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HICAPS Claims Made Easier at Absolute Dental

At Absolute Dental, we aim to make health fund claiming as straightforward as possible. Our West Perth practice has HICAPS facilities, so eligible patients can process participating private health fund claims at the time of their appointment.

If your fund approves a rebate for the dental treatment provided, HICAPS can apply that claim on the spot. You then pay the remaining gap, if there is one, without needing to lodge a separate paper claim.

A Faster Way to Process Eligible Claims

HICAPS means Health Industry Claims and Payments Service. It is an electronic claiming and payment system that connects healthcare providers with participating health funds so eligible claims can be processed at the point of service.

At Absolute Dental, HICAPS allows your claim to be sent electronically from our practice after your appointment. Your rebate depends on your fund, level of cover, waiting periods, annual limits and the dental item numbers claimed. For certainty, please check your expected rebate with your health fund before treatment.

Claiming With HICAPS, Step by Step

1
Book your visit

Book and mention HICAPS

When you book, let our team know if you would like to use HICAPS and which health fund you are with. You can also ask whether you should contact your fund before treatment to check your cover, waiting periods, annual limits and expected rebate.

2
See your dentist

Come in for your appointment

Your dentist will assess your oral health and explain the treatment recommended for your needs. If costs are discussed before treatment, any health fund rebate is set by your fund and may depend on the item numbers used.

3
Show your health fund card

Bring your health fund card

At reception, provide your physical health fund card or supported digital card before the claim is processed. Our team will use the details on your card to send the claim through the HICAPS terminal, where supported by your fund.

4
Complete the appointment

Complete the recommended treatment

After your treatment, the relevant dental item numbers are entered for the services provided. These item numbers help your health fund assess whether a rebate applies under your policy.

5
Claim on the spot and pay any gap

Claim on the spot and pay any gap

If the claim is accepted, HICAPS will usually show the rebate amount and any remaining gap payment at the time of processing. You can then pay the balance. If the claim cannot be processed on the spot, we can provide an itemised receipt so you can follow up with your health fund directly.

Behind the Terminal: How HICAPS Works

HICAPS works much like an EFTPOS terminal, but it communicates with participating health funds to process eligible claims. Please bring your physical or digital health fund card to your appointment and let our front desk team know you would like to claim through HICAPS.

After your treatment, our team enters the relevant dental item numbers into the terminal. HICAPS sends the claim to your health fund, and the fund returns the rebate amount that applies at that time.

In many cases, you only need to pay the remaining gap, if there is one. If a claim cannot be processed through HICAPS, we can provide an itemised receipt so you can contact your health fund about claiming directly.

Before You Claim: HICAPS Eligibility

To use HICAPS, you need an active private health fund policy that includes eligible dental extras and a valid health fund card or supported digital claiming option. Cover varies between funds and policies, so please check your waiting periods, annual limits, exclusions and rebate amounts with your health fund before treatment if you would like certainty about out-of-pocket costs.