💡 Top tip: You can also submit claims for multiple family members in one go.
How do I send an electronic health fund claim?
To send a claim, you must first have created an invoice via completing a treatment.
Navigate to the patient's 'Account' tab.
Click the 'New claim' button (which starts an electronic claim by default), or click the dropdown arrow to the right of it and select 'Electronic'.
In the claim builder window that opens - all applicable items will be ticked as default, but you can untick the items you don't want to send as part of this submission.
💡 Top tip: You can select treatment items from more than one practitioner within the same claim.
You can also select your preferred terminal for the claim to go through.
Check a health fund provider is assigned and that the health fund patient ID is correct, and click 'Send'.
You will then be prompted to swipe the patient's health fund card on the terminal.
This may take a moment to process, but once the claim has been successful, the information will come straight through to Dentally.
You will then be presented with a summary of information about the claim. You can click the arrow to expand the summary for additional details - this is useful if any claim fails.
Click 'Finish' to complete the claim process.
A payment line will then appear on the patient's 'Account' tab displaying the amount covered by the claim and this will automatically be deducted from the total balance.
The remaining balance is what you will then need to charge the patient.
How do I save a manual health fund claim?
To send a claim, you must first have created an invoice via completing a treatment.
Manually enter and process the claim directly on the HICAPS terminal.
Next, navigate to the patient's 'Account' tab.
Click the dropdown arrow to the right of the 'New claim' button, and select 'Manual'.
In the claim builder window that opens, tick the items you want to send as part of this submission.
📝 Please note: Only one provider or fee schedule can be sent on a single claim. Once you begin ticking procedure codes, any other codes with different providers/fee schedules will be greyed out.
Enter in the rebate amounts that have been covered in the 'Rebate Amount' column, based on the already completed claim from the terminal.
Click 'Save'.
A payment line will then appear on the patient's 'Account' tab displaying the amount covered by the claim and this will automatically be deducted from the total balance.
The remaining balance is what you will then need to charge the patient.
How do I view a health fund claim?
In the patient's 'Account' tab, find the invoice associated with the claim.
Click the dropdown arrow to the left of the invoice to see the associated claim.
Click the hyperlinked blue 'Claim ↗️' button. This will open the claim.
You will now see the details of the claim, including the provider, status, date and type, as well as the description and amount.
You can also view it in the 'Claims' tab within the patient record.
What can I do if I am having difficulties sending an electronic health fund claim?
If you are having trouble using electronic claims, we recommend ensuring you have set up the following first before contacting us for further investigation.
Check you have set up the terminal provider
You must have your card terminal provider set for claims to successfully send to your terminal. Go to 'Settings' > 'Sites' > 'Payments', select your terminal provider, and remember to hit 'Save'.
If you are having trouble with HICAPS disconnecting, try the following:
Troubleshoot your own wifi in the practice.
Ensure you can reload the Dentally app on Chrome. If not, please check the status page here.
Contact HICAPS. If other options have been ruled out, the issue likely lies with HICAPS themselves. When we notice an issue with HICAPS directly, we will always try to let you know via in-app communications.
If a claim fails, when viewing the claim summary you can click the arrow to expand the summary for additional details - you can then share these details if you need to contact support.