How to process a Medicare claim through HICAPS for CDBS

When claiming for CDBS through HICAPS Medicare Easyclaim, first ensure that the patient (child) has the Medicare card number added in their profile and default price list is set to CDBS:

In the Invoice, click on Payments/Claims > Hicaps Claim

Ensure your Hicaps terminal is connected and select the Provider, then click on Medicare Easyclaim:

In this pop up, select the patient card, then in the Claimant fields enter the parent's card details. (If Claimant fields are left blank, you will get the error that 'the claimant is a minor' when submitting)
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​For example:
Patient Card (child): 123456 (ID: 3)
Claimant Card # (parent): 123456
Claimant IRN: 1
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Make sure to select "Specialist" as the service type, then proceed to submit the claim to Medicare.

Please note that HICAPS has a limitation in that it may not immediately update the claim status. The verification process on their end can take up to 24 hours, which is why the claim transaction in Zavy will initially appear as "Pending."

Additionally, HICAPS does not provide an automatic update to Zavy regarding the claim status. Once you have the claim status and amount, you can manually update the transaction in Zavy by selecting 'Adjust transaction' from the claim entry and entering the claim amount, then mark it as processed.
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