SOUTHERN CROSS EASY-CLAIM

Easy-claim is a process which aims to simplify claiming for Southern Cross Health Society members.

Currently, members need to fill in a Southern Cross claim form to be reimbursed for services they have received (according to the benefits they have in their policy and eligibility criteria).  These forms are then processed and paid – it can be a time consuming and lengthy process.

In conjunction with Toniq Limited, Southern Cross delivers a solution which provides an ‘electronic’ and ‘easy’ process for Southern Cross members to claim for their prescription items (hence the name ‘Easy-claim’).

With Easy-claim, when Southern Cross members use certain services (e.g. obtaining medications from a pharmacy), by presenting their Member Card, they will be able to send a claim electronically to Southern Cross and have it paid while they wait (depending on their eligibility to be able to claim for the service involved).

This means the refund they would normally receive from Southern Cross is paid directly to pharmacies, and they are only required to pay the remaining balance (if there is any amount remaining).

Southern Cross Health Society is the first health insurer in New Zealand to launch electronic pharmacy claiming to its members.

• Pharmacy can offer a new service to its Southern Cross patients.
• Pharmacy claims are made seamlessly and automatically as part of normal prescription processing- no extra keystrokes!
• The ‘system’ validates patient policy cover and approves what can be paid and shows it on the patient’s receipt.
• Pharmacy receives daily payments and reconciliation reports.
• Potential for brand association with Southern Cross.

The key to making this new process work is the recording of the Member card that Southern Cross members (over 16 years old) receive.

(Note:  Some Southern Cross members may have the old blue ‘plus’ card and not the newly branded card as pictured above.  You can try to use the Member Card Number from the old card, but we recommend the member contacts Southern Cross to obtain their newly branded card – it is possible that their member card number may have changed if they have requested a new card from Southern Cross since being issued with the blue card).

Selecting the member in Toniq and recording the member’s card number is all that needs to be done to ready a patient for automatic claiming.  It is that easy!

Welcome to the world of the Easy-claim!