Claiming

1.      Open the patient’s record and locate the Accounts section.

2.      Locate and double-click the HealthPoint account to open it.

3.      Select the Invoices tab.

4.      Click   to create a new invoice.

5.      Within the new invoice, add Service Items and service type as desired.

6.      Click  to check rebate assigned and gap amount.

o      Tyro HealthPoint interface will display the gap estimate information.

 

7.      Click to display the rebate.

 

8.      If the patient agrees to proceed, click   to create an invoice.

9.      You will be prompted to select the Date of Issue. Alter it if desired, and then click  

10.   You will be prompted to print the invoice. Click   to process and submit the Health Point Claim.

11.   You will be prompted to accept or reject the Claim.

o      Click ‘ACCEPT (1)’ to accept the Claim, or alternately you can ‘REJECT (2) or cancel the transaction if you do not want to proceed.

o      Clicking on ‘ACCEPT (1)’ will display the benefit details and provides you the option to process the gap.

o      Note: If you accept the claim, you will have instant payment from Tyro HealthPoint within seconds.

 

12.   Click on ‘Yes’ to process the Gap Amount. You will be presented with the receipt window. Enter payment details and issue the receipt.

13.   You will receive the rebate instantly if you have not enabled the ‘Legacy HealthPoint Settlement’ (Refer Tyro Configuration in Bluechip 3.20.0 and Later). Reconciliation report is only available with the legacy settlement mode.

Same Day Claim Cancellation

Tyro HealthPoint allows you for same day claim cancellation if you want to reverse your sent Claim.

• You can only cancel on the same day of claiming. Cancelling the claiming will also reverse the receipt automatically. This requires the associated permission in BC Secure to delete the claim and reverse the receipt.
• To perform the same day claim cancellation, go to the Invoice window and click Tyro HealthPoint can take up to 55 seconds to cancel the Claim.

Processing Legacy HealthPoint Claims

Legacy HealthPoint Settlement is for non-consolidated settlement directly from health funds. Refer to Tyro Configuration in Bluechip 3.20.0 and Later to enable or disable the legacy mode.

• It is disabled by default as its usage is limited to very small proportion of pre-2015 merchants.
• Enabling this option means that you need to wait over 24 hours to receive the payment report and reconcile.
• Reconciliation report is only available with the legacy settlement mode.

When claims are invoiced within the patient’s account, the Claim transfers to the Tyro HealthPoint module. Click  located at the bottom right of the Bluechip main window and click HealthPoint Claims.

• You can now view claims associated with an individual practitioner or all practitioners.
• You can examine claims within a specific date range, and indicate to display finalised claims.
• When changes are made to these options, ensure you click the Refresh button or the Quick Refresh check box is selected to auto-refresh the display.
• Note that the Transmit button is enabled for legacy settlement mode only. With this type of settlement, you will need to wait at least 24 hours to retrieve the reconciliation report. However, the Transmit button is greyed out for consolidated settlement (which is enabled by default) as the rebate is paid at the time of claim submission within 4 seconds.

The status of claims determines the action required on the Claim. The following statuses will display once a claim has been sent to Tyro HealthPoint:

Claim Status	Description and Action
Awaiting Submission	Claim is waiting to be sent to Tyro HealthPoint. Click on the Transmit button.
Awaiting Processing Report	Waiting for the processing report for the Claim. It can take up to 2 business days to process. Click on the Transmit button to retrieve the process report.
Awaiting Payment Report	A claim has been successfully processed, however awaiting payment report
Receipted	When the Claim is paid and the user clicks Transmit, the claim status changes to ‘Receipted’ automatically without any need of further action.

 You can select the Claim and click Open to view HealthPoint Claim Summary with options to delete or manual receipt.