If you bill to patient Health Funds in your practice, you know how much work goes into ensuring you've got the right details before sending off your claim. If you had ECLIPSE installed at your practice you would have been lucky enough to have a Genie trainer do all of the necessary configuration of your health fund list. If you're not an ECLIPSE user however, you may still need to have your health funds set up so that you can bill appropriately. If your funds are already set up, you may find that over time with all of the health fund changes and new funds entering the market the need to add a new health fund to your system will arise. This article means you don’t need to worry – all the steps are listed below.
Before you begin
Before you go and add a new health fund entry it's worthwhile double checking to ensure somebody else hasn't already added the fund with a similar naming convention. You don't want to bloat your fund list with multiple entries that all really pertain to the one health fund so make sure you take the time to ensure the fund doesn't already exist.
For example, if you need to add GU Health as a health fund, you should first check whether you've already got Grand United or Grand United Corporate Health in your list, as these are alternate names the fund may already be under. If you're unsure about a particular find, contact Genie support for assistance.
To add a new health fund you will need to access the Health Funds list. To access this list, you will need to navigate to Open > Billing Items > Health Funds.
If the health fund you need to add is not in this list, you can click the Add button to add a new fund.
In the new window that appears enter the fund name and max known gap for the fund. If the fund charges a gap per item, ensure that you check the 'Per Item' checkbox (typically this is AHSA funds). Similarly if this fund is an AHSA or BUPA fund ensure that the correct checkbox is selected. Selecting these tickboxes will ensure that the correct fee schedule is downloaded whenever you update your fee schedules.
Once you have added the fund details click the magnifying glass to search for the account holder for this fund. If you are unable to find a matching record, you will be prompted to create a new Account Holder record for this fund.
Fill in the relevant information. If you do not have all the details, this window can be completed at a later time via Open > Account Holders. Click Save to be returned to the previous screen. You will see the Account Holder now appears and you can click OK to save this new health fund.
If you're an ECLIPSE user you will need to also retrieve the ECLIPSE information. This is not a necessary step if you are not using ECLIPSE.
To get the ECLIPSE information for your health funds, click the Get ECLIPSE Info button in the health fund list.
Genie will automatically bring in the ECLIPSE information for your listed funds if the names are exactly the same. If they do not match, a prompt will appear asking you to match them manually.
To link the funds manually, click and drag the fund from the right-hand column titled Genie Fund to the middle column titled Link to Genie Fund next to the correct ECLIPSE record. Click OK to obtain the ECLIPSE information. If you do not have a corresponding Genie Fund for the ECLIPSE Fund, Genie will automatically create a new record.
A list of all funds that participate in ECLIPSE can be found here.
In order to be able to raise invoices for a health fund an account holder record will need to be linked to it. If you have used the instructions above to create a new record the account holder record should already be created. If you previously added a new health fund via a patient's demographic record, you may find yourself needing to link the health fund to an account holder record.
To link an Account Holder to a health fund, double click on the health fund name in the health funds list and click the magnifying glass icon to search for an Account Holder.
If the Account Holder doesn’t already exist in your system, you will be prompted to create one.
Note: Before sending any claims, it is also a good habit to check that all your fee schedules are up to date. Fee schedules can be downloaded under Special > Software Updates > Fee Schedules.