HICAPS - Adjusted Gap Processing

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This feature allows Preferred provider fees to be adjusted when fees sent to the Health Fund does not match with the fee schedule established by the Health Fund. 

When a Health Fund receives an incorrect amount (outside agreed fee charge) from the Preferred provider, the fund will send an X900 item number to indicate that an Adjusted Gap Process needs to be performed.

Claim

The correct (adjusted) fee for the Item will be sent in the Item Claim Amount with an indication of Item Adjustment 
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Quote

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Cancel

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Discount Category

Adjusted GAP ADJ discount category is automatically used to reflect the adjusted fee amount for items in the invoice.
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