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Submitting to Healthcode 🇬🇧 - Beta

  1. UK Insurance Billing
  2. Submitting to Healthcode 🇬🇧 - Beta

    3. 12 min read

NOTE: This is an open beta and therefore as we are still in the testing phase, there may be some little kinks to iron out along the way.This guide may also be subject to change.

You can now download batch files for submission to Healthcode from right within your Jane account. 🎉

Here’s what you’ll find in this guide:

Signing up for a Healthcode Account

Healthcode is the UK’s official clearing service for electronic medical bills, and you can now validate and download your Insurer invoices right within Jane in a format which is accepted by Healthcode. 🎉

If you don’t already have a VEDA account with Healthcode, and you’d like to learn more, head over to their website.

If you’re already using VEDA you’ll just want to contact Healthcode so that they can make the switch from your current software to Jane.

If you’re currently using ePractice, you can register for a new VEDA site using the link above.

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How to connect Healthcode with Jane

Once you’re registered with Veda, it’s time to link your Jane account with Healthcode. To do that, you can click Settings > Integrations > Healthcode > Configure:

Healthcode Account for clinic/practice.

If your Healthcode account is set up as a practice or clinic you’ll want to add your Healthcode Site ID to the relevant field within the Location Information section.

You’ll also want to add your Insurer Provider Number here. This is essentially your Payee Number so Healthcode can identify who is to be paid. If you do have different Provider Numbers for different insurers, then you can use your BUPA Provider Number as the default here

Then, you can enter the Professional Number for any practitioners who you will be submitting invoices for. Typically this will be their HCPC registration number or other professional registration number.

Healthcode Account for individual practitioners.

If individual practitioners have their own Healthcode Site IDs then you can leave the fields within the Location Information section blank and you’ll just need to enter in the Healthcode Site ID of each practitioner, together with their Professional Number as above.

If you’re not sure of the relevant numbers to use, or if you are running into trouble with submissions you can contact Healthcode directly to verify and/or make the necessary adjustments.

There’s one last thing to do before we complete this step, and that’s to add your Healthcode Insurer Identifier for each insurer.

To do that, you can click Settings > Insurers > Edit alongside the insurer. From here, you’ll just want to select the relevant identifier from the Healthcode Insurer Identifier drop-down, and you can click to Save your changes.

And that’s it! You’re ready to go!

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Setting up your Billing Codes and Diagnosis Codes

Once you have configured Healthcode and set your Healthcode Insurer Identifier for each insurer, you’re all ready to start creating some custom Billing Codes and favouriting your frequently used Diagnosis Codes. Both are super important for the validation process when submitting files to Healthcode, so we’ve made it as simple as possible for you to access your most frequently used codes when required.

First, you’ll want to navigate to Settings > Billing Codes, and you’ll see the following Code Sets enabled for you:

ICD9-UK

Healthcode-ISC

If not, just pop a tick in the box alongside the relevant set, and you can click to Save Billing Code Sets

Let’s walk through how you can set up different rates for each insurer depending on the treatment offered when you’re using Healthcode.

  1. Filter to show just the Healthcode ISC Billing Codes
  2. Search for the codes that you currently use
  3. Click Assign Rate
  4. Set your Default Rate and populate the contracted rate for each insurer/third party.
  5. Click Create Billing Code to save your work

Here’s an example of how this works. Let’s say that in my clinic I offer an Initial Physiotherapy Assessment and the private price of that treatment is £75. I can search for the relevant code here:

Then, I can click to Assign Rate

If both AXA and BUPA will pay ÂŁ50 per patient for this treatment, then we would recommend setting your default rate to your most commonly billed amount.

Then if I created an AXA insurance policy on a patient’s profile, and added the ‘Initial Assessment - Physio’ Billing Code to their appointment, Jane will automatically change the fee for the visit to £50 based on my settings. Clever, eh? Let’s not get ahead of ourselves though, more about this later!

So, once you’ve followed the steps above for all the Billing Codes you use, then you’ll see these codes populate as Custom Billing Codes at the top. As I say, we’ll walk you through how this makes things a whole lot easier when adding billing codes to an appointment later.

Just like with Billing Codes, we make it really easy for you to find and favourite your most frequently used Diagnosis Codes. Any codes that you add will also be pulled through into the file that is generated for submission to Healthcode. Ready? Let’s get started.

Under Settings > Billing Codes you can search all Diagnosis Codes by set, and you can click the little star icon alongside the code to add it to your Favourites.

Here’s an example. Let’s say Shoulder Dystocia is one of my frequently used Diagnosis Codes. Here’s how I can favourite it.

  1. Search Diagnosis Codes for “dystocia”
  2. Find and favourite the relevant code

Once that’s done, you can click on the little star beside the search fields to view your compiled list of Favourites

Note: It’s worth bearing in mind that not all codes are valid for all insurers, and you may have to provide an alternative code in the event that it’s not accepted by Healthcode. You can read a little more about that here.

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Insurance Policies, Insuring Appointments and Healthcode

The good news is that when it comes to adding polices to a Patient Profile and insuring appointments, things aren’t really any different when using Healthcode. Phew, I hear you say. 😅

We’ve linked to our UK Insurance guides here in case you need a refresher:

UK Insurance - Insurance Policies

UK Insurance - Insuring an Appointment

Having said that, there are a couple of things to bear in mind.

We have implemented some validation rules to ensure that all generated files contain the information that specific insurers would like to see, so for exampe, you’ll need to ensure that the following fields are complete:

Claim Number/Authorisation Code/Pre-Authorisation Number

Policy/Membership/Registration Number

Also, when adding an insurance policy to an appointment, don’t forget to add a Diagnosis Code:

Don’t worry though, prior to downloading the files, any missing/incorrect information will be clearly explained and you’ll be able to make any necessary changes prior to submission. More about that below.👇

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Downloading files for submission

Well done on making it this far. Now for the exciting part. Let’s walk through how you can generate the file in Jane for submission to Healthcode. đŸ„ł

You’ll want to navigate to your Unsubmitted folder for this one by clicking Billing > Unsubmitted within the Claim Submissions menu.

It’s worth bearing in mind, if you have more than one Healthcode Site ID (for a location or individual practitioners) then you will only be able to generate a Healthcode submission file if all the invoices selected are associated with the same Site ID.

For that reason, you may wish to filter by Staff Member and/or Location here.

From here, you can click to select all invoices that you would like to submit to Healthcode. You’ll see them highlighted. Click View/Submit Selected.

Note: although we know that for the most part you will be creating batched submissions, i.e.multiple claims/invoices in one submission file, it is possible to follow the same workflow for a single invoice if required.

Here you’ll see a preview of your submissions and any failed validations and missing information will be shown in red. You can click directly on each link to edit this information, and this will open in another tab for you:

Once you’ve corrected any missing information here, you can click Refresh and you’re all set and ready to click the Download Healthcode file for X Claims button:

Once you click to download, Jane will work her magic, and you’ll be prompted to save the file to the device you’re using. You may want to rename it at this point, too, for ease of reference.

You’ll see all downloaded claims have now been moved to the Submitted. Nicely done. 🎉

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Submitting Claims to Healthcode

Now for the final piece of the puzzle, and this happens outside of Jane. 😊

Once you have your downloaded files you’re ready to upload them to the Healthcode VEDA portal. To do that from the Status Page you can select Submit Billing File under the quick links menu, or you can click Billing > Billing Files > Submit Billing Files:

From the Submit Billing Files page you can click Choose File, select your file and click Add

Then select the file(s) from the list and click Submit All:

You’ll see a successful submission message:

You can view submission status & the individual invoices part of the submission file under Billing > Billing Files > View Billing Files:

You can also see failed submissions under Billing > Failed Bills, and you can see the specific details of individual invoices under Billing > Bills. You can correct any issues or errors in these areas by clicking View Bill

We’ve popped a guide from VEDA here in case you wanted to read a little more.

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Receiving and Applying Insurer Payments

So, huge well done on making it this far, and for doing so, we have some good news. When it comes to reconciling the payments from insurers after successful submission to Healthcode, you don’t need to do anything different to what you’re doing now. 🎉

In case you do need a little refresher, we’ve linked to our UK Insurance guide here, and you’ll want to check out the section called “Receiving and applying insurer payments”:

Wrapping up

We really have covered a lot in these guides, so if you have any questions at all, don’t be afraid to get in touch with our lovely team. Happy downloading and submitting. 🎉
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