Private health insurance is life-changing for patients in Caringbah. With this type of health policy or contract, you pay a monthly premium, which allows you to get private medical care and access to health programs that would otherwise be way out of budget. These policies are a huge help in skipping long queues when seeking medical care and can make many treatments and medications much easier to afford.
The only issue with these programs – the claiming process. Collecting receipts, submitting paperwork, and waiting a long time for reimbursement can be a hassle – one that can put you in quite a pickle if you are already financially strained.
Fortunately, this lengthy process is coming to an end. HICAPS systems are now making health insurance claims easier than ever. Let’s take a look at what these systems are and how you can also benefit from them.
What is HISCAPS?
The Health Industry Claims and Payments Service (HISCAPS) is a type of system that automates and streamlines healthcare claims and payment processes. The systems are widely used all over Australia and here in Caringbah.
HISCAPS main function is to connect healthcare providers directly with health insurance firms. This makes it possible for healthcare providers to process payments more quickly – perhaps even instantly.
The biggest benefit that HISCAPS offer – It eliminates many of those upfront payments. Instead of paying out of pocket and claiming later, your health insurance provider allocates the payments immediately and directly from the medical provider.
HISCAPS also assists with all medical-related claims, including those made by dental clinics, physiotherapists, chiropractors, osteopaths, podiatrists, optometrists, massage therapists, psychologists, and general practitioners.
How On-The-Spot Health Fund Claiming Works
The first thing you need to do is find a healthcare provider that offers HICAPS claiming services. Shire Doctors and Dentists is a prime example. Our allied health clinic – and all medical practitioners functioning within our group – fully support and use this system.
To benefit from HISCAPS, all you need to do is book an appointment and visit one of our healthcare providers. After treatment – and before making payment – provide us with your health insurance card or digital membership details. The information will be entered into the HISCAPS terminal for claiming.
The system automatically contacts health insurance firms. This software will confirm your membership status, access available extras cover, identify your benefit limits, and determine your eligibility to claim for certain treatments. The system also calculates the benefit amount that the health insurance provider covers.
Private health insurance funds often cover only part of the treatment. If there is a gap between the balance paid by your health insurance and your medical bill, you will need to cover the gap yourself.
All of this occurs within just a few minutes. Before you leave the dental office, you will usually know the exact cost of your treatments, the amount covered by your insurance, and the exact difference between what is covered and what is charged.
Does Your Health Insurance Work With HICAPS?
The chances that your medical insurance uses HICAPS are pretty good. Most major private medical insurance funds do use these systems. The payouts might, however, be affected by certain aspects like the following;
Limits – Health insurance does have limits for doctor appointments and medications. Once reached, they won’t continue paying.
Waiting Time – Some health insurance companies take longer to allocate payments.
Included Treatments – Not all health insurance companies will cover all health issues and treatments.
If your annual limit is reached, the membership has expired, or the treatment or medication isn’t covered under your policy, your private health insurance will decline the payment request. In this case, patients will need to contact the health fund themselves.
How Patients Can Reduce Upfront Costs
HICAPS can be a wonderful solution if you want to avoid those out-of-pocket costs. Yet you will need to use it – and your health insurance – wisely to get the most out of your policy. Here are some practical tips to cut back on those upfront payments.
- Use healthcare providers that support HICAPS.
- Ensure that your health insurance works with HICAPS.
- Bring your current health fund card along.
- Check extras before the appointment – not all treatments are covered.
- Understand your insurance policy limits for each treatment that is covered.
- Ask about gap payments before booking your appointment.
Book Now at Our HICAPS-Approved Allied Health Clinic
Getting an unexpected upfront payment can be tough, especially if you are already spending a lot on medical insurance. The best way to avoid these unpleasant situations is by pairing up with an allied health clinic that fully uses and supports HICAPS. At Shire Doctors and Dentists, all of our medical professionals use this modern claiming solution so our patients can get the needed care more comfortably.
Contact Shire Doctors and Dentists now for any dental, medical, physio, or psychological treatments and enjoy instant claiming processes.