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What is health industry claims and payment services (HICAPS)?

It is an electronic health claims system that allows private health insurance members to claim automatically on the spot at their health service provider.

How do I claim?

After the consultation, your health fund card is swiped into the HICAPS terminal, then your claim details are entered and in seconds your whole transaction is processed.

Do I need to pay the full consultation fee before I can claim back?

There is no need to pay the full consultation fee up-front than wait to be reimbursed your benefit. If your claim is authorised by your health fund, you just pay the gap amount (the amount remaining after the claim from your health fund)

Are my treatment details kept confidential when claiming with my private health fund?

Yes, your treatment details are sent to your health fund through the HICAPS system. This can only be viewed by your provider and health fund, using a secure encryption protocol, which completely protects your privacy.