Make sure that you have connected Medipass for HICAPS before reading this help guide.

If you have already connected Medipass, then you are ready to process health insurance claims for your clients using HICAPS 🎉

This help guide will cover:

  • How to set up card payments so clients can pay a gap

  • How to set up private health insurance details for a client

  • How to set up up item codes correctly in services settings

  • How to create an appointment that can be claimed

  • How to initiate a HICAPS claim for a client

  • How your clients can make a claim and instantly receive the health fund benefit

  • How clients can pay the gap payment in the same transaction

  • Reviewing the HICAPS claim status after a claim has been submitted

  • How Splose automatically allocates the payment after the rebate and payment is completed from Medipass

  • Viewing the HICAPS claim details in Medipass

Connect to Medipass

In order to process health insurance claims for clients in Splose, you'll want to make sure that you have created a Medipass account and connected it to Splose.

Set up Medipass card payments

If you'd like clients to be able to pay a gap payment after making a claim with HICAPS all in one transaction, you will need to enable Medipass card payments. With this enabled, you can complete the entire transaction for clients without a terminal.

Add private health insurance details for a client

To pass a client's private health insurance details to Medipass, and save you from having to enter their details each time you need to process a claim for a client, you must enter the fund details from the client details page.

You can search from the list of Australian health funds.

Set up item codes correctly in services settings

In order to pass the correct service information to Medipass, you'll want to make sure your services have correct item codes in order to process a HICAPS claim.

In Settings, then Services, select a service and under actions, click the three dots to edit a service.

Check that you have the correct item code, then click Save.

You can also search item codes in Medipass in Services or while creating an invoice.

Initiate a HICAPS claim for a client

You must create an appointment and add the appointment to a case. You can see if an appointment is attached to a case by viewing the appointment from the appointment details side modal or the cases page.

Ensure that your provider number should be set up correctly and connected to Medipass. Click + Invoice from the appointment modal.

Thanks to our auto-saving invoice feature, all you need to do is click View invoice.

Here, you just need to select Add payment to bring up the payment modal.

Rather than allocate a payment, you will need to click the HICAPS claim + link next to the HICAPS logo.

The Medipass screen will be displayed and pre-fill available details from Splose for the claim, such as location, practice, provider information, referral information and client information.

All you have to do is review the information and then click Continue to payment.

📝 Note: It's not recommended to make any changes to the service here so that the invoice remains synced with Splose.

The Medidpass screen will be updated, showing that the transaction is now waiting for the client to approve the request.

How your clients can make a claim and instantly receive the health fund benefit

Your client will receive an SMS with a link to approve the HICAPS claim. The client will need to allow location services (if requested).

Upon clicking Continue, your client will then be moved to the payment request screen.

The client can choose to pay with Google Pay, Apple Pay, credit card or in person.

If the client completes the payment, the Medipass screen and payment modal will be closed and the invoice will be marked as paid, allocating the benefit payment and remaining payment as a new payment reference.

Your client will receive the following message and have the option to send a receipt to themselves.

Review the Medicare claim status after submitting a claim

If the client makes a claim and pays the gap payment, the Medipass screen will be closed down and a HICAPS status card will be displayed on the invoice.

You can click on the payment link to view the payment created.

View the HICAPS claim details in Medipass

You can open the transaction in Medipass form the Medicare status card to see the invoice overview.

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