The Health Fund rebate estimate, sometimes known as a quote, allows providers and patients to retrieve an estimate of the gap amount for a HealthPoint claim. It functions in very much the same way as a HealthPoint claim, but without financial settlement.
The process is similar to a claim:
- Enter and review health service details in the PMS.
- Swipe or tap patient's Health Fund membership card.
- Enter patient number if not already sent by PMS.
- Process rebate estimate and receive real-time response from Health Fund.
- Print claim assessment receipt and display result in PMS.
There is no need for a patient to Accept or Decline a rebate estimate. And there is no ability to Void or Cancel a Rebate Estimate.
It's important to note that a Rebate Estimate is a point in time assessment and there is no guarantee that the Health Fund will honour the assessment beyond the day for which it was processed. Further, during periods of high transaction volume at a Health Fund, a Rebate Estimate transaction may be queued longer than a claim. During this queuing period, it may not be possible to rapidly submit a Rebate Estimate followed immediately by a claim - the claim transaction may be declined, so you may need to wait.
initiateHealthPointRebateEstimate(requestParams, transactionCallbacks) - Tell the terminal to start a HealthPoint Rebate Estimate.
The request parameters are the same as for initiateHealthPointClaim and include:
| Request Parameters | Type | Description |
|---|---|---|
| claimItems | String | JSON array of claim items (max 16) |
| claimItemsCount | int | Total number of claim items |
| mid | Integer | Optional - Required for headless pairing, multi-merchant, or if your browser does not support local storage |
| tid | Integer | Optional - Required for headless pairing, multi-merchant, or if your browser does not support local storage |
| integrationKey | String | Use if your browser does not support local storage, headless pairing or multi-merchant as a feature |
| providerId | String | 8-character provider number (usually Medicare issued) |
| serviceType | String | 1-character category of service. See table below |
| totalClaimAmount | Int | The total amount of all claim items in cents |
| transactionid | String | Optional - Supply a custom transaction ID |
| transactionCompleteCallback | Function | Invoked when the transaction has been completed on the terminal |
| statusMessageCallback* | Function | Invoked to advertise what is happening on terminal, which is typically facing the customer rather than the merchant |
| questionCallback* | Function | Invoked when the terminal requires the merchant to answer a question in order to proceed with the transaction |
| Claim parameter | Type | Description |
|---|---|---|
| serviceReference | String | clinical reference or tooth number suffix. See reference below. (max 3 chars) |
| claimAmount | int | Claim amount in cents (max 10 digits) |
| serviceDate | String | Claim date (YYYYMMDD format) |
| description | String | Item description for receipt (max 32 chars) |
| serviceCode | String | Item number or service code (max 5 chars) |
| patientId | String | Patient identifier (exactly 2 digits) |
iclientWithUI.initiateHealthPointRebateEstimate({
providerId: "2147661H",
serviceType: "D",
claimItemsCount: "2",
totalClaimAmount: "25000",
claimItems: [
{
"claimAmount": "10000",
"serviceCode": "00001",
"description": "SKULL XRAY",
"serviceReference": "01",
"patientId": "02",
"serviceDate": "20191209"
}, {
"claimAmount": "15000",
"serviceCode": "00001",
"description": "SKULL XRAY",
"serviceReference": "01",
"patientId": "02",
"serviceDate": "20191209" }
]},
{transactionCompleteCallback: yourPosCode.handleComplete,
statusMessageCallback: yourPosCode.handleComplete,
questionCallback: yourPosCode.questionAsked });Callback functions for Rebate Estimates are the same as with claims (initiateHealthPointClaim). However, there are no questions to handle the patient Accept or Decline as in a claim transaction.
Rebate Estimates responses the same as in claims. Although a healthpointSettlementDateTime may be shown, a Rebate Estimate will not invoke a financial settlement to the provider.
{
"result": "APPROVED",
"transactionId": "55083fb77c7e6d455b68ec9bc9e3732dfcaa",
"healthpointRefTag": "2257825",
"healthpointTotalBenefitAmount": "25000",
"healthpointSettlementDateTime": "20191209064416",
"healthpointTerminalDateTime": "20191209064416",
"healthpointMemberNumber": "0000000000",
"healthpointProviderId": "2147661H",
"healthpointServiceType": "D",
"healthpointClaimItems": [
{
"claimAmount": "10000",
"serviceCode": "00001",
"description": "SKULL XRAY",
"serviceReference": "01",
"patientId": "02",
"serviceDate": "20191209"
},
{
"claimAmount": "15000",
"serviceCode": "00001",
"description": "SKULL XRAY",
"serviceReference": "01",
"patientId": "02",
"serviceDate": "20191209"
}
],
"healthpointGapAmount": "0",
"healthpointPhfResponseCode": "00",
"healthpointPhfResponseCodeDescription": "APPROVED",
"healthpointHealthFundName": "ISOFT FUND",
"healthpointHealthFundIdentifyingDigits": "0099"
}JS Fiddle - Please don't click on the Save button if you make any changes in the JS Fiddle sample app. Instead, please press run if you have made any changes. If you click save, it may break sample functionality.