How to process a claims with HICAPS

Processing private health fund claims, Medicare Easy claims and WorkSafe Victoria claims is easy with a HICAPS terminal.

Processing private health fund claims

After the consultation, swipe your patient’s health fund card through the HICAPS terminal. The claim details will need to then be entered, and the transaction will be processed in seconds.

Once authorised by the health fund, the patient will then need to pay the gap amount — this is the difference between the full fee for the treatment and the amount claimed from the health fund.

Learn more about completing a HICAPS claim (PDF, 184.5KB).

 

Processing Medicare claims

You can use Medicare Easyclaim to process both bulk bill and patient claims (Chronic Disease Management (CDM) items). Depending on how you settle your patient's account, there are three different payment types that you can lodge.

Fully paid account - you pay your account in full. Part paid account - you contribute to the settlement of your account. Unpaid account - your account has not been paid.

Once the patient’s account is paid in full, their Medicare card is swiped through the HICAPS terminal, and their rebate will be paid directly into their chosen account.

Learn more about Processing a Medicare Easyclaim (PDF, 1.5MB).

 

Processing WorkSafe claims

You can lodge WorkSafe Victoria invoices through your HICAPS terminal. This removes the need to send invoices (for most services) and reduces the time that it takes for you to get paid.

Here’s how to lodge a WorkSafe invoice:

Enter your WorkSafe HICAPS claim number along with the 11-digit WorkSafe claim number (provided by the patient) and follow the prompts.Enter the payment amount and press ‘Ok’.If the claim summary is correct, press the ‘Send’ button to forward the invoice to Worsksafe for assessment.

Important: remember to get the patient to sign the receipt (you’ll need to keep this on file for up to seven years).

For more information about lodging WorkSafe Victoria claims including helpful hints, see our Lodging a WorkSafe Invoice Reference Guide (PDF 133KB).

Please note: to process WorkSafe claims via your HICAPS terminal you’ll need to be a registered provider with WorkSafe. To register, update your details, or to view a list of approved services, visit the WorkSafe website.

Learn more about Processing a WorkSafe Victoria claim (PDF, 225KB).