HICAPS Connect

Introduction

HICAPS is an electronic health claims and payments system, which offers members of participating health funds the convenience of automatic claims processing in the practice.

This user guide explains the steps and requirements in preparing you and your practice to configure and use the latest and newest version of HICAPS called HICAPS Connect via EXACT. HICAPS Connect is a new software version introduced by HICAPS in 2009 which incorporates the normal Health Fund processing.

A new interface program called HicapsConnect.exe operates as an intermediate program which reads and writes claim information from EXACT and transmits it to the terminal for processing.

NOTE: This user guide does not provide details of how to use your HICAPS terminal. Please refer to the 'Terminal Operations Guide' provided with the terminal or contact HICAPS for further information about your terminal's functions and operation.

Information transfer between EXACT and HICAPS Connect

Below is a representative diagram showing the transfer of information between EXACT and HICAPS Connect:

1. A patient is billed in EXACT.
2. The patient's Health Fund membership card is swiped through the HICAPS terminal.
3. The patient's claim information is sent to the HICAPS Connect program which then transmits the claim information to HICAPS via the Terminal.
4. HICAPS processes the claim and sends back the approved claim information to the HicapsConnect.exe program via the Terminal.
5. If there is a difference between what was claimed and what was approved (the 'gap amount'), the patient pays the difference. If the 'EFTPOS' option of HICAPS Connect has been enabled, the patient then has the option of paying the gap amount via a debit or credit card.
6. Depending on what settings have been enabled, a HICAPS transaction statement is printed on the HICAPS terminal, or on the terminal and the printer attached to EXACT.

Prerequisites

Before using HICAPS Connect in EXACT, the following prerequisites must be met:

1. Practices are required to sign up with HICAPS to obtain the latest Terminal Software and Hardware.
   This is usually supplied to you on a CD provided by Software of Excellence.
2. Ensure the latest Terminal Software Version is at least HICT42.H4A.

   To update the software version, please contact Software of Excellence for assistance.

3. The EXACT software must be at least Version 10.11. For correct operation, please contact Software of Excellence to ensure your installed version includes the latest updates for HICAPS.

   A CD is available from SOE Support which contains everything required for ensuring your software is up to date and for installing HICAPS Connect.

To obtain Help with HICAPS

Help is available as follows:

Installation and Configuration of HICAPS Connect for EXACT:
Software of Excellence Australia
Main: 03 9873 1133
Fax: 03 9873 1033
Support: 1800 147 537
Email: support@soeidental.com

Help with HICAPS:
Ground Floor
151 Rathdowne Street
Carlton, VIC 3053
HelpDesk: 1300 650 852