ICDM codes for HCF to allow Tyro / HiCAPS claiming

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Currently, HCF provide a full rebate on an initial consultation where the ICD code is included in the claim.
As a physio, we have no where to include this code in the claim without making an item code for each of them with nil fee and adding it to the invoice. This still does not allow the client to claim through Tyro or HICAPS however. I noticed that some professions have to enter a clinical code which is available in Frontdesk already. Can this function be utilised to allow patients to claim the rebate via Tyro or Hicaps rather than pay fully for the consult and then go to HCF to claim it back??
I know I spoke with someone in support a while ago regarding this, but saw the clinical codes and wondered if it was a viable solution.
Alternatively, can we get a system whereby this code can be added please.
Cheers,Dave
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david donkin

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Posted 4 years ago

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Joyaa Antares

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Hi Dave,
Two questions, if I may ...
1. We are finding that HCF no longer always provide a full rebate. E.g a case this week with a trigger finger (HFC/ICD code M653). Are you noticing any problems like this?
2. We don't have our HICAPS fully integrated with FD, but "swish" the cards through separately - so we swish the HCF card using the gazetted fee ($80 here in Qld), then "add" the code 9980, then are prompted to enter the ICD code, M545 etc. Is this how you do things? If not, would this be a work-around for you?
Rgds, Joyaa
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david donkin

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Hi Joyaa,
Thanks for your reply.
We aren't finding any similar problems re rebates yet, but HCF did send out some guff about a month ago saying that they are now not supporting the 100% rebate on all their levels of cover. Obviously it was a short-term idea for them! Or more popular than the actuaries figured it would be.
We are using tyro which is fully integrated so don't have any manual entering abilities ta, but our old hicaps machine did allow the manual entry too
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Joyaa Antares

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Thanks Dave.
Re. point 1. -- I am finding HCF's change in policy a little annoying, because we knock down our initial fee to the gazetted $80 HCF want us to charge, ..., then we can find the session wasn't covered by their program after all (although typically it attracts the "normal" HCF cover under the client's policy). So then we have to explain to the client that we need to charge them the normal fee ($103 for an adult new client) as HCF didn't cover them fully, which I think rather makes us look like we are scamming, and doesn't warm the client to HCF either. ... I think I need to feed this back to HCF. What we actually need is a list of what is still covered under the "More for (Backs etc)" program, rather than a list of "Maybe's".
Regards, Joyaa
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Andrew, Community Manager

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Official Response
Hi David

The 'Clinical Codes' you found are for Dentists, Occupational Therapists and Psychologists use only, and unfortunately won't help you with submitting ICDM codes.

The main reason this can't be done is because the 'HICAPS Connect' software itself, which manages the connection between your HICAPS terminal and the PC doesn't currently support the use of ICD-10-AM codes. Once it does support the use of these codes we can also add support in Front Desk, but until it does there is nothing we can do.

From our discussions with HICAPS they do plan to add this functionality sometime in the future. Tyro are also working with HCF to provide an interface for these claims to be submitted.

As Joyaa has mentioned above it is possible to claim these codes manually on the terminals, but not through the integration.
(Edited)