HICAPS (Health Industry Claims and Payments Service) is an electronic claims system that allows people to claim their insurance rebate on the spot. Formed in 1998, it is Australia’s leading ancillary health claims billing solution, providing a simple, efficient system to allow payments to be processed for health funds and Medicare.
HICAPS is beneficial because it allows you to reclaim the cost of any dental treatments. From a routine check-up to comprehensive restorative work, you can claim the cost of your treatment back instantly.
Although we can help you with your health fund claims, the contract between you and your health fund is separate from the contract you have with our dental practice.
Due to privacy laws, we are unable to access specific information about your membership or your claims. If you have specific concerns, you will need to deal directly with your applicable health fund.
If you are unable to reach a satisfactory agreement with your fund, contact the Private Health Insurance Ombudsman (PHIO) who provides an independent service to help consumers with health insurance problems and enquiries.
Further information and contact details on PHIO can be found at www.phio.org.au
PHIO also manages the website www.privatehealth.gov.au where you can find out about private health insurance and search for and compare selected features for all private health insurance products offered in Australia.
Most health fund providers will have fixed rebates for particular services, regardless of the fees charged by your dentist. The level of rebate received also depends on your type of cover, and the premium paid. There are also other factors involved such as annual limits on the total amount that may be claimed and waiting periods before a plan is activated. Some common treatments will not have any rebates.