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HEALTHPOINT USER GUIDE. - Commonwealth Bank of Australia

1. CONTENTS ipi Mm Getting Started with HealthPoint 1 1 Introduction 1 2 Everyday Procedures 1 8 HealthPoint Maintenance Contact Details 2 1 HealthPoint Helpdesk Contacts 2 2 Merchant Enquiries 2 3 Health Fund Contacts Introducing the HealthPoint terminal 3 1 The HealthPoint Screen 3 2 The Idle Screen Symbols Some Tips from the Health Funds HealthPoint Admin Menu Map Quick Reference Guide 71 Obtaining a HealthClaim Rebate Estimate 7 2 Creating a Health Claim against a Health Fund 7 3 Cancelling a Health Claim 7 4 Printing a HealthClaims Reconciliation Report 7 5 Printing a HealthClaims Activity Report 7 6 Changing the Provider List 7 7 Changing the Item List Detailed User Guide 8 1 Obtaining a HealthClaim Rebate Estimate 8 1 1 Overview 8 1 2 Step by Step Guide 8 2 Creating a HealthPoint Claim against a Health Fund 8 2 1 Overview 8 2 2 Step by Step Guide 8 2 3 Claim Receipt Example 8 3 Cancelling a HealthPoint Claim 8 3 1 Overview 8 3 2 Step by Step Guide 8 3 3 Cancellation Receipt Example 8 4 Reporting 8 4 1 Overview 8 4 2 HealthClaims Shift Total Report c C101 0 5 Gd 2 O3 G3 52 G NYa Aa ab Sb ek 2 Ss Eo h o o N N X Oo n 0 CO O O O c dq EE lt 0c 5 OON l Oe 8 4 3 HealthClaims Reconciliation Report 8 4 4 HealthClaims Activity Reports 8 4 5 Printing Reports Step by Step Guide 8 5 Practice Activity Reconciliation 8
2. ITEM CODE COMPREHE ORAL EXAMI 1 DATE 21 10 2014 2 FEE 50 00 3 TOOTH NUMBER SELECTION PATIENT 1 111 COMPREHE ORAL E 22 HealthPoint User Guide Step D 3 Add Edit items for the current patient a If nothing further is required Press OK to make the claim Go to Step E b If items need to be added edited Choose the relevant option below i To add another item Select ADD Go to Step D 1 ii TO edit an item navigate to the item using the arrow keys and select the number key corresponding to the item Go to Step D 6 remove an item from your list Go to Step D 7 check your current list of items navigate up and down using the arrow keys When finished return to Step D 3 Step D 4 If the Item is not found in your list TEM NOT FOUND HealthPoint displays the ITEM NOT FOUND TY screen ADD ITEM a To add an ad hoc item to this claim but not your regular list of items Select ADHOC Go to Step D 5 b To add an item both to this claim and your regular list of items Press FUNC then Select YES Go to Step D 5 FUNE Eug Ine More Options All changes made to this item will be saved in your standard list To return to the KEY SERVICE screen without adding the item Select NO Return to D1 b1 Step D 5 Add New Service Item to Claim a To add the item as is Press OK b To make a copy of current item Select COPY X I HealthP
3. Q9 HealthPoint User Guide 11 9 SOME TIPS FROM THE HEALTH FUNDS To help you avoid some common mistakes with electronic claiming the health funds have provided the following tips Every time you swipe a patient s card and submit a HealthClaim HealthPoint connects to the relevant health fund and makes a real live claim for your patient If a patient disputes the amount of a rebate cancel the claim and advise them to make a manual claim with the health fund Cancellations must be made on the same day of service Whenever possible make one claim for the whole consultation including all the items covered Separate claims for each individual item may mean your patient receives a reduced benefit If a patient is receiving a course of treatment make claims on a consultation by consultation basis rather than one large claim at the end of the course If you are unsure about which service item codes apply for a particular type of service find them at csc com healthpoint or consult your professional association You must not make a claim for a service or appliance you have not supplied For example you cannot claim for a pair of glasses until the patient has actually received the glasses even if you bill the patient in advance You must not make claims for deposits taken when ordering appliances e g dental crowns glasses then claim for the remainder when the appliance is supplied Make only one claim for each applia
4. Services Charge Bere Fit Gap Coe Provider ME 5 DOROVAM Type OSTEOPATHY Fund HOSPITAL CONTRIBUTIONS FUND AUST LTD Each health fund is listed for each provider OOS 1 180 00 390 00 00 Fund Total 40 00 130 00 50 00 Fund HIE HEALTH FUND LIHITED 80 00 52 00 28 09 00 One line for each claim Fur Total 00 60 152 0 28 00 3 Tatal 60 00 482 00 78 00 One line for each void or cancellation Provider HE KATHLEEN TAYLOR Type Mapa Fund AUSTRALIAN UHITY HEALTH LTD 0001117 1 80 00 425 00 55 00 00 Furci Total 900 00 825 00 155 00 Total for this fund for this provider for this day Total jan di 125 00 155 00 Provider SOWA BLANCO Type REED MecoaGe Fund HEDIBAHK PRIVATE LID 0001118 1110 00 ir10 0 12 Fund Total 110 00 ing ud Toten H10 00 0 00 10 00 Total for all claims for this provider for this day TOTAL FEES 350 00 BOOT LER 241 00 TOTAL S107 00 Bummary of Claims Humber Amount Accepted by Fund 3 5107 00 Rejected by Fund i 0 00 These reconciliation totals should match those Total Submitted shown on the activity report for this day 40 HealthPoint User Guide 8 44 HealthClaims Activity Reports The HealthClaims Activity Report shows totals for the claims voids rejections and cancellations made during a particular day The report is created by the CSC HealthPoint systems at the end of each worki
5. or Fax 1800 500 874 Email HealthPointSupport csc com Web www csc com healthpoint 1 June 2014 To Account Owner Example Optical Account 023 456 12345678 210 First St Name Example Optical Centre Example NSW 2000 Period May 2014 Total Payments 1 580 00 Private and Confidential Statements of payments made by CSC on behalf of Private Health Funds Receipt Charge Benefit Gap Code Total Payment Payment Date 2014 05 26 Reference IBA052600041 Payment made 1 580 00 Location 210 First St Example Terminal OPT05550 Provider 1234561B One Provider Health Fund A 0000345 400 00 400 00 400 00 0000346 100 00 80 99 100 00 Fund Total 500 00 480 99 500 00 Health Fund B 0000347 220 00 200 00 20 00 200 00 0000349 800 00 400 00 400 00 400 00 Fund Total 1020 00 600 00 420 00 600 00 Provider 21474741L Two Provider Health Fund A 0000348 100 00 80 00 00 Fund Total 100 00 80 00 Health Fund B 0000350 180 00 100 00 80 00 00 100 00 100 00 0000351 800 00 300 00 500 00 00 300 00 300 00 Fund Total 980 00 400 00 580 00 400 00 400 00 End of Report Figure 2 CSC Claim Settlement Solution CSS Payment Statement Example Optical 210 First Street Example Sample Bank Statement NSW 2000 ConmonwealthBank gt TRANSACTION DETAILS BSB 023 456 Issue date O1 June 2009 Account Number 12345678 Date Description Debits Credits Balance Balance brought forward 31 000 11 6 May 2014 Taxi fare 20106 30 980 02 6
6. Go to D6 a else Go to D6 g e Option 4 To adjust the tooth mam number dentists only press the TOOTH NUMBER number key next to TOOTH 300 INITIAL CONSULT NUMBER i HealthPoint displays the TOOTH NUMBER screen li Enter the two digit ADA Australian Dental Association standard tooth number and then press OK iii To continue adjusting the item Go to D6 a else Go to D6 9 t The only exception is if you are modifying an item after choosing to add it to the standard list Refer to DA b HealthPoint User Guide 25 f Option 5 To adjust the body part Physiotherapists only press the number key next to BODY PART I HealthPoint displays the BODY BODY PART 500 INITIAL CONSULT PART screen li Enter the body part for this item and then press OK iii To continue adjusting the item Go to D6 a else Go to D6 g g Add Adjusted Item i Choose an Option below 1 Option 1 To add the updated item to your claim press ENTER 2 Option 2 To discard the changes made press DISCARD ii HealthPoint returns to the item list screen for the current patient Go to Step D 3 Step D 7 Remove Service Item from Claim a Find the Service item you want to remove by using the arrow keys b Press the number next to the Service Item HealthPoint displays the Item Summary screen c Select DISCARD d The Item is removed from the screen HealthPoint returns to the item list screen for the
7. a Choose the Details to be Updated i Press 1 to UPDATE ALL details li Press 2 to update PRACTICE DETAILS iii Press 3 to update HEALTH FUNDS details iv Press 4 to update PROVIDER DETAILS v Press 5 to update SERVICE ITEMS b HealthPoint will print out any applied changes If there are no updates HealthPoint will print No New Updates on the print out 5 HealthPoint will prompt you to confirm that the updates are correct Select YES DONE V You have successfully updated the Providers on your HealthPoint Terminal 7 7 Changing the Item List Start from the Idle screen with the terminal on the base Press XPOS Press 1 for HEALTHPOINT Press 9 for HEALTHPOINT ADMIN Press 1 for SERVICE ITEMS Select the SERVICE TYPE you want to modify by pressing the corresponding number key arFPwonr n gt oO Note The terminal will show the Modalities configured on your terminal 18 HealthPoint User Guide 6 Perform one or more of the following items a To add an item Select FIND enter the new item code then press OK then select YES edit the item details 1 name and 2 fee press OK b To edit an item already on the list select item select EDIT enter the details press OK Todelete an item select item press FUNC then select DELETE and then press OK Confirm the changes made by pressing OK HealthPoint displays the SERVICE ITEMS SUCCESSFULLY UPDATED screen To return to the HE
8. payments made by participating health funds using the Claim settlement system Once you receive this you will be able to reconcile your activity in 3 easy steps Just follow the simple instructions below to find out how HealthPoint User Guide 53 9 2 How to Reconcile your Accounts Easy as 1 2 3 Step 1 Print your HealthClaims Reconciliation Report For step by step instructions refer to Section 8 3 5 Printing Reports Step by Step Guide Step2 Cross check the individual health fund amounts from the HealthClaims Reconciliation Report Figure 1 to CSC Claim Settlement Solution payment statement Figure 2 NB To do this you will need reconciliation figure 1 to 4 and as a summary check reconciliation 5 Check that Reconciliation amounts 1 2 and 4 are reported on the CSC HealthPoint Payment Statement This can be found with the Payment date as the business day following the claim date Check the total for payment amount is equal to the total reconciliation for the practice Remember this may span reconciliation reports printed from multiple terminals depending on your site s requirements Step 3 Cross check CSC HealthPoint consolidated payment statement total against amount on bank statement Figure 3 credited by CSC HealthPoint 5 d 54 HealthPoint User Guide HealthClaims Reconciliation Report Date of Claims 25 5 2014 Customer Id OPTO5550 EXAMPLE OPTICAL 210 FIRST STREET 12345678 Claims by
9. the other Shift Total reports that were printed during the day in order to reconcile the day s activities 8 5 2 Next Future Day Reconciliation The Reconciliation Report and Activity Report are generated at the end of each day and are stored on HealthPoint systems These allow a practice to reconcile with banking statements and previous day s activities Next Day Reconciliation If your practice reconciles a previous day s activities the day after then you can use both the Activity and Reconciliation report Print a copy of the Activity and Reconciliation Reports entering the previous day s date as the report date See 8 4 5 These reports can be reconciled with your previous day s activities If you printed out Shift Reports for Same Day Reconciliation the total of these Shift Reports should match both the Activity and Reconciliation reports Reconciliation at a future date If your practice reconciles activities at a point in the future then you can use both the Activity and Reconciliation report Print a copy of the Activity and or Reconciliation report entering the date of the day you wish to reconcile To reconcile with your CSS Statement see Section 9 Reconciliation Guide 44 HealthPoint User Guide 8 6 1 Overview This procedure describes how you can maintain the list of items stored on your HealthPoint terminal You will be able to add edit and delete items in your list This includes adding new services
10. with the question Did the Receipt print correctly a If a reprint is required Select NO REPRINT Return to Step b If the Print was not successful but a reprint is not required Press FUNC then select NO SKIP c If the Print was successful Select YES DONE 7223 You have successfully printed the HealthClaims Report HealthPoint User Guide 43 8 5 Practice Activity Reconciliation This section describes how a practice can reconcile the health fund transactions that were executed on a given day with the activity they have undertaken For reconciliation with banking statements please see Section 9 Reconciliation Guide 8 5 Same Day Reconciliation The purpose of same day reconciliation is to allow a practice to balance their books and check which transactions were approved rejected or voided over the course of the day In order to execute Same Day reconciliation on HealthPoint the Shift Total report will need to be used See 8 4 5 One Shift per Day If your practice does not use the Shift Total report during the course of the working day print a Shift Total report at the end of the day to use for your reconciliation purposes Multiple Shifts per Day If your practice prints Shift Total reports during the course of the working day these will need to be kept aside until you reconcile at the end of the day When it is time for you to reconcile print a Shift Total report Take this report along with
11. 10pm AEST for eligible customers with a CommBank business transaction account and a linked CommBank merchant facility 11 6 Terminal FAQs Please refer to the EFTPOS Quick Reference Guide Additional documents and guides are available to download from commbank com au business merchant services 11 7 Health Fund FAQs What funds can I do a quote on The HealthPoint system is built so that you have the ability to reject every claim that is processed with every Health Fund In contrast HICAPS requires a separate process to be undertaken for a limited number of Health Funds which allow quoting 60 HealthPoint User Guide Can you cancel or reverse a claim Yes you can cancel a claim on the same day it has been submitted to the fund provided the patient is present and has their Health Fund card If you need to cancel a claim on a later day you should call the Health Fund in question 11 8 HealthPoint Application FAQs What forms are required for HealthPoint In addition to the normal CommBank Merchant documentation a practice is required to complete a HealthPoint application for each terminal requested at each site This application should include details of ALL providers wishing to use the terminal together with their provider number letter and the bank account details for settlement amounts Why do you need my Provider number We use this to register you with each of the participating Health Funds Each Provider s number is requ
12. 133 282 133 282 Defence Health 1800 335 425 1800 335 425 Frank Health Insurance see GMHBA GMF 1300 653 099 1300 653 099 GMHBA 1300 136 652 1300 136 652 HBF 20 402 133 423 131 334 02 9290 0163 health com au 1300 199 802 1300 199 802 HIF 1300 134 060 1300 134 060 Latrobe Health Services 1300 362 144 1300 362 144 Medibank 132 331 1300 654 887 Navy Health 1300 306 289 1300 306 289 nib 131 642 131 642 Onemedifund 1800 804 950 1800 804 950 Peoplecare 1800 808 690 02 4224 4333 Police Health 1800 603 603 1800 603 603 Queensland Country Health 1800 813 415 07 4750 3200 RACT Health Insurance see GMHBA rt health 1300 886 123 1300 886 123 Teachers Health 1800 727 888 1800 727 536 TUH Teachers Union Health 1300 360 701 1300 360 701 Uni Health Insurance 1300 367 906 1300 367 906 WESTFUND 1300 552 132 1300 552 132 8 HealthPoint User Guide 3 INTRODUCING THE HEALTHPOINT TERMINAL The HealthPoint terminal is an easy to use terminal with just 20 keys Some of the keys have special functions Printer built into the Terminal XPOS Button provides access to HealthPoint Menus Cancel OK Enter Yes Clear No The terminal must on the base when initiating and submitting a HealthPoint claim HealthPoint User Guide 9 3 1 The HealthPoint Screen Most HealthPoint screens have the following features CSC Title Most screens have a unique title Screen titles hi
13. May 2014 Office Supplies SYD 500 00 50 680 02 12 2014 Payroll EOPT 1 000 00 29 680 02 19 May 2014 Trans ref123456 5 191 65 34 871 67 20 May 2014 Trans ref678901 20 00 506 66 355 378 333 21 May 2014 Supplies OrderX090896 20 00 3555955 26 May 2014 CSCO52600041 1 580 00 6 938 33 Closing Balance 36 938 33 Figure 3 Example Bank Statement 56 HealthPoint User Guide 10 TRAINING MODE 10 1 Training Mode Overview Your HealthPoint terminal can be used to provide training for new and existing staff by activating training mode and using your HealthPoint test card By default training mode is disabled OFF Once you are in training mode your staff can follow the procedures in this user guide to teach refresh themselves on various transactions This is particularly useful for staff members who are new to the practice When Training Mode is enabled Dummy data is used for transactions and reports No data is being exchanged is not enabled Only CASH is enabled as a payment option t will only pretend to connect to the touch host Please note Training Mode is designed to support the HealthPoint transaction only When Training Mode is there is no indication on the usual HealthPoint transaction screens However all receipts will print with Training Mode on them HealthPoint User Guide 57 Training Mode Start from the Idle screen Step A Press XP
14. PAYEE DETAILS Step D Press 2 for reports HealthPoint displays REPORTS the reports screen 1 ACTIVITY REPORT 2 RECONCILIATION 3 SHIFT TOTAL 4 CURRENT SETTINGS Step E Choose the Report you want to Print a Press 1 for ACTIVITY REPORT Go to Step F b Press 2 for RECONCILIATION Go to Step G c Press 3 for SHIFT Reports Go to Step H 42 HealthPoint User Guide Step F Choose date for Activity Report ACTIVITY DATE a HealthPoint will prompt you for the PLEASE ENTER DATE ACTIVITY DATE for the report DOMMYYYY b Enter the date as one big number 14082014 in the format DDMMYYYY day month year with no spaces in between then press OK c HealthPoint retrieves and prints the report then displays the PRINT CONFIRMATION screen Step G Choose date for Reconciliation Report a HEALTHPOINT will prompt for RECONCILIATION DATE the Reconciliation date dips i PA PLEASE ENTER DATE DDMUIMYYYY b Enter the date as one big number in the format DDMMY Y Y Y day month year with no spaces in 14082014 between then press OK c HealthPoint retrieves and prints the report then displays the PRINT CONFIRMATION screen DID THE RECEIPT PRINT CORRECTLY NO REPRINT Step H HealthPoint retrieves and prints the report HealthPoint will print all the activities from the beginning of the day or all activities since the last Shift Report was printed Step I The PRINT CONFIRMATION screen is displayed
15. PROCEED Note If the patient is no longer at your practice and you do not have their card you CANNOT cancel the claim The health funds only permit cancellation if you use the health fund s card in the presence of the patient on the same day that the claim was submitted Step E 1 If you have already swiped the patient s card to find the claim Go to Step F 34 HealthPoint User Guide Step E 2 If you have found the claim by entering the Claim ID HealthPoint displays the CANCEL FUND CLAIM screen a Swipe the patient s card CLAIM CANCELLED ENTER TO CONTINUE b HealthPoint attempts to make a connection to the HealthPoint systems If successful go to Step F d If an error occurs during the claim submission HealthPoint displays the HEALTH FUND failed submission screen For example d1 Answer the question by pressing CLAIM FAILED BUE TO the blue FUNCTION key for the slide RECEIVE ERROR out menu HostMar Dial 3 18 d2 If you select RETRY ESL Eey ko HealthPoint tries again to cancel the claim d3 If you select DISCARD HealthPoint discards the attempt to cancel the claim and then returns to REVIEW CLAIM screen Step F HealthPoint processes the cancellation and prints a copy of the Cancellation receipt The receipt shows the health fund s responses to the cancellation A response of 00 means the cancellation has been accepted and approved Note Explanations of the o
16. Provider Provider Name Type Re Services Charge Benefit ceipt HEALTHFUND A PROVIDER ONE OPTICAL 000345 5 800 00 400 00 400 00 PROVIDER ONE OPTICAL 000346 1 180 99 100 80 99 r Fund Total 980 99 406 95 1 Total for Provider One Fund A HEALTHFUND B 4 i PROVIDER ONE OPTICAL 000347 Total reconciled 500 00 1 220 00 200 00 PROVIDER ONE OPTICAL 000349 Find Total 50000 4202 9020 2 Total for Provider One Fund B roviaer lota B D E H Total reconciled 600 00 PROVIDER TWO OPTICAL 1 100 00 80 i Fund Tota 100 00 l 526 66 3 Total for Provider Two Fund A PROVIDERTWO OPTICAL 000350 Total reconciled 80 00 180 00 100 00 PROVIDER TWO OPTICAL 000351 1 800 00 500 00 Fund Total 980 00 l 86 08 4 Total for Provider Two Fund B Provider Total 1080 00 600 00 Total reconciled 400 00 GRAND TOTAL FEES 3080 99 1500 99 i GRAND TOTAL OF REBATE EXPECTED 1580 00 CLAIM ACTIVITY NUMBER TOTAL Claims Submitted e Accepted by Fund 5 Total for Practice N Rejected by Fund L i E m Total reconciled 1580 00 Claims Voided NIL Claims Cancelled 0 NIL Check against the Activity Report END OF REPORT Figure 1 HealthClaims Reconciliation Report HealthPoint User Guide 55 PO Box 148 North Ryde NSW 1670 26 Talavera Rd Macquarie Park NSW 2113 For information on payment transactions Call 1300 301 692 Select 1 for Support and then 2 Electronic Claiming
17. Step J 1 If the receipt is correct select YES DONE Give the receipt to the patient DID THE RECEIPT PRINT HealthPoint returns to the Idle screen CORRECTLY 722 You have finished creating a HealthPoint claim Step J 2 If the receipt did not print correctly select NO REPRINT Return to Step J Step J 3 If the receipt did not print correctly and it is not required Press FUNC then Select NO SKIP HealthPoint returns to the Idle screen 72 You have finished creating a HealthPoint Claim 8 2 3 Claim Receipt Example Your CBA ID and Claim Reference Number Claim Response Gap HealthPoint CBA Touch ipi 8150056261 5 Tolonro fd Moog ie Pork 064 2113 Telephone 928035572 Customer 009300 Claim Recpt No CBA 9905 0000256 Date Processed 16 04 2015 09 47 This receipt ocknowledges on electronic cloin accepted by the above Health Fund through 151 HeolthCiaias Membership No 0000000000 Card No 90360095000012300 1 Provider MR OLIVER WESTMAN Provider Ho SHOH Tye of Services DENTAL Services Claimed Then Descr iption Setit Patient ID 00 16 04 2015 FAL DX 150 00 31 00 00 2 PERL OR 16 33 00 CLAIM TOTAL 216 33 157 33 00 GAP TOTAL 59 00 Assessment Codes 0 APPROVED 00 APPROVED Declaration by Member I declare thot the services shan on this hove been provided are rorcopersdile od net all Furd rules I author
18. is labelled ABC To enter A press 2 once to enter B press 2 twice and to enter C press 2 three times Step A 2 Option 2 edit the fee press 2 SERVICE FEE a HealthPoint displays the SERVICE SERVICE NUM 110 FEE screen b Enter the fee for the service then 0 00 press OK HealthPoint allows you to edit this fee as you process the claim For example some practices offer concession rates for some patients You would have to edit the fee when creating the claim c Select OK to save the changes you have just made HealthPoint returns to the SERVICE ITEMS screen You have edited the item details To continue editing go to Step F else to finalise your changes go to Step G 48 HealthPoint User Guide 8 7 Practice Maintenance 8 7 1 Overview Practice Maintenance describes the process by which you are able to update your practice details on your HealthPoint terminal Details which can be updated include Provider List Including their banking details e Practice Contact Details 8 72 Practice Maintenance Process In order to reflect Changes made to your practice on your HealthPoint terminal such as changing the Provider List or Changing Practice contact details the Provider form needs to be submitted to CSC HealthPoint The submitted form is processed by CSC HealthPoint and the system will be updated Once the Updates are made they will be made available for downl
19. or adjusting the fees on existing items Optometrists This procedure can be used to edit your ancillary item codes To edit your MBS item codes for Medicare claiming please refer to the MediClear Quick Reference Guide 8 6 2 List Maintenance Step by Step Guide Start from the Idle screen with the terminal on the base IDLE SCREEN Step A Select XPOS HealthPoint displays the XPOS menu HEALTHPOINT 2 MEDCLEAR 9 ADMIN Step B Press 1 for HEALTHPOINT HealthPoint displays the HEALTHPOINT screen Step C Press 9 for HEALTHPOINT ADMIN HealthPoint displays the HEALTHPOINT ADMIN HEALTHPOINT ADMIN 1 SERVICE ITEMS Screen 2 REPORTS 3 UPDATE CONFIG 4 PAYEE DETAILS Step D Press 1 for SERVICE ITEMS For example HealthPoint displays the SERVICE TYPE screen This list of service types will depend on the 1 OPTICAL service types modalities you have activated on I DENTAL your terminal 3 OCC THERAPY A PHYSIOTHERAPY HealthPoint User Guide 45 Step E Select the service type For Example a Select the service type you want to OPTICAL modify by pressing a number key 1110 SPECTACLE FRAMES b HealthPoint will retrieve a list of 2 120 REPL REPAIR FRAME items known to the terminal 3 211 SV STOCK LENS 1 TID TET nts END Step F Perform one or more of the following actions ACTION 1 View more items OPTICAL a Option 1 Use the
20. private health funds Other HealthPoint features supported on this device are EFTPOS and Medicare Easyclaim To help you find your way through this guide you may like to use the following lists of topics For an introduction to HealthPoint and HealthClaims read 1 The HealthPoint keypad starting on page 8 2 Some tips from the health funds page 11 3 he Quick Reference Section starting on page 13 1 2 Everyday Procedures For the details of the everyday procedures covered in HealthPoint training see the following sections 1 The Quick Reference Section starting on page 13 is a useful summary of procedures or daily use Creating a Health Claim and submitting it starting on page 19 Cancelling a Health Claim starting on page 35 HealthClaims reporting starting on page 36 HealthPoint training also covers the following maintenance procedures Maintenance editing the standard list of items codes etc starting on page 43 Practice Maintenance updating practice and provider details starting on page 47 6 HealthPoint User Guide 2 CONTACT DETAILS CSC HealthPoint Website csc com healthpoint the CSC HealthPoint website contains a variety of information including Item Codes Health Fund by Modality flyers User Guides CSC HealthPoint Helpdesk For reporting of HealthPoint faults instructions on how to process HealthPoint transactions and adding or deleting providers call 1300 301 692 Avai
21. screen see more screens of providers by pressing the white arrow keys b If the provider is not available on the terminal you will need to update your practice details See Section 8 5 Practice Maintenance END Q HealthPoint User Guide 21 Step C 3 HealthPoint displays a list of services PROVIDER OF SERVICES applicable to the provider selected 6 EN DENTI ST For example if you selected a provider who is 2 OSTEO PROV Dentist the services displayed might look like 3 OPTICAL PROV this Step D Add up to 16 service items to the health claim Step D 1 Find a Service Item D1 a Option 1 Navigate through the list using the white arrow keys to find the service item When the item is displayed on the screen press the corresponding number key to select it Go to Step D 2 D1 b Option 2 Search for the item by selecting FIND 1 HealthPoint displays the KEY SERVICE screen 2 Enter the Item Code and Press OK 3 If the item is not found go to Step D 4 4 If the item is found HealthPoint displays the selected ITEM SUMMARY Screen Choose an option i add the service item as is Go to Step D 2 ii To adjust the service item Go to Step D 6 Adjust Service Items Step D 2 Add Service Item D2 a Press OK to add the item to the claim D2 b HealthPoint displays the SELECTION PATIENT screen This screen shows the items you have added to the claim for the current patient KEY SERVICE
22. service to be delivered at a 2 Press 2 for Yesterday future date 1 Press 1 for Today 3 Press 3 for another day then enter the date as one big number in the format DDMMYYYY day month year with no spaces in between then press OK iii TO continue adjusting the item Return to D6 a else go to D6 g 24 HealthPoint User Guide c Option 2 To adjust the fee for this SERVICE FEE service press the number key next 11 COMPREHE ORAL FEE n EXAM I HealthPoint displays the 0 00 SERVICE FEE screen li HealthPoint displays the fee stored in the item list Enter the correct fee by typing over the fee Note The fee entered must displayed and then press OK always be equal to the amount actually charged to the patient iii continue adjusting the item including discounted amounts Go to D6 a else go to D6 g Adjusting the fee will only modify the fee for the current transaction d Option 3 To adjust the description SERVICE DESCRIPTION press the number key next to M DESCRIPTION SERVICE NUM 110 I HealthPoint displays the co SERVICE DESCRIPTION screen SPEC ii Enter the Item s name and then press OK Press the key labelled with the letter one or more times according to the letter s position For example the 2 key is labelled ABC To enter press 2 once to enter B press 2 twice and to enter C press 2 three times iii To continue adjusting the item
23. the rebate did not cover the fees for the services rendered HealthPoint displays the METHOD OF PAYMENT screen Select the payment method METHOD OF PAYMENT 11 1 To allow the patient to pay by HOW DOES THE PATIENT EFTPOS select EFTPOS and WANT TO PAY THE GAP process the EFTPOS transaction 20 00 according to the Quick IWL 255 Merchant Operator Guide If your terminal is Multi Merchant you will be required to select the Merchant for payment Go to Step J 1 2 To allow the patient to pay by cash select CASH Go to Step J 11 a3 To allow the patient to pay by invoice Press FUNC then select INVOICE HealthPoint will print accounts Go to Step J Ed The receipt prints out the remaining gap The practice will need to decide how they wish to process this remaining gap Step 2 Option 2 If there are monies owing to the Patient For example if the patient has overpaid HealthPoint displays the METHOD OF PAYMENT screen 2 Select the payment method 12 a1 To refund the patient to via EFTPOS select EFTPOS and process the EFTPOS transaction according to the Quick IWL255 Merchant Operator Guide If your terminal is Multi Merchant you will be required to select the Merchant for payment Go to Step J 12 a2 To refund cash to the patient select CASH Go to Step J Step J HealthPoint will print the relevant receipts then ask if the receipt is printed correctly 30 HealthPoint User Guide
24. 0 HealthPoint User Guide 8 2 2 Step by Step Guide Start from the Idle screen with the terminal on the base Step A Swipe the patient s health fund card IDLE SCREEN Step A 1 If the swipe is successful and HealthPoint displays the PATIENT REF NO Screen proceed to Step B PATIENT REF NO Step A 2 If the card won t swipe you cannot proceed with the claim Please inform your patient that you are unable to process a Health Claim on their behalf as their card is not registering END Q Step B Enter the patient reference number on their health fund card to the left of their name then press OK Note You do not have to enter a leading zero For example if the patient is numbered O1 on the card just enter 1 into HealthPoint If the patient reference number is not shown on the card e g some older Medibank Private cards derive it from the patient s position in the list of patients on the card Start with patient 1 at the top of the list Count down the first column and then down the second column until you reach the patient you are referring to Step BA If this is the first patient go to Step C Step B 2 If this is a subsequent patient go to Step D Step C Select the servicing provider Step C 1 HealthPoint displays the PROVIDER OF SERVICE screen Step C 2 Select the servicing provider from the list by pressing the corresponding number key a If the provider is not on the first
25. 0 301 692 to report HealthPoint faults for instructions on how to process HealthPoint claims and to add delete providers You can also email us at HealthPoint csc com or mail to CSC HealthPoint PO Box 148 North Ryde NSW 1670 Health Funds Visit csc com healthpoint for the contact details of each health fund to raise specific enquiries relating to claim assessment statements and private health fund claims Commonwealth Bank Merchant Enquiries 24 hours a day 7 days a week Call Freecall 1800 230 177 for general merchant enquiries and EFTPOS hardware difficulties CBA4089 270315
26. 5 1 Same Day Reconciliation 8 5 2 Next Future Day Reconciliation 8 6 Item Maintenance 8 6 1 Overview 8 6 2 List Maintenance Step by Step Guide 8 6 3 Editing Item Details Sub Process Step by Step Guide 8 Practice Maintenance 8 7 1 Overview 8 7 2 Practice Maintenance Process 8 7 3 Practice Maintenance Step by Step Guide 8 8 Provider Merchant Association 8 8 1 Overview 8 8 2 Step by Step Guide Reconciliation Guide 9 1 Claims Settlement Solution CSS 9 2 How to Reconcile your Accounts Easy as 1 2 3 10 Training Mode 11 101 Training Mode Overview 10 2 Activating and Deactivating Training Mode Frequently Asked Questions 11 1 HealthPoint Claims FAQs 11 2 HealthPoint Reconciliation FAQs 11 8 HealthPoint Reporting FAQs 11 4 HealthPoint Transaction FAQs 11 5 HealthPoint Cost amp Payments FAQs 11 6 Terminal FAQs 11 7 Health Fund FAQs 11 8 HealthPoint Application FAQs 11 9 HealthPoint Setup FAQs 12 Appendix A Health Fund Responses 12 1 Claim Responses 12 2 Item Responses 12 3 Cancellation or Rejection Void Responses 39 40 41 43 43 43 44 44 44 47 48 48 48 48 50 50 50 52 52 53 56 56 5f 58 58 58 58 59 59 S 99 60 60 61 61 63 67 HealthPoint User Guide 5 1 GETTING STARTED WITH HEALTHPOINT Welcome to HealthPoint the complete health payments processing system This user guide covers HealthClaims functionality for making ancillary claims against
27. ALTHPOINT ADMIN screen Press OK V You have successfully changed your item list HealthPoint User Guide 19 8 DETAILED USER GUIDE 8 1 1 Overview Use this procedure to obtain a HealthClaim Rebate Estimate for your patient Note The patient must have a valid health fund card and be present at the time of transaction For a brief summary of this procedure see Quick Reference Section 7 1 Obtaining a Hebate Estimate on HealthPoint 8 1 2 Step by Step Guide Follow Step A up to Step G in Section 8 2 2 for Creating a HealthPoint Claim against a Health Fund Once you have advised the patient of the Rebate Estimate select REJECT then DISCARD to finish the process J You have obtained a Rebate Estimate A Claim has not been processed To submit a claim after the service is provided AF follow all the steps in Section 8 2 8 2 Creating a HealthPoint Claim against a Health Fund 8 21 Overview Use this procedure to create a Health Claim and submit it to a fund on behalf of your patient On conclusion a HealthClaims Receipt is printed for both your practice records and your patient The HealthClaims Receipt is a paper record of the claim sent to the health fund via HealthPoint Note The patient must have a valid health fund card and be present at the time of claim For a brief summary of this procedure see Quick Reference Guide 7 2 Creating a HealthPoint Claim against a Health Fund 2
28. HealthPoint displays the PROVIDER OF SERVICES screen Step E Press the corresponding number for the Service Provider you wish to link to a Merchant HealthPoint displays the SERVICE PROVIDER screen This is the list of merchants Step F Press the corresponding number of the Merchant who will receive the selected Service Provider s rebates To unlink a Service Provider to a Merchant Press 1 for N A Step G HealthPoint displays the PROVIDER OF SERVICES screen Press OK to confirm changes HealthPoint User Guide 51 KEY Provider Details H ea Ith Pol nt Linked Merchant Details Practice Details CBA Touch ABN 8192449628 26 Talavera Rd Macquarie Park NSW 2113 Telephone 0280356721 Customer 10 8499309 List of Providers Provider None Provider No Benefits Recipient Merchant ID EFTPOS MR OLIVER WESTMAN 9364280 DENTAL This provider has been linked to a merchant TIOGA WR LUCY LU 225687KF PHYSIOTHERAPY This provider is not linked to a merchant END OF REPORT Step H HealthPoint will send the information to the server and a receipt will print out the Provider Merchant associations Step I The PRINT CONFIRMATION screen is displayed with the question Did the Receipt print correctly a If a reprint is required Select NO REPRINT b If the Print was successful Select YES DONE If the association is incorrect repeat the process If errors pe
29. INED The health fund has not approved the transaction It has not given a specific reason Call the relevant health fund for information on what to do next 14 CARD NO IS NOT VALID The health fund does not recognise the card you swiped Discard the claim re enter the claim and re submit it If you get this message again advise the patient to contact their fund and arrange for a new card 19 NO ITEMS ENTERED No service items were entered for this claim HealthPoint should have trapped this error before submitting the claim so please report this to the CSC HealthPoint Help Desk immediately 21 CONTACT HELP DESK The system has taken no action for this claim Please contact the CSC HealthPoint Help Desk 30 SYSTEM DATA ERROR This is a serious error so please report it to the CSC HealthPoint Help Desk immediately 32 COMPLETED PARTIALLY Only part of the claim has been processed The action required will depend on which part of the claim has been processed Contact the CSC HealthPoint Help Desk for advice on how to proceed 40 MEMBERSHIP NOT COVERED The patient s fund membership does not cover the services provided Advise the patient to check their cover with their health fund 42 MEMBERSHIP CEASED SUSP The patient s fund membership has either ceased or been suspended Advise the patient to check with their health fund 51 MEMBERSHIP UNFINANCIAL The patient s health fund membership has not been p
30. OS HealthPoint displays the XPOS menu Step B Press 9 for Admin Step C Press 4 for training mode Step D Press 1 for training mode Step E Activate or Deactivate training mode TRAINING MODE 1 To Activate Training Mode Press 1 2 Deactivate Training Mode Press 2 The status of training mode is highlighted on the screen For example in the below screen shot training mode is OFF Step F HealthPoint displays the training mode screen Click CANCEL to return to the Idle screen 58 HealthPoint User Guide 11 FREQUENTLY ASKED QUESTIONS 111 HealthPoint Claims FAQs Can I claim Medibank Private Members bonuses through the terminal This functionality is not currently available on HealthPoint Our research has shown it is not a popular request by patients as they often prefer to save these bonuses to use if they require a hospital visit Can process DVA or Work Safe claims Vic DVA functionality is not currently available for either HICAPS or HealthPoint Work Safe Vic is not available with HealthPoint Which Health Funds can I claim with This depends on which modality the provider is HealthPoint has Health Fund flyers for each modality Please refer to these they can be found on the CSC website csc com healthpoint 11 2 HealthPoint Reconciliation FAQs How dol reconcile HealthPoint has a brochure to explain how to reconcile This is included in your Welcome Kit and ca
31. ach claim One line for each void Fund Total 150 00 13 75 36 25 Fund GMHBA LIMITED or cancellation 0003768 50 00 17 00 33 00 00 Fund Total 50 00 17 00 33 00 Total for this fund for this provider for this shift Total 150 00 32 75 117 25 TOTAL FEES 150 00 432 795 117 25 Total for all claims for this provider for this shift TOTAL REBATE 32 75 Summary of Claims Number Accepted by Fund 3 Rejected by Fund These totals should reconcile with the activity Total Submitted report for the day Touch Tan 10 000000404 HealthPoint User Guide 39 8 4 3 HealthClaims Reconciliation Report The HealthClaims Reconciliation report is HealthPoint s record of the claims sent through to each health fund during a particular day Each provider is shown in a separate section The Reconciliation report can be printed once for any given day and is available to be printed the following day Once you have printed today s reconciliation report you can no longer cancel claims on that report through HealthPoint CSC recommends that you print this report at close of business Reconciliation Report HealthPoint See TRAINING HODES Reconciliation Report CBA Touch 8192449661 26 Talavera Fd Mxgur ie Pork I 2113 Telephone 0260356721 Customer ID 843909 Date of Claims 01 12 2012 Date selected for the report Period Covered 00 00 23 59 Claims by Provider
32. ages and to ensure that you receive any CSC network bulletins or software change notifications 11 4 HealthPoint Transaction FAQs Can do a Health Fund transaction without the card No the card must be present and swiped The terminal will not allow the card details to be entered manually This is a requirement of the Health Funds Can I do a HealthPoint transaction with the terminal off the base No the terminal must be on the base when initiating and submitting a HealthPoint claim The base must have an active internet connection The terminal can be lifted off the base to process an EFTPOS transaction or gap payment 11 5 HealthPoint Cost 8 Payments FAQs How much does each Health fund transaction cost me Nothing The cost of the transaction is borne by the Health Fund When does the money from the Health Fund arrive in my account With CSS Health Funds for claims processed on Monday these funds will generally be credited on Tuesday to the bank account and available for use on Wednesday Health Funds not participating in CSS vary but generally pay the next business day For EFTPOS settlement refer to CommBank FAQs at commbank com au business merchant services With Everyday Settlement the EFTPOS and credit card sales your business makes are settled into your linked business transaction account on the same day every day even on weekends and public holidays Everyday Settlement is available on transactions made until
33. aid Advise the patient to check with their health fund 54 CARD HAS EXPIRED The patient s health fund card has expired You must have a valid card to claim via HealthPoint Advise the patient to contact their fund and arrange for a new card 56 INVALID MEMBERSHIP NO The health fund does not recognise the card you swiped Discard the claim re enter the claim and re submit it If you get this message again advise the patient to contact their fund and arrange for a new card 57 NO ANCILLARY COVER The patient does not have ancillary cover Advise the patient to check their cover with their health fund 58 TRANS NOT PERMITTED The system cannot process this transaction Please contact the CSC HealthPoint Help Desk 60 PROVIDER NOT KNOWN The health fund does not recognise this provider Check the provider number in HealthPoint s provider table is correct If it is call the CSC HealthPoint Help Desk and ask them to check the provider has been registered with the relevant health fund 61 BENEFIT LIMIT EXCEEDED The patient s benefit limit has been exceeded for the period specified in their policy Advise the patient to check their cover and the relevant limits with their health fund 69 NO BENEFIT PAYABLE No benefit is payable on this claim Advise the patient to check their cover with their health fund HealthPoint User Guide 63 91 SYSTEM BUSY TRY AGAIN The system cannot process your claim at th
34. arrow keys to 1110 SPECTACLE FRAMES navigate in the desired direction 2 120 REPL REPAIR FRAME b Option 2 Press FUNC then 3 211 5V STOCK LENS 1 Select DOWN ACTION 2 Edit an Item a Navigate to the item using the arrow keys b Select the item by pressing the corresponding number key Item is displayed on screen c Edit the item details as described in Section 8 4 3 Editing Item Details Sub Process Step by Step Guide ACTION 3 To add a new item a Press FIND HealthPoint displays FIND ITEMI the FIND ITEM screen KEY SERVICE b Enter the item code and then ITEM CODE press OK Select the appropriate outcome below C1 Outcome 1 Item is Not Found ITEM NOT FOUND If the new item is not on the list ADD ITEM HealthPoint displays the ITEM NOT FOUND screen ii add the item Press FUNC then Select YES HealthPoint displays the EDIT SERVICE Screen iii Edit the item details as described in Section 8 4 3 Editing Item Details Sub Process Step by Step Guide 46 HealthPoint User Guide c2 Outcome 2 Item is Found i HealthPoint displays the THIS ITEM ALREADY EXISTS screen It tells PRESS ENTER TO CONTINUE li Press OK iii The FIND ITEM screen is displayed Return to to search for another item else press CLEAR until the SERVICE ITEM screen is displayed Step F 4 Option 4 To delete an item from the list DISPLAY SERVICE 11 a Select
35. current patient Go to Step D 3 Step E Review Claim Step E 1 To make the claim with the items displayed go to Step F Step E 2 To see a summary of the claim use the arrow keys to navigate up and down Return to the top of the screens to make your claim Go to Step F Step E 1 To add another patient select ADD Return to Step B Step F Submit your Claim Step F 1 To submit this HealthClaim to the appropriate health fund select SUBMIT cc MEMBER CARD NUMBER 9036009900001230001 HBR PATIENTS 1 FHC Esp i SUBMIT 26 HealthPoint User Guide Step F 2 HealthPoint attempts to make a connection to the HealthPoint systems and displays a message on the screen which indicates what it is currently doing These messages include e CONNECTING TO HOST SENDING PLEASE WAIT RECEIVING PLEASE WAIT e PRINTING PLEASE WAIT a OUTCOME 1 Claim is successful cc i If the Claim submission is successful CLAIM APPROVED the HealthPoint terminal prints a copy REBATE 545 00 of the claim receipt including the GAP 20 00 assessment and displays the HEALTH FUND assessment screen Go to Step G The printed assessment shows the health fund s responses to each item and to the claim as a whole A response of 00 or 0000 means the claim or item has been approved Explanations of the other responses are detailed in Appendix A Health Fund Responses see page 67 b OUTCOME 2 Health Fund
36. e moment Wait a few seconds and retry by pressing the RETRY key Should this condition persist please call the CSC HealthPoint Help Desk 92 SYSTEM UNAVAILABLE The system is temporarily unavailable Call the CSC HealthPoint Help Desk who can investigate why the system is currently unavailable 93 SYSTEM PROBLEM The system is experiencing a problem Call the CSC HealthPoint Help Desk who can investigate what is going on 94 DUPLICATE TRANSACTION The system is reporting that this transmission has been submitted more than once HealthPoint should not have attempted this SO please report this to the CSC HealthPoint Help Desk immediately Each claim is made up of one or more service items When the claim is submitted the health fund sends a response for each individual item in addition to the response for the claim as a whole HealthPoint prints these responses next to the item on the claim receipt Unless otherwise indicated all responses except OO APPROVED mean the item has been rejected If the response is not in the following table please contact the relevant health fund for an explanation 00 APPROVED The health fund has approved this item 01 BENEFIT NOT PAYABLE According to the rules for this health fund no benefit is payable on this item 64 HealthPoint User Guide 02 RESTRICTED ITEM The rebate for this item is restricted by the patient s policy and consequently no benefit is payable f
37. e patient sign the health fund assessment b Verify the patient s signature and write your initials on the assessment c File the patient signed and verified assessment Retain for two years d Select ACCEPT Go to 8 Step G 2 If the patient rejects it a Select REJECT b HealthPoint attempts to make a connection to the HealthPoint systems to send a claim rejection similar process to the claim submission i If successful go to G2 c ii If an error occurs during the claim submission HealthPoint displays the HEALTH FUND failed submission screen and will ask you if you want to print a manual receipt Error messages include e Fund Busy e Fund Unavailable e System Problem B ink Down e RDX Disconnect b2 1 Answer the question Do you wish to print a manual receipt i Select DISCARD HealthPoint discards the rejection and then returns to the Idle screen END Q 28 HealthPoint User Guide As the claim submission process was not completed there is no record of the claim 77 The entire transaction is cleared from the terminal You may like to try again a few minutes to see if the Health Fund becomes available ii If you press RETRY HealthPoint tries to REJECT the claim again If this is unsuccessful contact the Health Fund to confirm or log a request for the HealthPoint team to investigate c After HealthPoint has finished rejecting the claim and receiving the health fund s r
38. e procedure please refer to the Detailed User Guide in Section 8 7 1 o N gt gt Q Start from the Idle screen with the terminal on the base Swipe the patient s health fund card Enter the patient reference number then press OK HealthPoint displays the PROVIDER OF SERVICE screen select the servicing provider from the list by pressing the corresponding number key Add up to 16 service items from the list a Find the service item use the arrow keys to navigate to the item Press the corresponding number to select the item Press 2 to edit the fee enter the fee and press OK Press OK to add the selected item to the claim lo Either select ADD to add more items or press OK to complete the claim with the selected items To submit this Health Claim to the appropriate health fund select SUBMIT HealthPoint submits the claim and retrieves the health fund response then prints a claim assessment Advise the patient of the health fund s rebate of the claim To end the process select REJECT then DISCARD V You have obtained a Rebate Estimate A Claim has not been processed To submit a claim after the service is provided see Section 7 2 14 HealthPoint User Guide 7 2 Creating a HealthPoint Claim against a Health Fund Start from the Idle screen with the terminal on the base Enter the patient reference number then press OK 2 1 Swipe the patien
39. ed What would you like to do with the Claim 1 Select DISCARD to discard the claim and return to the swipe screen 2 Select MANUAL to produce a record of the claim for manual processing go on to step 8 3 Press FUNC then Select ADJUST to return to HEALTHFUND summary screen 8 Ifyou have already received monies from the patient enter that amount then press OK If not leave the amount blank and press OK HealthPoint User Guide 15 If there are monies owing HealthPoint asks for the METHOD OF PAYMENT Answer the question selecting EFTPOS CASH or press FUNC then select INVOICE and process accordingly If the receipt printed successfully select YES DONE a Give the receipt to the patient b HealthPoint returns to the idle screen V You have finished creating a HealthPoint Claim 7 3 Gancelling a HealthPoint Claim Start from the Idle screen with the terminal on the base Select XPOS Press 1 for HealthPoint Press 2 to Cancel a Claim Find the Claim to be Cancelled a Option 1 Use Claim Receipt Number i Enter the claim receipt number which you can find on the top of the printed claim receipt then press OK li If you have entered the Claim ID the Claim will be retrieved and presented screen Proceed to Step 5 b Option 2 Swipe the Health fund card used to generate the claim i If you have swiped the customer Health Fu
40. ervice fee charged for this item When you select an item HealthPoint includes a standard fee which you can modify Do not set this value to zero for this item Modify the claim and include the service fee 16 SERVICE DATE NOT VALID The service date supplied for this item is in the future HealthPoint does not allow dates in the future to be entered so please check the date and time on HealthPoint are correct 17 SERVICE DATE TOO OLD The date of service for this item is too far in the past Check the date and time on HealthPoint are correct If it is advise the patient to make a manual claim to their health fund 18 BODY PART IS REQUIRED The health fund will not approve payment for this item unless you identify the body part to which the item applies Modify the claim and identify the body part 19 PATIENT NOT COVERED The patient was not covered for this type of service as at the date the service was performed Advise the patient to check their cover with their health fund 20 NO DEPENDENT STATUS The patient is no longer covered as their dependent status on the policy holder ceased as at the date the service was performed Advise the patient to check their cover with their health fund HealthPoint User Guide 65 21 INVALID PATIENT NO The patient reference number for the patient to whom this service was provided is not correct Check the patient number on the health fund card For some fund card
41. esponse it prints a copy of the rejection receipt c 1 If the health fund does not accept the rejection see Health Fund Responses to HealthClaims for information on what to do next END Q c 2 If the health fund accepts the claim rejection HealthPoint displays the VOID APPROVED screen For example G2 c2 1 Answer the question on the VOID VOID APPROVED APPROVED screen WHAT DO YOU WANT TO DO WITH CLAIM i To discard your claim Select DISCARD HealthPoint returns to the Idle screen You have discarded the claim you were submitting END Q ii To make a manual claim Select MANUAL the patient should make a manual claim with their Health Fund Go to Step H iii To adjust your claim Press FUNC then select ADJUST HealthPoint returns to the HEALTH FUND summary screen Navigate to the items you wish to adjust and submit it again Return to Step F Submit your Claim Step H HealthPoint displays the ENTER DEPOSITS RECEIVED screen H 1 If you have already received monies from CURRENT 20 00 the patient perhaps by way of a deposit or ENTER DEPOSITS RECV down payment enter that amount and then press OK 0 00 HealthPoint User Guide 29 H 2 If there was no deposit paid leave the amount as zero and press OK H 3 HealthPoint adjusts the gap amount by the amount you just entered Step I Monies Owing Step 1 1 Option 1 If there are monies owing to the Service Provider because
42. for treatment of their ailment 10 ITEM NO IS NOT VALID The health fund does not recognise this item number You may not have an up to date list of the current items If this is the case please call the CSC HealthPoint Help Desk and arrange for an up to date list to be sent to your Health Message Centre mail box 11 ITEM NO CEASED USE This item number is no longer in use as of the date the service was performed You may not have an up to date list of the current items If this is the case please call the CSC HealthPoint Help Desk and arrange for an up to date list to be sent to your Health Message Centre mail box 12 ITEM NOT FOR PROVIDER The health fund will not pay benefits for this item when performed by this provider Check with the health fund as to the status of the provider and what services the health fund will accept when performed by them 13 ITEM NO NOT APPROVED The health fund does not approve this item no benefits have been paid Check the item number is correct If it is contact the health fund for clarification 14 ITEM MAX USE EXCEEDED The health fund imposes a limit on the number of times this item may be used within a particular period and this limit has been exceeded for this patient Advise the patient to check with their health fund as to any restrictions it imposes on this item 15 SERVICE FEE MISSING The health fund will not approve payment for this item unless you supply the s
43. ghlighted at the top of the MEMBER CARD NUMBER M 9036009900001230001 HBR PATIENTS 1 sugar FUNC Key tor ADD White Key Labels If the two outer white ENL LU AME keys have a function on the screen its label appears above the key For example Submit a claim the SUBMIT label appears above the left outer white key 66 99 3 2 The Idle Screen Most procedures in this user guide start from the Terminal s Idle screen For Example When HealthPoint is displaying this screen you may swipe a health fund card Medicare card and insert or swipe a credit debit or charge card The terminal must be on the base when initiating and submitting a HealthPoint claim 10 HealthPoint User Guide 4 SYMBOLS The following symbols are used in the procedures detailed in this guide Start Each procedure starts with a description of what state HealthPoint should be in before you work through the procedure Most procedures start from the Idle screen Finish The tick indicates you ve completed the procedure End The Omega symbol indicates that you ve reached an end point in the procedure You will need to start again Please Wait This symbol indicates that at this point in the procedure HealthPoint makes a telephone call to the CSC Health Message centre to send and receive information Tip This symbol indicates that there is there is a tip which may be of use eg
44. ied to the health fund prior to this ttem being claimed Advise the patient to check with their health fund 31 QUOTATION REQUIRED A reduced benefit has been paid because a quotation should be supplied to the health fund prior to this ttem being claimed Advise the patient to check with their health fund 32 EXCEEDS QUOTATION No benefit has been paid because the fee for this item exceeds the quotation given Advise the patient to check with their health fund 33 EXCEEDS QUOTATION A reduced benefit has been paid because the fee for this item exceeds the quotation given Advise the patient to check with their health fund 34 AGE RESTICTION No benefit has been paid because the health fund applies an age restriction to this item Advise the patient to check with their health fund 35 AGE RESTRICTION A reduced benefit has been paid because the health fund applies an age restriction to this item Advise the patient to check with their health fund 36 GENDER RESTRICTION No benefit has been paid because the fund applies a gender restriction to this item Advise the patient to check with their health fund 37 GENDER RESTRICTION A reduced benefit has been paid because the fund applies a gender restriction to this item Advise the patient to check with their health fund 38 INVALID CHARGE No benefit has been paid because the health fund deems the charge for this item invalid Check with the health fund for an exp
45. ired for each provider using the terminal Your Provider Number must be the one that relates to the site where the terminal is to be installed Why do you need a copy of my Provider number letter The Health Funds require a copy of your Provider Number letter and the data on your HealthPoint Application form must EXACTLY match that on your Provider Number letter have provider numbers from all different Health Funds how do I know which Provider Number is required The Provider number required on your Application is your Medicare Provider number If you are a Naturopath Remedial Massage Therapist Myotherapist or Acupuncturist then you should use your Medibank Private Provider number This information is printed on page 2 of the HealthPoint Application form What modalities can use HealthPoint Dentists Optometrists Physiotherapists Chiropractors Osteopaths Podiatrists Dieticians Speech Pathologists Occupational Therapists Psychologists Naturopaths Acupuncturists Remedial Massage Therapists Exercise Physiologists Myotherapists Can all modalities use Medicare All modalities EXCEPT for Naturopaths Acupuncturists Remedial Massage Therapists and Myotherapists can use Medicare 11 9 HealthPoint Setup FAQs How many multi merchants can be added to a terminal A total of 9 multi merchants per terminal Do I have to change my Bank account No your payments can be made to any bank account However by choosing to set
46. ise the Fund to pay o rebate directly to the provider ard to verify aspect of this claim with the provider Sigotur of verified Tasch Tan 10 454657478 HealthPoint User Guide 31 Name of Health Fund Fees charged Rebate the fund will pay Item Response Code Description of each response code is printed on the receipt Patient Signs here Write your initials here 32 HealthPoint User Guide 8 3 1 Overview HealthPoint allows you to cancel a HealthPoint claim on the same day that it was submitted A Health Claim can only be cancelled if The Patient is at your practice and you have their Health Fund card Claim was submitted earlier in the day note the day ends at midnight and is based on Sydney Australia time HealthClaims service is available note this varies based on the Health Fund s agreed operating hours Once you have printed a reconciliation report for a day you can no longer cancel claims on that report through HealthPoint N For a brief summary of this procedure please refer to the Quick Reference Section 7 3 Cancelling a HealthPoint Claim 8 3 2 Step by Step Guide Start from the Idle screen with the terminal on the base Step A Select XPOS HealthPoint displays the XPOS menu Step B Press 1 for HealthPoint Step C Press 2 for Cancel Claim CANCEL CLAIM Step C 1 If required enter your four digit operator ID then pres
47. lable Monday to Friday 8 00am to 6 00pm AEST and Saturday 8 00am to 2 00pm AEST Except for Public Holidays Note The training department operates Monday to Friday 9 00am to 5 00pm AEST Except for Public Holidays Please assist us by having your CommBank Merchant number CommBank Terminal number found on the HealthClaims receipt available when contacting the above helpdesks Your Merchant Details CommBank Merchant No CBA ID CBA CommBank Merchant Enquiries For general merchant enquires and EFTPOS hardware difficulties call 1800 230 177 24 hours 7 days a week Manual Authorisation For Visa Mastercard Credit Card call 13 26 36 24 hours 7 days a week For Debit Cards call 1800 813 700 24 hours 7 days a week Please have the following information ready merchant number card details card number expiry date transaction amount HealthPoint User Guide 7 2 3 Health Fund Contacts For enquiries about a fund member s entitlements or problems with their card call the relevant fund s Member Services number For enquiries about provider numbers or any difficulties with provider payments call the relevant fund s Provider Information number Health Fund Member Services Provider Information ACA 1300 368 390 1300 368 390 ahm 134 246 134 246 Australian Unity 03 9697 0560 132 939 03 9697 0435 Budget Direct Health see GMHBA BUPA 131 135 1800 060 239 CBHS 1300 654 123 1300 654 123 cua Health
48. lanation 39 NOTIONAL CHARGE No benefit has been paid Check with the health fund for an explanation 40 CONVERTED ITE No benefit has been paid Check with the health fund for an explanation 41 REFER TO FUND No benefit has been paid Check with the health fund for an explanation 42 SYSTEM PROBLEM The system is experiencing a problem Call the CSC HealthPoint Helo Desk who can investigate what is occurring 50 PROVIDER NOT KNOWN The health fund does not recognise this provider Check the provider number in HealthPoint s provider table is correct If it is call the CSC HealthPoint Help Desk and ask them to check the provider has been registered with the relevant health fund 51 NOT ALLOWED FOR PROV The health fund does not pay benefits when this service is performed by this provider Advise the patient to check with their health fund HealthPoint User Guide 67 12 3 Cancellation or Rejection Void When you attempt to cancel a claim or when the patient rejects voids an assessment the health fund sends a response which HealthPoint displays and prints on the receipt If the response is not in the following table please contact the relevant health fund for an explanation 00 APPROVED The health fund has approved this cancellation 21 CONTACT HELP DESK The system has taken no action Please contact the CSC HealthPoint Help Desk 25 UNABLE TO FIND CLAIM The system cannot find the clai
49. lation of a electronic cloin accepted by the Health Fund through HealthClains Membership No 0000000000 Menber Cord 9036005900001230001 Provider MR OLIVER WESTMAN Provider No 93589 Type of Services DENTAL Services Claimed Befit 02 05 03 2015 0011 COMPREHE ORAL EXAM 150 00 91 00 00 02 05 03 2015 0022 INTRAORAL Items being Cancelled PERIL OR 66 33 66 33 00 CANCELLED 216 33 157 33 00 Assessment Codes 00 APPROVED 00 APPROVED Declaration by Member 1 ocknouledge thot the Fund hos concel led the clala ot my request ond accept thot the Fund will not pay the indicated retote to the provider os originally cloined for the services rendered Signature Patient Signs here of Weber Verified Write your initials here HealthPoint User Guide 37 8 4 Reporting 8 4 1 Overview HealthPoint provides three types of reports in order to aid you with reconciliation at your practice The available reports are HealthClaims Shift Total Report HealthClaims Reconciliation Report HealthClaims Activity Report For more information see the corresponding sections below Please note if there are no reports available for a particular day a message will appear as follows FAILED TO RECEIVE XX DUE TO NO REPORT FOR DATE 8 4 HealthClaims Shift Total Report The HealthClaims Shift Total Report allows you to break up your reporting throughout the day to allow for r
50. m you are trying to cancel Please contact the CSC HealthPoint Help Desk 30 SYSTEM DATA ERROR This is a serious error so please report it to the CSC HealthPoint Help Desk immediately 58 TRANS NOT PERMITTED This system does not permit this type of transaction HealthPoint should not have attempted this transaction so please report this to the CSC HealthPoint Help Desk immediately 76 NOT SAME DAY AS CLAIM The claim you are attempting to cancel was not created today You cannot cancel this claim 91 SYSTEM BUSY TRY AGAIN The system cannot process your cancellation or rejection at the moment Wait a few seconds and retry by pressing the RETRY key Should this condition persist please call the CSC HealthPoint Help Desk 92 SYSTEM UNAVAILABLE The system is temporarily unavailable Call the CSC HealthPoint Help Desk who can investigate why the system is currently unavailable 93 SYSTEM PROBLEM The system is experiencing a problem Call the CSC HealthPoint Help Desk who can investigate what is occurring 94 DUPLICATE TRANSACTION The system is reporting that this transmission has been submitted more than once HealthPoint should not have attempted this so please report this to the CSC HealthPoint Help Desk immediately Contact us for more information or to change your details HealthPoint Helpdesk Mon to Fri 8 00am to 6 00pm amp Sat 8 00am to 2 00pm AEST except Public Holidays Call 130
51. n also be found on the CSC website csc com healthpoint What is CSS Claims Settlement Service CSS is a service that collects the rebate amounts on a daily basis from the participating Health Funds noted on the Health Fund flyer consolidates the payments and deposits to a provider s bank account Not all Health Funds are participating however CSC continues to work with these Health Funds to encourage and assist them to connect to this service CSC has a brochure to explain How to reconcile which is included in your Welcome Kit and can also be found on the CSC website csc com healthpoint Do the funds consolidate deposits and do still receive statements from each Health Fund Health Funds participating in CSS will have their payments consolidated and you will receive a statement once a month listing all transactions Health Funds not participating in CSS will deposit separately to your account and provide individual statements 11 3 HealthPoint Reporting FAQs How often should I retrieve reports CSC holds an electronic mailbox for you which holds all of your reports from the Health HealthPoint User Guide 59 Funds and CSC If you submit claims frequently then you should also retrieve reports from your mailbox frequently e g If you submit daily you should also retrieve daily For practices submitting claims less frequently we recommend that this mailbox is accessed at least once a week to avoid any communications error mess
52. nce when the appliance is supplied Review the HealthPoint Service Terms and Conditions to make sure you understand your legal obligations under your agreement with the health funds If you need another copy of your terms and conditions call the CSC HealthPoint Help Desk on 1300 301 692 Hemember that the health funds have the right to refuse to accept a claim that does not comply with their requirements If in doubt always consult the health fund in question The terminal must be on the base when initiating and submitting a HealthPoint claim 77 The base must have an active internet connection The terminal can be removed from the base when processing on EFTPOS transaction or gap payment 12 HealthPoint User Guide 6 HEALTHPOINT ADMIN MENU MAP SERVICE TYPE 1 DENTAL 1 11 COMPREHE ORAL 2 OPTICAL 2 12 PERIODIC ORAL 3 CHIROPRACTIC 3 13 ORAL EXAML LIM HEALTHPOINT ADMIN 1 ACTIVITY REPORT 1 DEVICE DETAILS SERVICE ITEMS 2 RECONCILIATION REPORT 2 PRACTICE DETAILS REPORTS 3 SHIFT TOTAL 3 HEALTH FUNDS UPDATE CONFIG ACURRENT SETTINGS 4 SERVICE ITEMS PAYEE DETAILS ID UPDATE CONFIG 1UPDATE ALL 4 PRACTICE DETAILS 3 HEALTH FUNDS 4 PROVIDER DETAILS 5 SERVICE ITEMS PROVIDER OF SERVICES 1MR ABCXYZ SMITH HIDDEN PASSWORD SERIAL 1111111 7 QUICK HealthPoint User Guide 13 REFERENGE GUIDE For more information on any step in the following quick referenc
53. nd Card you will be presented with a list of possible claims to Cancel li To navigate through the possible claims use the arrow keys Once you have the Claim you want to cancel Select PROCEED to Cancel the Claim a If you have not already done so you will be prompted to Swipe the patient s card to authorise the cancellation b HealthPoint cancels the claim retrieves the health fund s response and prints a cancelled receipt i Have the patient sign the cancellation receipt li Verify the patient s signature and write your initials on the cancellation receipt File the patient signed and verified cancellation receipt Retain for two years iv HealthPoint displays the Print confirmation screen After the receipt prints correctly Select YES DONE HealthPoint prints another copy of the receipt for the patient If this copy has printed correctly select YES DONE Select OK to finish the cancellation and return to the Idle screen V You have finished cancelling a HealthPoint Claim 16 HealthPoint User Guide 7 4 Printing a HealthClaims Reconciliation oa Rom N Report Start from the Idle screen with the terminal on the base Select XPOS Press 1 for HEALTHPOINT Press 9 for HEALTHPOINT ADMIN Press 2 for REPORTS Press 2 for RECONCILIATION Enter the Date for reconciliation then Press OK This should be entered as DDMMYYYY HealthPoint prints the reconciliation report Once
54. ng day and will be available for you to retrieve on the next working day You may retrieve reports at any time If there are no reports waiting for you to retrieve there is no harm done If you printed more than one SHIFT TOTAL report during a day e g because you had a change in staff add the totals of all the SHIFT reports before reconciling with the activity report There is only ever one activity report per day HealthPoint Activity Report HealthPoint see TRAIHING HODEs A iBO0FT Activity Report CBA Touch ABN 61920496281 dh Talavera Rd Wocquorie Pork NSA 2113 Telephone 02800721 Customer 10 843359 Date of Transactions 04 12 2012 Date the claims included in the totals were processed Benefit Totals and submitted Type Humber Total Bubmitted 5 5273 10 Voided 1 544 00 Cancelled 0 00 These transaction totals should match those shown on the reconciliation report s for this day ihack against the Beconciliotion Pepot EHD OF REPORT HealthPoint User Guide 41 8 4 5 Printing Reports Step by Step Guide Start from the Idle screen with the terminal on the base IDLE SCREEN Step A Press XPOS HealthPoint displays the XPOS menu Step B Press 1 for HEALTHPOINT HealthPoint displays the HEALTHPOINT screen Step C Press 9 for HEALTHPOINT ADMIN HEALTHPOINT ADMIN HealthPoint displays the HEALTHPOINT ADMIN 1 SERVICE ITEMS Screen 2 REPORTS 3 UPDATE CONFIG 4
55. o update PRACTICE DETAILS c Press 3 to update HEALTH FUNDS details d Press 4 to update PROVIDER DETAILS e Press 5 to update SERVICE ITEMS HealthPoint will retrieve the relevant updates and apply them to the terminal VI HealthPoint will print out any applied changes If there are no updates HealthPoint will print No New Updates on the print out vii vill HealthPoint will prompt you to confirm that the updates are correct a If they have printed correctly Select YES DONE b Else Select NO SKIP Please contact the CSC HealthPoint Helpdesk to resolve the issue You have completed the Practice Maintenance process WW t 9 50 HealthPoint User Guide Overview If your practice has multiple merchants you can set up a default merchant to receive the EFTPOS gap monies for each provider By default no merchants are linked and at the time of payment the merchant to receive the EFTPOS monies must be selected each time 8 8 2 Step by Step Guide Start from the Idle screen with the terminal on the base IDLE SCREEN Step A Select XPOS HealthPoint displays the XPOS menu 1 HEALTHPOINT Step B Press 1 for HEALTHPOINT HealthPoint displays the HEALTHPOINT screen Step C Press 9 for HEALTHPOINT ADMIN HEALTHPOINT ADMIN HealthPoint displays the HEALTHPOINT ADMIN screen 1 SERVICE ITEMS 2 REPORTS 3 UPDATE CONFIG 4 PAYEE DETAILS Step D Press 4 for PAYEE DETAILS
56. oad on your HealthPoint Terminal 8 73 Practice Maintenance Step by Step Guide 1 Obtain the Provider Form a Option 1 Contact the CSC HealthPoint Helpdesk on 1300 301 692 to request a form b Option 2 Access the website csc com healthpoint click on the Provider tab and download the CommBank Change of Details form Fill in the Provider Form with the relevant Updated details Return the form to CSC HealthPoint a Option 1 Email us on HealthPoint csc com b Option 2 Fax 1800 500 874 c Option 3 Mail CSC HealthPoint PO Box 148 North Ryde NSW 1670 4 CSC HealthPoint Helodesk will process your application and on completion an update is sent directly to your terminal 5 Update your Terminal a Option 1 Immediate Update As soon as the update is available the Update Screen will pop up after you finish processing a claim i You can immediately update your HealthPoint terminal by clicking Yes You have completed the Practice Maintenance process b Option 2 Manual Update gt Start from the Idle screen i Select XPOS HealthPoint displays the XPOS menu Press 1 for HEALTHPOINT HealthPoint displays the HEALTHPOINT screen HealthPoint User Guide 49 iii Press 9 for HEALTHPOINT ADMIN HealthPoint displays the HEALTHPOINT ADMIN screen iv Press 3 for UPDATE CONFIG HealthPoint will display the UPDATE CONFIG screen v Choose the Details to be Updated a Press 1 to UPDATE ALL details b Press 2 t
57. oint copies the item as displayed on the screen to your claim ii HealthPoint then displays the copy of the item on the screen as a new current 1 DATE 21 10 2014 item HealthPoint displays 2 FEE 0 00 the number of copies made 3 TOOTH NUMBER next to the COPY key EZB lii You can now make changes to this new copy of the item To edit the item Go to Step D 6 1 Where X is the number on the screen COMPREHE ORAL EXAMI HealthPoint User Guide 23 The Copy function is particularly useful if the only changes made to the item are to enter a different body part or tooth number To discard the item select DISCARD HealthPoint returns to the KEY SERVICE screen If required keep pressing the CLEAR button until you return to the SELECTION PATIENT Screen Return to Step D 3 Step D 6 Adjust Service Items a Choose the relevant option below i To Adjust the Date of Service Go to D6 b li To Adjust the Fee for the Service Go to D6 c To Adjust the Description for the Service Go to D6 d iv Adjust the Tooth Number for the Service Go to D6 e v To Adjust the Body Part for the Service Go to D6 f b Option 1 To adjust the date of service press the number key next to DATE i HealthPoint displays the SERVICE DATE screen ii Select the date of service from the list by pressing a number key 1 TODAY 2 YESTERDAY 3 OTHER Note A claim cannot be made for a
58. or this item 03 RESTRICTED ITEM The rebate for this item is restricted by the patient s policy and consequently only a reduced benefit is payable for this item 04 PREVIOUSLY PAID A benefit has already been paid for this item Advise the patient to check their cover with the health fund 05 BENEFIT LIMIT REACHED The patient s benefit limit for this item has been exceeded for the period specified in their policy so no benefit has been paid Advise the patient to check their cover and the relevant limits with the health fund 06 BENEFIT LIMIT REACHED The patient s benefit limit for this item has been exceeded for the period specified in their policy so a reduced benefit has been paid Advise the patient to check their cover and the relevant limits with the health fund 07 WITHIN WAITING PERIOD The patient does not qualify for this item because they have not completed the waiting period specified in their policy Advise the patient to check their cover and the relevant waiting periods with the health fund 08 PREREQ SRVCE REQUIRED A pre requisite service is required before benefits are payable on this item Advise the patient to check with the health fund as to what is required to qualify for benefits on this particular item 09 PRE EXISTING CONDITION No benefit is payable as this item applies to a pre existing condition Advise the patient to check with their health fund as to what benefit restrictions apply
59. printed Select YES DONE to return to the HealthPoint Admin Menu V You have successfully retrieved and printed your report 7 5 Printing a HealthClaims Activity Report FWP Q Start from the Idle screen with the terminal on the base Select XPOS Press 1 for HEALTHPOINT Press 9 for HEALTHPOINT ADMIN Press 2 for REPORTS Press 1 for ACTIVITY REPORT Enter the Activity Date then Press OK This should be entered as DDMMYYYY HealthPoint prints the reconciliation report Once printed Select YES DONE to return to the HealthPoint Admin Menu V You have successfully retrieved and printed your reports HealthPoint User Guide 17 7 6 Changing the Provider List To update your HealthPoint Provider list you must call the CSC HealthClaim Helo Desk on 1300 301 692 Additional Providers require registration with CSC and the Health Funds prior to claiming on the HealthPoint Terminal The Provider application can be found on the CSC website Once the Providers are registered you can update your terminal to reflect the additional Provider gt Start from the Idle screen with the terminal on the base 1 Select XPOS HealthPoint displays the XPOS menu 2 Press 1 for HEALTHPOINT HealthPoint displays the HEALTHPOINT screen 3 Press 9 for HEALTHPOINT ADMIN HealthPoint displays the HEALTHPOINT ADMIN screen 4 Press for UPDATE CONFIG HealthPoint will display the UPDATE CONFIG screen
60. rejects the claim i lf the Health Fund has rejected the claim see Health Fund Responses to HealthClaims for information on what to do next END Q c OUTCOME 3 Error occurs during peg uc transmission CLAIM FAILED DUE TO If an error occurs during the claim submission RECEIVE ERROR HealthPoint displays the relevant error screen HostMar Dial 3 18 Lif LT Li i nk fd uim Fiati T Most errors that occur during a claim submission are one offs We recommend you try again press RETRY c2 Choose the appropriate option below c2 1 To resubmit the claim I Select RETRY HealthPoint tries to send the claim again ii If the error occurs again call the CSC HealthPoint Help Desk on 1300 301 692 END O c2 2 c2 3 HealthPoint User Guide 27 To discard the claim completely i Select DISCARD li HealthPoint discards the claim completely and then returns to the Idle screen You will need to restart the claims process from 1 To process a manual claim i Select MANUAL ii HealthPoint will stop processing the health claim and the patient will need to make a manual claim with their Health Fund to secure their rebate Go to 8 Step G Advise the patient on the health fund s rebate of the claim and ask them if they accept it Note If you press FUNC and select PRINT HealthPoint prints another copy of the receipt Step G A If the patient accepts it a Have th
61. rsist call CommBank to correct your merchant information You have successfully linked unlinked a Provider and Merchant 52 HealthPoint User Guide 9 RECONCILIATION GUIDE 9 1 Claims Settlement Solution CSS The Claims settlement Solution is an exciting new service that delivers benefits to your practice Designed to save you time and money Claim settlement offers quick and easy reconciliation process that will reduce The number of deposits to your bank account which may help you save on bank fees and he number of statements you receive from health funds Consolidated payment of claims Historically Private Health funds made individual deposits to your account which made reconciliation time consuming The Claim Settlement System enables Private Health funds to send a consolidated payment to your account This will occur each settlement day for the total amount of all the claims processed by you and any other providers sharing the same bank account For claims processed on a Monday these funds will generally be credited to your bank account on the Tuesday and available for use by you on Wednesday Note for some banks account holders the deposit may take up to a further two business days and processing of payments will not occur on weekends and public holidays Consolidated statement of health fund information CSC HealthPoint will issue a monthly statement for each registered bank account detailing all
62. s OK OPERATOR ID Step D Find the claim to cancel KEY ID NUMBER ON Step D 1 HealthPoint will display the RECEIPT OR SWIPE Find Claim screen PATIENT CARD To find a specific claim you have two options HealthPoint User Guide 33 Step D 2 Option 1 Find using the claim receipt number a Enter the claim receipt number which you can find on the top of the printed copy of the claim and press OK b HealthPoint retrieves the claim and displays it on the terminal Go to Step E Claim Recpt Ho 99909 0000226 Key in this Date Processed 05 03 2015 12 47 Note You only need the second part of the number after the space Note You do not need to key in all of the zeros at the front of the claim number For example to find claim 000020 you only need to key in 20 Step D 3 Option 2 Find a claim associated with a membership 0009302 ITEMS 1 l DR DENTIST ONE a To find a claim associated with a TOTAL 10 00 membership Swipe the Health Fund 20 10 2014 SUCCESS Card used to submit the claim b HealthPoint will connect to the HealthPoint Claim server and find all the claims associated with the membership card that were submitted on the current day c If more than one claim was submitted Press FUNC and Select NEXT to navigate to through the claims until the appropriate claim is reached Go to Step E Step E To cancel this HealthClaim with the appropriate health fund Select
63. s the first patient on the card is number O Correct the claim accordingly and re submit it 22 MEMBERSHP NOT COVERED The patient s fund membership does not cover the services provided as at the date the service was performed Advise the patient to check their cover with their health fund 23 MEMBERSHP CEASED SUSP The patient s fund membership has either ceased or been suspended as at the date the service was performed Advise the patient to check with their health fund 24 MEMBERSHP UNFINANCIAL The patient s health fund membership has not been paid as at the date the service was performed Advise the patient to check with their health fund 25 NO ANCILLARY COVER The patient did not have ancillary cover as at the date the service was performed Advise the patient to check their cover with their health fund 26 ITEM NOT COVERED The patient was not covered for this particular item as at the date the service was performed Advise the patient to check their cover with their health fund 27 POSSIBLE DUPLICATE Check with the health fund 28 EXCESS APPLIED No benefit has been paid for this item 66 HealthPoint User Guide because an excess applies Advise the patient to check with their health fund 29 EXCESS APPLIED A reduced benefit has been paid because an excess applies Advise the patient to check with their health fund 30 QUOTATION REQUIRED No benefit has been paid because a quotation must be suppl
64. t s health fund card 2 2 HealthPoint displays the PROVIDER OF SERVICE screen select the servicing provider from the list by pressing the corresponding number key 4 Addup to 16 service items from the list a b C Find the service item use the arrow keys to navigate to the item Press the corresponding number to select the item Press 2 to edit the fee enter the fee and press OK See 7 7 Changing the Item List to pre populate an amount against specific item numbers Press OK to add the selected item to the claim Either select ADD to add more items or press OK to complete the claim with the selected items To submit this Health Claim to the appropriate health fund select SUBMIT HealthPoint submits the claim and retrieves the health fund response then prints a claim assessment for the patient to sign 7 Advise the patient of the health fund s rebate of the claim and ask them if they accept it a Option 1 Patient Accepts Rebate Offered i accept the rebate offered select ACCEPT Have the patient sign the health fund assessment lil Verify the patient s signature and write your initials on the assessment iv File the patient signed and verified assessment Retain for two years Option 2 Patient Rejects Rebate Offered i To reject the rebate offered select REJECT HealthPoint rejects the claim and retrieves the health fund response The Terminal will show VOID Approv
65. the item to edit from the list 1 BENEFIT 11 either by pressing the corresponding gt FEE 10 00 number or using the FIND key b Using the FUNCTION key to access the menu Press the bottom right key labelled DELETE c Press the OK to confirm you want to delete the item HealthPoint deletes the item from the list Step G Confirm Changes Step G 1 Press OK Step G 2 HealthPoint contacts the HealthPoint SERVICE ITEMS systems to update the items SUCCESSFULLY UPDATED a If Successful the SERVICE ITEMS SUCCESSFULLY UPDATED screen is displayed b Press OK to continue L c HealthPoint returns you to the HealthPoint Admin screen ENTER TO CONTINUE 77 You have modified the item list HealthPoint User Guide 47 8 6 3 Editing Item Details Sub Process Step by Step Guide Note MBS items require additional data and are described in the Medical Services User Guide Step A Choose the Item Detail that you wish EDIT SERVICE 123 to Edit Step A 1 Option 1 To edit the name and or SERVICE DESCRIPTION description of the item press 1 SERVICE NUM 110 a HealthPoint displays the SERVICE DESCRIPTION screen SPEC b Enter the item s name and then press OK Note HealthPoint will display this service description on the services item selection screen and on claim receipts Press the key labelled with the letter one or more times according to the letter s position For example the 2 key
66. ther responses are detailed in the Cancellation and Rejection Responses section of Appendix A Health Fund Responses Step F 1 HealthPoint displays the PRINT dU elec DID THE RECEIPT PRINT CORRECTLY REF RINT Step F 2 If it has printed incorrectly select NO REPRINT Step F 3 Else select YES DONE another copy of the receipt will print V HealthPoint User Guide 35 Step G HealthPoint displays the PRINT CONFIRMATION screen Step G 1 If it has printed incorrectly select NO REPRINT Step G 2 Else Select YES DONE HealthPoint displays the Claim Cancelled screen CLAIM CANCELLED ENTER TO CONTINUE Step G 3 Press OK to return to the Idle screen Step H Sign Receipts Step H 1 Have the patient sign the cancellation receipt Step H 2 Verify the patient s signature and write your initials on the cancellation receipt Step H 3 File the patient signed and verified cancellation receipt Retain for two years You have finished cancelling a HealthPoint claim 36 HealthPoint User Guide 8 3 3 Cancellation Receipt Example Name of Health Fund Description of each response code is printed on the receipt HealthPoint CBA Touch 81524496261 2 Tolovera Rd ie Pork 16 2113 Telephone 0280386721 Customer 10 CSC Test Fund Cancellation of Claim Recpt Ho CBAS990S 0000226 Date Processed 05 03 2015 12 49 This receipt acknowledges the concel
67. tle your merchant facility to a CommBank business transaction account Everyday Settlement will HealthPoint User Guide 61 occur 7 days a week 365 days a year on card transactions made up until 10pm AEST This means that funds can be accessed on the same day as they are processed Funds for claims processed as part of CSS or direct by health funds will be processed at the earliest next business day refer FAQ 11 5 have run out of paper where do get some more Stationery can be ordered online from https eftposstationery evolveshop com au epages stationery sf I2 APPENDIX A HEALTH FUND RESPONSES The health funds provide a response for each claim and each item of a claim Any response except 00 means the claim or item has been rejected by the Health Fund Likewise the health funds provide a response to rejections and cancellations made by the patient Any response except OO means the cancellation or rejection has not been processed and the claim will stand Look up the response code in the tables in the following sections Note Not all health funds use all of the responses listed For each claim you submit with HealthPoint the health fund sends a response which HealthPoint displays and prints on the claim receipt All responses except OO APPROVED mean the claim has been rejected or revised In general if the health fund rejects the claim the patient should settle their account in the us
68. ual manner and make a regular paper based claim with their health fund If the response is not in the following list please contact the relevant health fund for an explanation 00 APPROVED The health fund has approved this claim 01 PROVIDER NOT APPROVED The health fund has not approved the provider who performed the services for electronic claiming Check the provider number in HealthPoint s provider table is correct If it is contact the health fund to clarify this provider s status Some health funds e g Medibank Private will only permit providers to submit claims for items within their own modality e g Physiotherapists may not be able to make claims using Chiropractic codes Claims containing items from a modality other than the providers will get this response Check the provider s modality with the health fund 62 HealthPoint User Guide 03 INVALID PROVIDER NO The provider number supplied is not valid HealthPoint should have trapped this error before submitting the claim so please report this to the CSC HealthPoint Help Desk immediately 04 PLEASE RETAIN CARD The health fund has asked you to retain the patient s card if possible Call the relevant health fund for information on what to do next 10 REFER CLAIM TO FUND The health fund has requested that this claim be referred to them for manual assessment Call the relevant health fund for information on what to do next 12 TRANSACTION DECL
69. unning totals The Shift Total Report can be printed on the claim date to allow for reconciliation on the same day as claim submission The HealthClaims Shift Total report is HealthPoint s record of the claims sent through to each health fund during a shift By executing the report Allthe transactions from the shift are printed A new shift is started A Shift starts from the beginning of the day until the first Shift Total Report is printed Subsequent shifts are from the end of the previous shift to the next Shift Report Multiple shift reports be printed during the day However each claim will only appear one Shift Total report If you print more than one Shift Report for a day be sure to add the totals when reconciling with the Reconciliation and or the Activity report 38 HealthPoint User Guide Shift Total Report HealthPoint TRAINING MODEs Shift Totals Report CBA Touch ABN 81920496281 26 Talavera Rd Macquarie Pork NSW 2113 Telephone 0280356721 Customer 10 899909 Date of Claims 05 12 2012 Period Covered 00 00 11 54 Time span of shift on the report Claims by Provider Receipt Services Charge Beref it Gap Code Provider MR SIMON SKENCER Type CHIROPRACTIC Fund MEDIBANK PRIVATE LTD Each health fund is listed for each provider 0003756 50 00 2 00 48 00 00 Fund Total 150 00 2 00 48 00 Fund BUPA AUSTRALIA 0003787 50 00 13 25 336 25 00 One line for e

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