Health Fund Rebate Estimate

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. You may need to wait

Health Fund Rebate Estimate Implementation

initiateHealthPointRebateEstimate(requestParams, transactionCallbacks) - Tell the terminal to start a HealthPoint Rebate Estimate.

Request Parameters

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

claimItems Table

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)

Request Example

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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 });

transactionCallbacks

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 Estimate Response

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.

Response Example

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{
    "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"
}

HealthPoint Renate Estimate Demo

Demo - JS Fiddle

JS Fiddle

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