Halcyon Claiming System
Karo are a leading provider of a full suite of programmes end to end so PHO’s can focus on their core business for providing great quality care to patients through their General Practice networks. Can work with all major PMS systems used by General Practice in New Zealand.
Karo provide PHO’s and DHB’s the following suite of tools:
Halcyon Provider Portal
Karo provides a secure web application for providers to submit claims to their PHO which is known as the “Halcyon Provider Portal”.
It integrates 100% into MedTech-32, MedTech Evolution, My Practice, Indici, Profile for Mac and Profile for Windows, and can also be used as a stand-alone product in a web-browser outside of a PMS. Plans are in place to integrate it with other major PMSs as demand dictates.
The Provider Portal contains business logic to determine a patient’s potential eligibility for PHO clinical programmes and presents the clinician with a tailored menu on this basis, allowing clinicians to easily assess a patient’s eligibility for a given programme.
The Provider Portal has been designed to be clean, simple, and easy to use, and care has been taken to ensure that forms do not end up cluttered with extraneous information. The Provider Portal is cross-browser compatible and fully utilises the latest technologies available in all modern web browsers whilst retaining backwards compatibility with older versions.
Forms can range from simple claiming forms to advanced decision support forms and can incorporate any advanced logic or algorithms required to assist the user in completing the form.
The Provider Portal is fully integrated with the PMS, meaning that it can pre-populate itself from data already recorded in the PMS, and writes back relevant information to the patient’s record. As it is connected directly to the Halcyon PHO Portal, the user gets instant feedback on the acceptance (or otherwise) of their claim.
The Provider Portal also provides a variety of live reports to the user, which they can use to track such things as claims status, available allocations for a given programme, or a patient’s status within a given programme.
Halcyon PHO Portal
Karo provides a secure web application for PHOs to manage incoming claims, which is known as the Halcyon PHO Portal.
This allows a PHO to track and view the status of any given claim. They have full access to search, view, edit or delete any claim, and can approve claims rejected by the business rules. Where appropriate, claims that have already been paid can be reversed or adjusted, meaning a credit or debit can be loaded against the claim in the PHO’s next claims payment cycle. All changes against a claim are logged in a viewable audit screen.
The PHO Portal is designed to be cross-browser compatible and uses a sleek modern user interface. It contains many features for delivering data and info metrics in visually interesting ways to help users with their work functions.
The PHO Portal features a customisable, role-based, user authorisation system, meaning that a user can be given permission to view only the claims or programmes to which they are authorised to access.
The PHO Portal includes a payment close-off system, in which claims can be closed-off month by month and loaded into one of several accounting systems for payment.
For Practice issues, the first contact point is your PHO. If required the PHO can escalate the issue to Karo.
Karo has a helpdesk for the PHO to contact regarding issues with either the PHO or Practice Portal. Practices are not to contact the helpdesk directly and will be redirected to their PHO if this does occur.
The Karo helpdesk is contactable between 9-4 during the week.
The Karo helpdesk is also the location for any Halcyon change requests or new programme requests to be sent.