There are two types of integrated health fund reports: a claims reconciliation report and a payments reconciliation report. The claims reconciliation report provides a list of all claims processed for a given calendar day. The payments reconciliation report provides a report of payments made for approved claims that are settled by HealthPoint. Funds that are classified as non-consolidated by HealthPoint (currently only HCF) will not appear in these reports.
Please note that developing reporting features is optional, but recommended to ease provider financial reconciliation.
This example using jsFiddle shows how iClient can be used to access canned reports.
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.
// Claims Report for 21st September, 2024
iclient.healthpointReconciliationReport(
{
reportType: "claims",
reconDate: "20240921"
},
yourPosCode.reportCallback
);
The response body consists of the following XML elements (see table below for example):
| Response element name | Description |
|---|---|
| claims-reconciliation-response/claims-reconciliation | Contains report header elements |
| claims-reconciliation-response/claims-reconciliation/healthpoint-terminal-id | Terminal ID in the HealthPoint system (This value is different to the Tyro TID) |
| claims-reconciliation-response/claims-reconciliation/claim-date | Date (in yyyyMMdd format) of claims included in the report. Note date can differ from submission due to amendments |
| claims-reconciliation-response/claim | Contains details of a claim. |
| claims-reconciliation-response/claim/terminal-date-time | Timestamp (in yyyyMMddHHmmss format) when terminal submitted a claim |
| claims-reconciliation-response/claim/transaction-date-time | Timestamp (in yyyyMMddHHmmss format) claim was received by HealthPoint |
| claims-reconciliation-response/claim/response-date-time | Timestamp (in yyyyMMddHHmmss format) claim response was received by HealthPoint |
| claims-reconciliation-response/claim/settlement-date-time | Timestamp (in yyyyMMddHHmmss format) when settlement issued |
| claims-reconciliation-response/claim/provider-id | Provider who made the claim. |
| claims-reconciliation-response/claim/private-health-fund-id | Fund that processed the claim |
| claims-reconciliation-response/claim/ref-tag | Unique transaction reference, included on receipts |
| claims-reconciliation-response/claim/status | Status of the claim, as shown below |
| Status | Definition |
|---|---|
| NEW | Claim is approved but not yet settled. |
| CAN | Claim has been cancelled. |
| VOID | Claim rejected by user. |
| AVOID | Claim autovoided (reversed) due to system error. |
| PAY | Settled via HealthPoint consolidated settlement. |
| PRC | Required action processed (reversed). |
| TPY | Test Paid. Settled by fund directly. |
| EST | Rebate Estimate. Gap amount returned but not an approved claim. |
| Response element name | Description |
|---|---|
| claims-reconciliation-response/claim/total-claim-amount | Total claim amount in cents. |
| claims-reconciliation-response/claim/private-health-fund-total-benefit-amount | Benefit amount in cents. |
| claims-reconciliation-response/claim/private-health-fund-response-code | Response code from the fund, or 32 for adjustment, or 93 if no response from fund. |
| claims-reconciliation-response/claim/text | Any text entered when the claim was amended. |
| claims-reconciliation-response/check | Reconciliation data summary. Can be used to check that all expected claims have been received and processed. |
| claims-reconciliation-response/check/total-number-claims | Total number of claim elements. |
| claims-reconciliation-response/check/sum-benefit-amount | Sum of all benefit amounts, in cents. |
| claims-reconciliation-response/check/sum-claim-amount | Sum of all claim amounts, in cents. |
<claims-reconciliation-response>
<claims-reconciliation>
<healthpoint-terminal-id>TYR11111</healthpoint-terminal-id>
<claim-date>20240921</claim-date>
</claims-reconciliation>
<claim>
<terminal-date-time>20240921123455</terminal-date-time>
<settlement-date-time>20240921040000</settlement-date-time>
<response-date-time>20240921123455</response-date-time>
<transaction-date-time>20240921123455</transaction-date-time>
<provider-id>2147661H</provider-id>
<private-health-fund-id>PHF00999</private-health-fund-id>
<ref-tag>0000010</ref-tag>
<status>e.g. NEW, PAY, TPY (see table above)</status>
<total-claim-amount>10000</total-claim-amount>
<private-health-fund-total-benefit-amount>5000</private-health-fund-total-benefit-amount>
<private-health-fund-response-code>00</private-health-fund-response-code>
<text>any text entered when claim was amended</text>
</claim>
<claim>
<terminal-date-time>20240921123455</terminal-date-time>
<settlement-date-time>20240921040000</settlement-date-time>
<response-date-time>20240921123455</response-date-time>
<transaction-date-time>20240921123455</transaction-date-time>
<provider-id>2147661H</provider-id>
<private-health-fund-id>PHF00999</private-health-fund-id>
<ref-tag>0000011</ref-tag>
<status>e.g. NEW, PAY, TPY (see table above)</status>
<total-claim-amount>10000</total-claim-amount>
<private-health-fund-total-benefit-amount>5000</private-health-fund-total-benefit-amount>
<private-health-fund-response-code>00</private-health-fund-response-code>
<text>any text entered when claim was amended</text>
</claim>
<check>
<total-number-claims>2</total-number-claims>
<sum-benefit-amount>10000</sum-benefit-amount>
<sum-claim-amount>20000</sum-claim-amount>
</check>
</claims-reconciliation-response>
If the report is unavailable, a report unavailable response is returned:
<claims-reconciliation-response>
<claims-reconciliation>
<healthpoint-terminal-id>TYR11111</healthpoint-terminal-id>
<claim-date>20240921</claim-date>
</claims-reconciliation>
<unavailable>
<text>Report unavailable.</text>
<text>Please try again later.</text>
</unavailable>
</claims-reconciliation-response>
HealthPoint Payments Reconciliation Example
// Payments Report for 21st September, 2024
iclient.healthpointReconciliationReport(
{
reportType: "payments",
reconDate: "20240921"
},
yourPosCode.reportCallback
);
The response body consists of the following XML elements (see table below for example):
| Response element name | Description |
|---|---|
| payments-reconciliation-response/payments-reconciliation | Contains report header elements. |
| payments-reconciliation-response/payments-reconciliation/healthpoint-terminal-id | Terminal ID in the HealthPoint system (This value is different to the Tyro TID). |
| payments-reconciliation-response/payments-reconciliation/payment-date | Date that payment settlement instruction was sent |
| payments-reconciliation-response/payment | Contains details of a settlement payment |
| payments-reconciliation-response/payment/terminal-date-time | Timestamp (in yyyyMMddHHmmss format) when terminal submitted a claim |
| payments-reconciliation-response/payment/transaction-date-time | Timestamp (in yyyyMMddHHmmss format) claim was received by HealthPoint |
| payments-reconciliation-response/payment/response-date-time | Timestamp (in yyyyMMddHHmmss format) claim response was received by HealthPoint |
| payments-reconciliation-response/payment/settlement-date-time | Timestamp (in yyyyMMddHHmmss format) the payment submitted to a provider |
| payments-reconciliation-response/payment/provider-id | Provider who made the claim |
| payments-reconciliation-response/payment/private-health-fund-id | Fund that processed the claim |
| payments-reconciliation-response/payment/ref-tag | Unique transaction reference, included on receipts |
| payments-reconciliation-response/payment/total-claim-amount | Total claim amount in cents |
| payments-reconciliation-response/payment/private-health-fund-total-benefit-amount | Benefit amount in cents |
| payments-reconciliation-response/payment/private-health-fund-response-code | Response code from the fund, or 32 for adjustment from HealthPoint |
| payments-reconciliation-response/payment/payment-amount | Amount paid for the claim, in cents |
| payments-reconciliation-response/payment/text | Any text entered when the claim was amended |
| payments-reconciliation-response/payment/bsb | BSB number for settlement |
| payments-reconciliation-response/payment/account-number | Bank account number for settlement |
| payments-reconciliation-response/payment/payment-reference | Bank Lodgement Reference displayed on bank account statement |
| payments-reconciliation-response/check | Reconciliation summary data. Can be used to check that all expected claims have been received and processed. |
| payments-reconciliation-response/check/total-number-payments | Total number of payment elements |
| payments-reconciliation-response/check/sum-payment-amount | Sum of all payment amounts, in cents |
| payments-reconciliation-response/check/sum-claim-amount | Sum of all claim amounts, in cents |
<payments-reconciliation-response>
<payments-reconciliation>
<healthpoint-terminal-id>TYR11111</healthpoint-terminal-id>
<payment-date>20240921</payment-date>
</payments-reconciliation>
<payment>
<terminal-date-time>20240921123455</terminal-date-time>
<settlement-date-time>20240921040000</settlement-date-time>
<response-date-time>20240921123455</response-date-time>
<transaction-date-time>20240921123455</transaction-date-time>
<provider-id>2147661H</provider-id>
<private-health-fund-id>PHF00999</private-health-fund-id>
<ref-tag>0000010</ref-tag>
<total-claim-amount>10000</total-claim-amount>
<private-health-fund-total-benefit-amount>5000</private-health-fund-total-benefit-amount>
<private-health-fund-response-code>00</private-health-fund-response-code>
<payment-amount>5000</payment-amount>
<text>any text entered when claim was amended</text>
<bsb>069690</bsb>
<account-number>100001</account-number>
<payment-reference>your payment ref</payment-reference>
</payment>
<payment>
<terminal-date-time>20240921123455</terminal-date-time>
<settlement-date-time>20240921040000</settlement-date-time>
<response-date-time>20240921123455</response-date-time>
<transaction-date-time>20240921123455</transaction-date-time>
<provider-id>2147661H</provider-id>
<private-health-fund-id>PHF00999</private-health-fund-id>
<ref-tag>0000011</ref-tag>
<total-claim-amount>10000</total-claim-amount>
<private-health-fund-total-benefit-amount>5000</private-health-fund-total-benefit-amount>
<private-health-fund-response-code>00</private-health-fund-response-code>
<payment-amount>5000</payment-amount>
<text>any text entered when claim was amended</text>
<bsb>069690</bsb>
<account-number>100001</account-number>
<payment-reference>your payment ref</payment-reference>
</payment>
<check>
<total-number-payments>2</total-number-payments>
<sum-payment-amount>10000</sum-payment-amount>
<sum-claim-amount>20000</sum-claim-amount>
</check>
</payments-reconciliation-response>
If the report is unavailable, a report unavailable response is returned:
<payments-reconciliation-response>
<payments-reconciliation>
<healthpoint-terminal-id>TYR11111</healthpoint-terminal-id>
<payment-date>20240921</payment-date>
</payments-reconciliation>
<unavailable>
<text>Report unavailable.</text>
<text>Please try again later.</text>
</unavailable>
</payments-reconciliation-response>