Before you start
Processing a HealthPoint claim online using Tyro Health Online allows your patients to instantly claim their health fund benefit and only pay the gap. Online claims submit directly to HealthPoint without the need for a physical EFTPOS terminal. Swiping a physical health fund card is not required, instead, the approval request is sent to the patient's mobile device to be approved and finalised.
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 (THOP) - enabling businesses to process Visa and MasterCard debit and credit card payments, all within the same online claim workflow. Read more about setting up THOP.
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.
Entering this information is optional. If you do not enter this information, the patient will be required to enter this detail themselves directly once they receive the payment request.
For certain funds, you may be required to enter card issue number or card issue date details. Click here to learn more about how locate these details.
Next, select the location and provider for this invoice.
Finally, 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 claim (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 patient record in Tyro Health Online.
Once the payment request is viewed by the patient on their device, it must be approved by the patient from your location within 15 minutes, or the transaction may be cancelled.
2. Process any gap payment
Follow our step-by-step guide on processing the gap using Tyro Health Online Payments. 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.