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Health Reports and Reconciliation

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 by funds that are settled by DXC. Funds that are classified as non consolidated by DXC will not appear in these reports please click the link to view consolidated and non consolidated funds (DXC HP Health Funds by Modality).

Please note, developing this feature is optional.

Claims Reconciliation Report

  • IReport HealthpointClaimsReconciliationReport(string date).
  • IReport HealthpointClaimsReconciliationReport(string merchantID, string terminalID, string date).
Parameter NameDescriptionValid Values
dateThe date of the report.Format: yyyyMMdd
merchantIdAllows the PMS to pass in the desired Merchant ID for the gap payment (part of multi-merchant support).The Tyro Merchant ID.
terminalIdAllows the PMS to pass in the desired Terminal ID for the gap payment (part of multi-merchant support).The Tyro Terminal ID.

The response body consists of the following XML elements (see table below for example):

Response Element NameDescription
claims-reconciliation-response/claims-reconciliationContains report header elements
claims-reconciliation-response/claims-reconciliation/healthpoint-terminal-idTerminal id in the DXC system (This value is different from the Tyro TID)
claims-reconciliation-response/claims-reconciliation/claim-dateDate of the claims included in the report (Note that amended claims may be included from a different date if the amendment took place on this date). Value is in yyyyMMdd format.
claims-reconciliation-response/claimContains details of a claim
claims-reconciliation-response/claim/terminal-date-timeLocal time on the terminal when the claim was submitted. Value is in yyyyMMddHHmmss format.
claims-reconciliation-response/claim/transaction-date-timeTime that the claim was received by the DXC Claim Server. Value is in yyyyMMddHHmmss format.
claims-reconciliation-response/claim/response-date-timeTime that the claim response was received by the DXC Claim Server. Value is in yyyyMMddHHmmss format.
claims-reconciliation-response/claim/settlement-date-timeTime that the payment instruction is expected to be sent to DXC’s bank for execution. Value is in yyyyMMddHHmmss format.
claims-reconciliation-response/claim/provider-idProvider who made the claim
claims-reconciliation-response/claim/private-health-fund-idFund that processed the claim
claims-reconciliation-response/claim/ref-tagThe reference tag generated by the terminal that identifies a transaction per terminal.
claims-reconciliation-response/claim/statusStatus of the claim:
StatusDefinition
NEWClaim is approved but not yet settled.
CANClaim has been cancelled.
VOIDClaim rejected by user.
AVOIDClaim autovoided (reversed) due to system error.
PAYSettled via DXC consolidated settlement.
PRCRequired action processed (reversed).
TPYTest Paid. Settled by fund directly.
Response Element NameDescription
claims-reconciliation-response/claim/total-claim-amountTotal claim amount in cents
claims-reconciliation-response/claim/private-health-fund-total-benefit-amountBenefit amount in cents
claims-reconciliation-response/claim/private-health-fund-response-codeResponse code from the fund, or 32 for adjustment via CSS, or 93 if no response from fund.
claims-reconciliation-response/claim/textAny text entered when the claim was amended
claims-reconciliation-response/checkContains a summary of the reconciliation data. Can be used to check that all expected claims have been received and processed.
claims-reconciliation-response/check/total-number-claimsTotal number of claim elements
claims-reconciliation-response/check/sum-benefit-amountSum of all benefit amounts, in cents
claims-reconciliation-response/check/sum-claim-amountSum of all claim amounts, in cents

Example:

Example claims reconciliation report response XML

<claims-reconciliation-response>
 <claims-reconciliation>
 <healthpoint-terminal-id>TYR11111</healthpoint-terminal-id>
 <claim-date>20131106</claim-date>
 </claims-reconciliation>
 <claim>
 <terminal-date-time>20120401123455</terminal-date-time>
 <settlement-date-time>20120402040000</settlement-date-time>
 <response-date-time>20120401123455</response-date-time>
 <transaction-date-time>20120401123455</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>20120401123455</terminal-date-time>
 <settlement-date-time>20120402040000</settlement-date-time>
 <response-date-time>20120401123455</response-date-time>
 <transaction-date-time>20120401123455</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>

:::info If the report is unavailable, a report unavailable response is returned. :::

Report Unavailable Response Body

<claims-reconciliation-response>
 <claims-reconciliation>
 <healthpoint-terminal-id>TYR11111</healthpoint-terminal-id>
 <claim-date>20120601</claim-date>
 </claims-reconciliation>
 <unavailable>
 <text>Report unavailable.</text>
 <text>Please try again later.</text>
 </unavailable>
</claims-reconciliation-response>

Payments Reconciliation Report

  • IReport HealthpointPaymentsReconciliationReport(string date)
  • IReport HealthpointPaymentsReconciliationReport(string merchantID, string terminalID, string date)
Parameter NameDescriptionValid Values
dateThe date of the reportFormat: yyyyMMdd
merchantIdAllows the PMS to pass in the desired Merchant ID for the gap payment (part of multi-merchant support).The Tyro Merchant ID.
terminalIdAllows the PMS to pass in the desired Terminal ID for the gap payment (part of multi-merchant support).The Tyro Terminal ID.

The response body consists of the following XML elements (see table below for example):

Response Element NameDescription
payments-reconciliation-response/payments-reconciliationContains report header elements
payments-reconciliation-response/payments-reconciliation/healthpoint-terminal-idTerminal id in the DXC system (This value is different from the Tyro TID)
payments-reconciliation-response/payments-reconciliation/payment-dateDate that the payment instructions were sent to the bank. Value is in yyyyMMdd format.
payments-reconciliation-response/paymentContains details of a claim
payments-reconciliation-response/payment/terminal-date-timeLocal time on the terminal when the claim was submitted. Value is in yyyyMMddHHmmss format.
payments-reconciliation-response/payment/transaction-date-timeTime that the claim was received by the DXC Claim Server. Value is in yyyyMMddHHmmss format.
payments-reconciliation-response/payment/response-date-timeTime that the claim response was received by the DXC Claim Server. Value is in yyyyMMddHHmmss format.
payments-reconciliation-response/payment/settlement-date-timeTime that the payment instruction is expected to be sent to DXC’s bank for execution. Value is in yyyyMMddHHmmss format.
payments-reconciliation-response/payment/provider-idProvider who made the claim
payments-reconciliation-response/payment/private-health-fund-idFund that processed the claim
payments-reconciliation-response/payment/ref-tagThe reference tag generated by the terminal that identifies a transaction per terminal.
payments-reconciliation-response/payment/total-claim-amountTotal claim amount in cents
payments-reconciliation-response/payment/private-health-fund-total-benefit-amountBenefit amount in cents
payments-reconciliation-response/payment/private-health-fund-response-codeResponse code from the fund, or 32 for adjustment via CSS.
payments-reconciliation-response/payment/payment-amountAmount paid for the claim, in cents
payments-reconciliation-response/payment/textAny text entered when the claim was amended
payments-reconciliation-response/payment/bsbBSB number
payments-reconciliation-response/payment/account-numberBank account number
payments-reconciliation-response/payment/payment-referenceReference displayed on bank account statement
payments-reconciliation-response/checkContains a summary of the reconciliation data. Can be used to check that all expected claims have been received and processed.
payments-reconciliation-response/check/total-number-paymentsTotal number of payment elements
payments-reconciliation-response/check/sum-payment-amountSum of all payment amounts, in cents
payments-reconciliation-response/check/sum-claim-amountSum of all claim amounts, in cents

Example payments

<payments-reconciliation-response>
 <payments-reconciliation>
 <healthpoint-terminal-id>TYR11111</healthpoint-terminal-id>
 <payment-date>20131106</payment-date>
 </payments-reconciliation>
 <payment>
 <terminal-date-time>20120402123455</terminal-date-time>
 <settlement-date-time>20120403040000</settlement-date-time>
 <response-date-time>20120402123455</response-date-time>
 <transaction-date-time>20120402123455</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>20120402123455</terminal-date-time>
 <settlement-date-time>20120403040000</settlement-date-time>
 <response-date-time>20120402123455</response-date-time>
 <transaction-date-time>20120402123455</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:

Report Unavailable Response Body

 <payments-reconciliation-response>
 <payments-reconciliation>
 <healthpoint-terminal-id>TYR11111</healthpoint-terminal-id>
 <payment-date>20120602</payment-date>
 </payments-reconciliation>
 <unavailable>
 <text>Report unavailable.</text>
 <text>Please try again later.</text>
 </unavailable>
</payments-reconciliation-response>