Before you start...
Setting up the HICAPS Digital Claims integration is essential prior to processing any payments or claims for WorkSafe Victoria via HICAPS Digital Claims.
Adding Claimable Services and Classes
Once HICAPS Digital Claims is integrated with Nookal, Services, Classes, Inventory and Passes must be set as Claimable.
1. Go to Setup > Items > Services.
2. Click on the Service to open the details page.
3. In the Integrations section, tick the “Is Claimable” box next to HICAPS.
Important!
Enable Integrations needs to be ticked before the item can be used for claiming with HICAPS Digital Claims.
4. Click Save Changes.
5. Repeat for all Claimable Services, Classes, Inventory and Passes as required.
6. Once the items are set as Claimable, go back to Setup > Connections > Integrations > HICAPS Digital Claims > Configure.
7. Click on the WorkSafe Victoria tab.
8. Add the specific Code for each item Claimable with WorkSafe Victoria.
9. Once all the codes are added, click Save Custom Codes.
Submitting WorkSafe Victoria Claims
1. In the Diary, open the booking and click Generate Invoice.
2. Edit or add items if required and click on Pay Via and then HICAPS.
3. Select WorkSafe Victoria.
4. Click Setup to expand the section in which some required WorkSafe Victoria claiming details will be pre-filled from information in Nookal.
5. Enter or edit the Patient Membership No. Please note, that this will only need to be entered manually for each client's first Claim. These details will then be saved for all future Claims.
6. Select the Treating Provider Discipline.
7. Select the Referrer. The Referrer list is pulled in from the Cases > Payer > Referral section and the Cases > Referral section. For more information see Setting up Third-Party Payers.
Please note, that the Referrer must have a provider number to be listed.
Hot Tip
There are 17 modalities now available for digital claiming.
Out of the 14 new modalities the requirement for providing an invoice with a 'Referring Provider' will apply to the following:
Acupuncture, Dietetics, Exercise physiology, Counselling, Naturopath, Occupational Therapist, Psychologist, Remedial massage, Social worker, and Speech Therapy.
Claims can still be submitted without the referral details.
However, please note that such claims will be placed in a pending queue, which will result in longer processing times for adjudication and payment.
Information about which services are billable with online invoicing, along with helpful troubleshooting advice can be located at Services billable via online invoicing | WorkSafe Victoria.
8. Select the Provider No. Type.
Important!
Providers can have one or more Provider Numbers registered with their WSV account.
Depending on the Modality the Provider Number can be allocated by Medicare, &/or WSV, &/or Medibank.
9. Select the Treating Provider.
10. Select the Code Entity.
Hot Tip
Click Validate to check that the information entered is accurate before submitting the Claim.
11. Double check the correct items for claiming have been selected, and click Pay with HICAPS.
12. The invoice will be submitted, and the status will be set as Pending. Any action related to the Claim can be seen in the History tab on the invoice. The paid amount will automatically be added to the invoice once WorkSafe Victoria has processed the Claim.
Hot Tip
As part of the most recent update, WSV have included more items that require unique descriptions. To avoid rejected claims due to incorrect descriptions, please see the WorkSafe Victoria website for a list of Services Billable and their respective descriptions.
Same Day Claim Cancellation
Same day cancellations of claims is possible up until 5pm AEDT. To cancel a claim:
1. Open the invoice and click on Pay Via and then HICAPS.
2. Open the History tab, and click Cancel.
3. Enter a Reason for cancellation and click Cancel.
Discover more...
View a list of submitted claims and their statuses using the HICAPS Report via Reports > Financials > HICAPS.
Click here for more information on how to use the HICAPS Report.