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Reviewed · Updated 2026-06-19

HICAPS

Processes health claims and payments for clinics, practitioners, and patients.

Reviewed by the Conversion Gems editorial team ·
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Best for
Healthcare providers
Category
Finance, Billing & Accounting
The bottom line

The de-facto standard for private health claiming in Australia — essential infrastructure for any allied health or medical practice.

7.3
Our score
7.3 / 10
Conversion Gems editorial verdict
A$30/mo terminal; digital 1.45%/claim
Features7/10
7 - comprehensive AU health-fund and government-scheme coverage; terminal + digital options; 50+ PMS integrations; lacks international reach.
Value8/10
8 - free health-fund claim processing is exceptional value; A$30/month terminal rental is reasonable for the AU market.
Ease of use7/10
7 - terminal operates like EFTPOS (familiar to staff); digital portal is straightforward; initial registration per funder adds friction.
Ecosystem7/10
7 - 100% AU health fund connectivity and 50+ PMS integrations; ecosystem value is AU-specific and does not extend internationally.
Support7/10
7 - NAB-backed with established practitioner support channels; no evidence of 24/7 live support on standard plans.

Community ratings

2.3/ 5 aggregate · across 1 source
Trustpilot
2.35+ reviews

Third-party ratings shown verbatim; aggregate weighted by review volume.

What it really is

HICAPS — Australia's largest point-of-sale health-fund claiming and EFTPOS terminal service for practitioners.

Our take

HICAPS is the dominant healthcare claims network in Australia, used by 100,000+ practitioners across 40+ medical disciplines and connected to 100% of Australian private health insurers. The DB pricing of '$25/transaction' is incorrect — health-fund and Medicare Easyclaim transactions carry no per-claim fee; revenue comes from physical terminal rental (A$30/month) and card-processing fees (up to 1.1%). A digital browser-based option charges 1.45% per approved claim plus A$0.10 per invoice with free setup. The DB 'free_trial' price tier also mislabels the product — standard access is paid, though promotional 12-month free terminal rental offers exist.

Why we rate it

No other platform covers 100% of Australian health funds with free per-claim processing — it is the network effect moat that makes HICAPS nearly unavoidable for Australian allied health practices.

The catch

Australia-only; no international use case. Physical terminal requires NAB account for same-day settlement. Digital product's 1.45% per-claim fee adds up for high-volume practices.

Best for
Allied health practices (physio, chiro, dental) needing instant health-fund rebates at checkout
GPs and specialists processing Medicare Easyclaim alongside private health claims
Multi-practitioner clinics integrating with an existing practice management system
Not good for
Non-Australian healthcare providers — product is AU-market only
Practices seeking a fully software-based billing solution with no hardware dependency
High-volume digital-only claimers where 1.45% per-claim fees accumulate significantly
Friction report
Time to value
Moderate: terminal application and delivery adds setup time; digital portal is faster to activate but requires provider registration with each funder.
Scale breakpoint
Digital plan's 1.45% per-claim fee becomes costly at high claim volumes; multi-terminal practices pay A$30/month per primary location.
Walled garden
Moderate: HICAPS is the dominant AU health claims network, making switching costly; 50+ PMS integrations reduce lock-in somewhat but the terminal ecosystem ties practices to NAB.

Frequently Asked Questions

Alternatives

Step up

Medipass or Tyro Health for fully software-based multi-funder claiming with deeper PMS billing automation.

Lighter alternative

Medicare Online (Services Australia) for practices needing only Medicare bulk-billing with no private health fund claims.

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Tags

#HealthClaims#Australia

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