Healthcode Setup & Submission

Article author
Orla OHiggins
  • Updated

What is the purpose of this article? 


This article will take a Super User through the process of setting up the Healthcode integration with their Meddbase Chamber.  

This article will detail: 

What is Healthcode?


Users can send invoice data to Healthcode EDI to confirm whether the insurer will fund the selected treatment for the assigned invoicing diagnosis. Healthcode will map a provider's* clinicians and treatment sites to a designated validation platform (HC VEDA), as well as its contracts and services. Invoice data can be transmitted directly from Meddbase to their invoice validation service to provide real-time feedback on the eligibility and validity of invoices. This ensures any errors are rectified before they are sent to the insurer, cutting down on the turnaround time and making sure you receive payment as soon as possible.
Healthcode can also supply providers with electronic remittances for most insurers.
These will contain a full breakdown of invoices paid (including any shortfalls/excess declarations).
*Provider (Healthcode definition): A hospital, clinic, practice or practitioner that either provides medical care and/or surgical treatment to a patient or gives access to the same and is identified by a unique code within Healthcode’s internal systems. The unique codes are referred to as an SP number for practitioners and an HP number for all other types of provider (hospitals, clinics etc).

Pre-requisites for this process


Providers will need to submit a spreadsheet containing details of their Treatment Sites practitioners (including their GMC/professional numbers) and services to Healthcode for mapping. This will need to be configured in the Meddbase chamber, Meddbase will allocate each practitioner and treatment site a unique code, in Healthcode this is called a 'A Code'. If you would like a copy of this spreadsheet or need advice completing it, please contact support.

Healthcode are then able to map the A codes to the practitioners and Treatment Sites provided.

To start the process of signing up to Healthcode for you will need to register through the Healthcode website (https://www.healthcode.co.uk/ > Register)

  • The application will be sent through to Healthcode’s Registrations team for set-up.
  • Once this is completed, Healthcode will send through a ‘Welcome’ email with the credentials required to access your Healthcode Account, as well as for the VEDA site. The Welcome email should contain the Site ID of the VEDA Site.
  • The password is now known as the API Key (a long alphanumeric reference needed to place in the password section in MedDBase)
  • The third credential is a Web Services User ID (using a regular account username in MedDBase will not work for the integration link)
  • Details on how to access these credentials via the Healthcode Account can be found here: https://www.healthcode.co.uk/help-and-support/healthcode-account-frequently-asked-questions/

Note: Please be aware that Healthcode will attempt to map all relevant ICD10 codes to ICD9 where available, but there may not always be a suitable code.


Troubleshooting Healthcode invoicing issues:

Depending on the error messages output by Meddbase, customers may find this helpful in remediating most of their billing issues: https://www.healthcode.co.uk/help-and-support/veda-invoice-errors-and-how-to-fix-them/

Please note the link contains screenshots of HC VEDA – although Meddbase clients will be submitting bills via the API, the error reasons will remain the same.

 

Other helpful links
Healthcode’s Glossary of Terms:

https://www.docs.healthcode.co.uk/glossary-of-terms__trashed/glossary/#provider

 

How to set up Healthcode


Enabling the feature

To begin setting up the integration:

  • Go to Admin > Configuration > Chargeable feature
  • Check ‘Healthcode’
  • Accept the warning
  • Click Save

Initial setup

First, you will need to ensure Healthcode is checked under Admin > Configuration > Chargeable features. 

Next, you will need to add your Healthcode account details to Meddbase. To do this:

  • Go to Admin > Configure work types
  • Click the 'Outstanding Debt' work type (Note: if this work type is not visible, you will need to add it as a new work type)

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Configure the following settings:

 

Enable Healthcode Invoicing

Check this box to enable Healthcode invoicing.

Use Test Environment

Enables Meddbase users to submit invoices to Healthcode for testing and training purposes. Important: please do not use this without first speaking to a member of Healthcode as they will need to configure your test environment.

Site Id, User Name, Password

Healthcode will provide these to you once an account has been setup for you. Please contact Healthcode directly if you need to obtain these details.

Default Setting

Must be outpatient on the bill to Healthcode. This is a global setting but can be changed per session on an individual clinician’s site schedule.

You can find out from the insurance company if you need to use a particular 'setting' to make the invoice valid.

 

Healthcode Settings


Following the initial setup, there are different Healthcode settings in the system which need to be addressed to complete the Healthcode configuration. These are: 

  1. Chamber company settings
  2. Insurer settings 
  3. Doctor settings
  4. Site settings
  5. Diagnostic codes

Chamber company settings

Once the integration has been turned on in chargeable features, a new section should be available to add to your chamber company's details page.

  • Start Page > Company > [Find Company] > Company Details

2022-01-28_11_35_57-Healthcode_Setup___Settings.png

If this section is not visible:

  • Go to Layout > Unlock Layout for Editing > Layout Sections > Healthcode to add it to your layout page.
  • Save your changes by clicking Layout > Lock Layout.

Claim as a hospital:

Invoices submitted to Healthcode have a 'claim source', which can be either 'Consultant', 'Hospital' or 'Screening Centre'. The default claim source is 'Consultant', but some insurers require billing companies to claim as 'Hospital' for electronic invoicing.

If the creditor needs to claim as a hospital in order to satisfy a particular insurer, then 'claim as hospital' should be ticked.

Insurer settings

Once the integration has been turned on, a new section should become available to add to each insurance company's details page.

2022-01-28_11_38_17-Healthcode_Setup___Settings.png

If this section is not visible:

  • Go to Layout > Unlock Layout for Editing > Layout Sections > Healthcode to add it to your layout page.
  • Save your changes by clicking Layout > Lock Layout.

Insurer code

This is a code that uniquely identifies the insurer to Healthcode. Below are some typical codes used for insurers:

Company Insurer code
Aetna agb
Allianz awc
Aviva nuh
Bupa bup
Bupa Global bui
Cigna cig
Exeter Family Friends efs
Healix hhs
Pruhealth pru

Simplyhealth

bcw

Vitality

slh
WPA wpa

If an insurance company you use is not listed above, please contact them for the code they use to identify with Healthcode.

You will find out from the insurance company if you need to use a particular 'setting' to make the invoice valid.

This can be found under the Outstanding Debt work item settings:

2022-01-28_12_21_01-Healthcode_Setup___Settings.png

The setting can also be overridden per session:

2022-01-28_12_22_01-Healthcode_Setup___Settings.png

Doctor settings

Once the integration has been turned on, a new section should be available to add to each doctor's personal details page.

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If this section is not visible:

  • Go to Layout > Unlock Layout for Editing > Layout Sections > Healthcode to add it to your layout page.
  • Save your changes by clicking Layout > Lock Layout.

 

Has been registered (mandatory)

Enables invoices for appointments carried out by this doctor to be sent electronically to Healthcode.

Invoice as payee (optional)

Some consultants have custom contracts with insurers in order to get paid more if a particular service is performed by them. The invoice may be raised by the clinic, but the insurer needs to know (via Healthcode) that it's being billed on behalf of the specialist, so that they get the better price. If a consultant has one of these custom contracts, then 'invoice as payee' should be ticked on their record.

Site settings

Your sites can be found under Admin > Common Catalogues > Sites. You can optionally set these up as payees under their site details.

Invoice as payee:

Some consultants have custom contracts with insurers in order to get paid more if a particular service is performed by them. The invoice may be raised by the clinic, but the insurer needs to know (via Healthcode) that it's being billed on behalf of the specialist so that they get the better price. If a consultant has one of these custom contracts, then 'invoice as payee' should be ticked on their record.

This setting will appear on clinician records once the Healthcode section has been made visible:

2.png

Some insurers demand that the site be entered as the payee provider, in which case the site needs to appear on the invoice as the payee. If this is the case, then 'invoice as payee' should be ticked for that site.

This setting can be found under the site settings (under Common Catalogues):

3.png

Diagnosis codes

Each invoice submitted to Healthcode must include a diagnosis. Healthcode accept ICD9, ICD10, or OSICS codes for sports injuries.

Contact Healthcode for advice on choosing the correct diagnosis codes for your clinic. Once done, you may either add the diagnosis codes manually or import the codes into your chamber. Please contact Meddbase support for advice on adding the diagnosis codes to your chamber.

Once you have added and saved your diagnosis codes you can start using them in the system. There are three possible places to enter a diagnosis code:

Within a consultation on a clinical form (Note: 'Capture diagnosis during consultation' must be enabled under Admin > Configuration > Accountancy in order for this to appear):

5.png

From a patient's profile page when creating a new Authorisation (under the Eligibility section):

6.png

Once an invoice has been raised and you have selected ‘Edit Healthcode Details' or 'Submit to Healthcode’ (Note: if either of the above two has been entered the ‘Diagnosis’ field in this section will have auto-populated):

7.png

 

Submitting an invoice to Healthcode


Once you have enabled the feature, an option should appear on invoices to submit to Healthcode:

8.png

Once you have clicked ‘Submit to Healthcode’ you will see that the status of the invoice changes from ‘Not Sent’ to ‘In Healthcode Queue’. A work item is added to the Outstanding Debt section where you can see the invoice status and manage your debt.

If the screening is successful and no errors are returned, the invoice will be sent through to Healthcode and in Meddbase, the invoice status will be automatically marked as sent

If the screening isn't successful and errors are returned by the EDI, the status invoice will still be not sent. This allows you to correct the invoice depending on the errors returned. You will then repeat the above process.

 

Troubleshooting


If the 'Healthcode' button does not appear on invoices, first check that the debtor is an insurance company. If the debtor is a patient, then the button will not appear.

If the error is one of the following:

You may have used an insurer code that is not configured in Healthcode yet

This means Healthcode needs to 'map' an insurer in their setup. You will need to inform Healthcode if you want to start using a new insurer that you have not used before.

Healthcode web services said: Access Denied: 

Your site ID is not recognised or your password is incorrect. You will need to contact Healthcode to verify your site ID.

Healthcode web services did not recognise this chamber's Site Id

Your site ID is not recognised or your password is incorrect. You will need to contact Healthcode to verify your site ID.

Healthcode web services could not validate the username for this site

Contact Healthcode as your username is not valid.

Healthcode web services were unavailable

Healthcode is currently unavailable. Contact Healthcode or try again later

One or more problems were found with the Healthcode setup

Please verify your setup. If you need training for your set, MMS can provide onsite or remote training session. Please contact Meddbase support to arrange training.

Billing item 'xxxxx' is not associated with an appointment

This happens if billing items are added by hand to an invoice, rather than by adding a service to an appointment. You cannot issue an invoice to Healthcode unless it has an associated appointment. In this case, you will need to re-issue the invoice via an appointment.

Debtor 'xxxx' does not have any healthcode settings provided / Debtor 'xxxx' is not configured as an insurer for Healthcode

This means the insurer doesn't have a code set. Please see Insurer settings for further details.

 

Review Date


This article was updated on 23.09.2024