FAQ: Claims, Referrals and Funding

If you are encountering issues with this topic, you may be able to troubleshoot these issues yourself first. If your issue is still not resolved, you can contact Halaxy for assistance.

Answers

Why are referral details not appearing automatically?

In order for a patient's referral details to automatically appear on an appointment, you need to link the fee to the referral type that is being used for the appointment. This is especially important if you using a new fee (such as a telehealth fee when you previously used face-to-face fees only).

Once linked, adding the fee to an appointment will automatically find the linked referral type in the patient's claim details and use it for the appointment. The referral must also be added to the patient's claim under the funder.

If a referral has no referral type, Halaxy will apply the referral to any appointment that uses a fee under that funder. Referral types allows you to specify exactly which fees should be used for a particular referral rather than just any fee under the funder.

How do I track a referral by hours instead of appointments?

To change this for an individual existing referral:

  1. Open the patient profile and click the Funding tab.

  2. Under the Claims & Referrals section, open the claim with the referral. Next to the referral, click the Icon-Edit.svg pencil icon.

    Referrals-Edit-01.png
  3. In the pop-up, change the Limit from Appointments to Hours.

  4. Click Save.

To change this for future referrals, you can set this up when creating referral types.

Why is my appointment not showing the referral?

There are a number of reasons why the referral may not be showing:

  • the patient may have exceeded their appointment limit;

  • the expiry date may have passed; or

  • there is a problem with who the referral has been assigned to.

You can change these when you add or edit the referral on the appointment/invoice or the patient's Funding page in the profile.

A patient has two referrals. Which one will be used?

By default, Halaxy works behind the scenes to determine (based on fees, funder, expiry date, limits etc.) which is the most recent and valid referral and assigns that one to the invoice. However, you can choose between referrals from the invoice or from the Appointment Information from that appears when you click the appointment on the Calendar.

How do I search for who has referred patients to me?

You can create a report that shows referrals by following the steps below:

  1. Click Reports > Contact.

  2. On the top right, click New Report.

  3. Select the report parameters you require, such as Referral Date.

  4. Click Run.

How do I change or correct the referral limit count?

The referral count is based on the number of appointments with a status of Attended, plus the number of "prior appointments" you specified when creating the referral ("prior appointments" count towards the limit but are not appointments on your Halaxy calendar).

You can quickly check which appointments are linked to the referral by navigating to the patient's Funding page, then hovering your mouse cursor over the "appointments attended" part of the Limit column:

User hovers the cursor over a referral, showing appointments in current and previous calendar years

From within the popover, you can click to jump to any appointment or invoice shown. From the Appointment Information panel or the invoice, you can modify the referral details and unlink the referral if needed.

To edit the number of "prior appointments" (which count as part of the limit but are not appointments in your Halaxy calendar):

  1. Open the patient profile and click the Funding tab.

  2. Expand the patient's claim under the relevant funder, then click the Icon-Edit.svg pencil icon next to the referral you wish to edit.

  3. Click Add prior appointments. A new field appears where you can enter the number of prior appointments to count towards the limit.

    The user adds a referral and clicks "Add prior appointments"
  4. Click Save.

The appointment limit should now include the number of prior appointments you specified, along with any linked appointments in your Halaxy calendar.

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