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Process a HealthPoint online claim
Process a HealthPoint online claim

How to submit a HealthPoint claim and process a gap payment online using Tyro Health Online

Nick avatar
Written by Nick
Updated over a week ago

Before you start

Processing a HealthPoint claim online using Tyro Health Online allows your patients to instantly claim their health fund benefit and just pay the gap. Online claims submit directly to HealthPoint without a physical EFTPOS terminal - send an approval request to the patient's mobile phone (via SMS), swiping a physical health fund card is not required.

In order to process a gap payment for a private health insurance online claim, a business is required to have set up Tyro Health Online Payments - enable businesses to process Visa and MasterCard debit and credit card payments, all within the same online claim workflow. Read more about setting up MCP.

HealthPoint claims can also be submitted to HealthPoint using a connected Tyro terminal, where the request is sent from Tyro Health Online or an integrated PMS - using a Tyro EFTPOS terminal requires the patient to tap or swipe their health fund card.

Making the selection between an 'online' or 'terminal' claim is done after selecting the transaction type and entering patient/claimant details and item codes (see 1C below).

1. Enter the claim information in Tyro Health Online

A) Get started and select the transaction type

  • Click the "Get Paid" tab, then the "Private Health Insurance" tile (select the "Tyro HealthPoint" tab if you have more than one claiming integration set up).

  • Select the transaction type and choose whether you want to submit a claim or rebate estimate (quote).

B) Enter the patient/claimant details and item codes

  • Search for a saved patient or enter their details by clicking 'Add new patient' if you haven't created an invoice for this patient before (optional).

  • Afterwards, select the location and provider for this invoice.

  • Next select the item code (check out HealthPoint Modality Item Codes) and enter the price for the consultation.

ICD-10 item codes (e.g. HCF 'More For') are now supported and require a second claim item code (ICD-10) under the 'Service reference' section.

C) Choose patient approval method and submit

There are two ways to submit a private health insurance claims (via HealthPoint) and each option involves a different way for patients to approve the claim. Find out more about the different ways claims can be submitted.

  • Select “approval via SMS” to submit a digital claim.

  • Click "submit" to send the SMS to your patient using the mobile phone number entered or saved under their record in Tyro Health Online.

When the claim is run (after patient confirms their member details), it must be approved/declined by the patient from your location within 15 minutes, or the transaction will be cancelled.

2. Process any gap payment

Once you have set up MCP, you can follow our step-by-step guide on processing the gap using MCP. Alternatively, if you're comfortable enabling your patients to not pay the gap via Tyro Health Online, and you will manage gap payments directly, you can enable ‘Pay in Person'.

If you have any questions, click on the pink chat bubble on our website or email our Customer Support team.

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