What is Southern Cross Health Society 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. 

What are the key benefits for pharmacy?

• Provides a strong incentive for patient loyalty.
• Enhanced delivery of services to customers.

What does this mean for pharmacies?

• 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.

What does this mean for Southern Cross members?

• Member is not 'out of pocket' for eligible claims,
• Member can take full advantage of policies with cover for small medicine claims that may have been  'too much trouble' to claim in the past
• Recognition of the value of a Southern Cross policy in routine daily life.

How does Easy-claim work?

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!

How can i get started with Southern Cross Easy-claim?

Pharmacies should contact Southern Cross for more details, on 0800 700 053.

After completing an application process and set up process (with both the Toniq team and Southern Cross), the pharmacy's Toniq system will be ready to start using Easy-claim.

This article contains text from a Southern Cross User's guide. Note: some names, terms, images, logos will be the property of Southern Cross.