Partners can submit HealthPoint claims via the Tyro Health SDK and obtain transaction status changes via both callbacks and webhooks.
Use function:
To process a HealthPoint claim or HealthPoint Digital claim, the following fields apply. Any required field not passed to the SDK will be prompted within the Tyro Health submission page.
Required column values:
| Value | Description |
|---|---|
| M | Mandatory |
| O | Optional |
| C | Conditional |
| Field | Type/Format | Required | Description | Example |
|---|---|---|---|---|
platform | String Valid values only | M | The SDK supports two modes - one for payment transactions and another for claims. Set to: funder for HealthPoint claims | funder |
funder | String Valid values only | M | For private health and overseas insurance claims set to phi. | phi |
funderData.phi.merchantId | String | O | The merchant identifier (MID) | 1 |
funderData.phi.terminalId | String | O | The terminal identifier(TID) | 99922 |
funderData.phi.isRebateEstimate | Boolean | O | Set to true to send as a quote/rebate estimate. Note that quotes / rebate estimates will not transfer funds - these are a point in time estimates of the fund benefit amount. If not set, defaults to false. | true |
paymentMethod | String | M | For HealthPoint claims to differentiate between terminal vs digital, the SDK will make use of paymentMethod. Accepted values are terminal or phone. If not provided, defaulted to terminal | phone |
providerNumber | String Up to 16 alphanumeric characters | M | Servicing provider number or other registration identifier which must be valid and active in Tyro Health Online and HealthPoint for a given funder. For PHI quotes and claims, a Medicare issued provider number should be used where available. Where a Medicare provider number is not applicable, use the appropriate identifier - a Medibank, Fund specific or HealthPoint issued provider number. The provider number can also be used to set the default terminal identifier (TID) and merchant identifier (MID) if multiple TIDs and MIDs exist for a business. | 0034503W |
invoiceReference | String | O | Provider nominated unique transaction reference number, such as an invoice number from the practice management or accounting system. Used for reconciliation purposes. | INV-20220315-001 |
| patient {} object | ||||
patient.firstName | String Up to 40 characters | O | Patient first name as on their health fund card | John |
patient.lastName | String Up to 40 characters | O | Patient last name as on their health fund card | Curtains |
patient.dob | String YYYY-MM-DD | O | Patient Date of Birth in 'YYYY-MM-DD' format. | 1967-11-02 |
patient.reference | String 2 digits | M | Patient unique reference number, sometimes known as the card rank, as shown on health fund card. Only applicable for claims. | 01 |
patient.mobile | String | O | Optional mobile phone number of the member. This can be used for patient searches in the Tyro Health Online portal International or national notation supported. | +61411111111 or 0411111111 |
patient.healthFundCode | String Valid values only | O | Health fund brand code. The reference list of valid codes can be found here: (https://docs.medipass.io/developer-portal/eftpos-and-healthpoint/healthpoint-support/#health-funds)For testing purposes in staging use TST | BUP |
patient.accountNumber | String Valid values only | O | Fund account number dependent on fund | 123456789A |
patient.refId | String Up to 128 alphanumeric characters | O | An optional but recommended patient unique reference as set by you, such as a UUID. This value is used to uniquely identify a patient in Tyro Health Online. Omitting refId will cause duplicate patient records to be created and could make patient searches more difficult for providers who also use the Tyro Health Online portal to check on status of a claim and remittance. If supplied and valid, this value will pre-populate patient details from the patient record in the business as set in any prior claim. Any patient details sent for an existing patient record will update those values. | 5AD5E2AF-69D2-43D3-9321-428495205E5E |
claimableItems [] array - Array of fund claimable items. | ||||
claimableItems[].serviceDateString | String YYYY-MM-DD | M | Date of the service in 'YYYY-MM-DD' format. | 2022-01-12 |
claimableItems[].itemCode | String 5 numeric | M | Item code - note item code must be valid for HealthPoint, the provider registered profession and service date. For podiatry and dentistry item codes, remember to remove any leading alpha characters such as P* or D*. | 5001 |
claimableItems[].price | String Currency notation, up to 6 numeric and 2 decimal digits | M | Gross (including GST) price each unit in $XX.XX format. This will be the amount claimed with the health fund. | $15.95 |
phi.claimItems.clinicalCode | String 2 alphanumeric* Note 3 alphanumeric is permitted for HCF quotes/claims | O | Two digit code. These may be required by some private health funds. Only applicable for: • Dentistry: as two digit Tooth ID • Psychology: as two digit Primary Condition code • Occupational therapy: - digit one as Primary Condition indicator- digit two as Diagnostic Intervention indicator. For HCF only: the ICD short code used in the "More for" program. | 12 |
For HealthPoint claims to differentiate between terminal vs digital, the SDK will make use of
paymentMethod.
Accepted values areterminalorphone. If not provided, defaulted toterminal
When a transaction is processed, the SDK will pass through the transaction details to the first parameter of the onSuccess callback.
The response payload contains a number of attributes with a complete description of the transaction model in our online API documentation.
Key response attributes include
| Field | Type/Format | Description | Example |
|---|---|---|---|
id | String 64-128 bit ID | a unique transaction level identifier | 12BA46C3-BA6B-4192-9368-BD78AFAAB489 |
status | String | Overall transaction status | Approved |
amountClaimsBenefit | String Currency notation | Total benefit paid by health fund | $60.00 |
amountBalance | String Currency notation | Any unpaid amount on aggregate charges. If gap is successfully processed via EFTPOS in same transaction, this will be zero | $0.00 |
claims[].status | String | Overall claim status | Approved |
claims[].gatewayRefId | String | Unique transaction reference from health fund | 1245572346 |
| For each claimableItem | |||
claims[].claimItems[].status | String | Individual items can be approved or declined | Approved |
claims[].claimItems[].amountBenefit | String Currency notation | Benefit paid on item by health fund | $60.00 |
claims[].claimItems[].amountGap | String Currency notation | Gap amount - difference between charged and benefit | $40.00 |
claims[].claimItems[].clientMessage | String | Message to display to user (usually for declined items) | 00 - Approved |