calculate. If the price for the HS Card for Top Up plans will change in the future, enter the new cost effective date, cost and GST.  The totals will auto-calculate based on the date of the Claim if the patient has been flagged as TOP UP as their Maintenance Plan.