HICAPS On-The-Spot Claiming | Hocking Dental Care

What HICAPS actually is

HICAPS is the on-the-spot claiming system used by most Australian health funds. When your appointment finishes, we run your fund card through the terminal at reception, the claim is submitted electronically, and your rebate is applied there and then.

You pay only the difference between our fee and what your fund covers. There is no paper form, no waiting for a cheque, and no need to lodge anything yourself.

It is worth being clear about what it is not. HICAPS is a payment terminal, not a fund and not an insurer. It does not decide what you get back — your policy does. What it removes is the fortnight between paying a bill and being reimbursed for part of it.

How the appointment ends

Treatment is completed and coded
Every item has an Australian Dental Association item number. Those numbers, not the description, are what the fund prices.
Your card goes through the terminal
Physical card or the digital one in your fund's app — either works.
The fund answers in seconds
It checks your level of cover, any waiting periods, and how much of your annual limit is left.
The rebate comes off the invoice
What remains is the gap.
You pay the gap
Card or cash, and you leave with an itemised receipt showing the fee, the rebate and what you paid.

What to bring, and what to check first

Bring

Your physical health fund card, or the digital card in your fund's app. That is all we need; we handle the rest at the desk.
The card belonging to the person being treated, or the family card with them listed on it.
Any referral or prior-approval paperwork, if a treatment needed one.

Worth checking beforehand

How much of your annual extras limit is left, particularly late in the calendar year.
Whether a waiting period still applies. Major dental typically has a twelve-month wait on a new policy.
Whether the item you are booked for is covered at all under your level of cover.
If you are not sure, we can run the claim and tell you the gap before you pay.

If your fund is not on HICAPS

A small number of funds do not participate. In that case we give you an itemised receipt with the correct item numbers, which you submit to your fund directly. Most now accept a photograph of the receipt through their app, so it is a two-minute job rather than an envelope.

The rebate is the same either way. The only difference is whether you are out of pocket for the full fee for a few days in between.

Common questions

HICAPS: what people ask

Does HICAPS tell me how much I will get back before I book?: No — it processes the claim after treatment, so the figure appears at the end rather than the beginning. If you want to know in advance, ask us for the item numbers for what is planned and ring your fund with them. That gives you an exact number against your own policy rather than an estimate.
Can I claim for my whole family on one card?: Yes, provided everyone treated is listed on the policy. Bring the family card. If a partner holds their own separate cover, that claim goes through on their card.
What happens if my annual limit runs out mid-appointment?: The claim comes back with a partial rebate or none, and you pay the balance. This is the commonest surprise in November and December, which is why it is worth checking your remaining limit before booking anything substantial.
Can I claim through HICAPS and still pay by card?: Yes. The rebate is applied to the invoice first, and you settle whatever is left however you like.
Is the receipt enough for my tax return or for a fund audit?: The itemised receipt shows the date, the item numbers, the fee, the rebate and what you paid, which is the level of detail funds and accountants ask for. Keep it; we can also reprint one if you lose it.
My fund rejected part of the claim. What now?: Ask us to check the item numbers first, because a rejection is occasionally a coding question we can resolve. Beyond that it is a matter between you and your fund — most rejections are waiting periods or annual limits rather than anything about the treatment.

All frequently asked questions

Questions about cost?

We will check your cover before you book

Call us with the treatment you are considering and we will give you the item numbers to quote to your fund, so there are no surprises.

Call (08) 9306 2755

Which system do you use?

Which system do you use?

HICAPS

What HICAPS actually is

How the appointment ends

What to bring, and what to check first

If your fund is not on HICAPS

HICAPS: what people ask

We will check your cover before you book

Which system do you use?

Which system do you use?