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1. GLOSSARY OF TERMS
Term
Description
AEST (Australian
Eastern Standard Time)
The time zone used for automatic settlements on the HICAPS Trinity
terminal unless otherwise configured.
benefit
Value of rebate authorised by a Health Fund.
body part
Two-digit alpha/numeric identifying the part on the body on which the
service was performed.
cancel
Reverses a transaction processed through the terminal.
card
A membership card issued by a Health Fund or an EFTPOS or credit card,
issued by a bank.
claim
After treatment is provided, details are sent electronically via the
terminal to the Health Fund.
claim declined
When a Health Fund declines to pay the request, a brief response
message will print with each declined item and/or claim.
claim receipt
Either the terminal or the associated Practice Management System prints
a receipt, which must be signed by the patient to acknowledge services
and approve the transfer of payment to the provider.
claim to sale
The terminal facility allowing you to start an EFTPOS transaction using
the Gap amount returned from the HICAPS Claim.
clinical code
Two-digit alpha/numeric identifying the body part/primary condition/
diagnostic intervention on which the service was performed.
fallback
The terminal was unable to contact the bank to process an EFTPOS
transaction, but the transaction has been approved/declined and will be
sent to the bank with the next transaction.
gap payment
The amount remaining after the Health Fund has approved a benefit for
the specified services.
heartbeat
A short message sent by the terminal to the terminal management
system every hour. It sends statistical information and checks for updates.
HICAPS
Health Industry Claims and Payments Service. The company responsible
for the switching of transactions to health funds from the terminal.
issue date
The date the membership card was issued. Those cards with issue dates
have them printed on the bottom right-hand corner of the card.
item cost
The amount charged for a given item of service.
item number
Numeric code identifying the type of service performed.
Refer to the HICAPS website for a full list of approved service item
numbers by modality. https://www.hicaps.com.au/support/guides/item-
number-guides
member
A customer of a Health Fund.
