Adding and Verifying Patient and Claimant Medicare Details

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If your patient would like to claim available Medicare rebates online (or if you would like to claim for bulk billed appointments), you only need to enter the patient’s details once to enable online Medicare rebates claiming. You can add claimants where required and verify both patient and claimant Medicare details instantaneously to ensure rebates are paid as soon as possible.

Three ways to enter patients' Medicare claiming details

If your patient would like to claim available Medicare rebates online (or if you would like to claim for bulk billed appointments), you only need to enter the patient’s details once to enable online Medicare rebates claiming.

For your convenience, you can add a patient's Medicare details to their profile in three ways:

  1. The patient’s profile: go to the Funding page on the patient's profile, and under Claim & Referrals, Medicare is listed if an appointment covered by Medicare has been made with the patient. If Medicare is not listed, you can add Medicare as one of the patient's funding body by clicking New Claim. Click Update Claim Details.
  2. When making an appointment: click the appointment on your calendar to access the appointment details, and the Medicare Claim section is shown is the fee is a Medicare fee; click the edit (pencil) icon next to it to add or edit the patient's Medicare details; and
  3. On an invoice: go to the invoice, and the Medicare Claim section is shown if the fee is a Medicare fee; click the edit (pencil) icon next to it to add or edit the patient's Medicare details.

The patient's Medicare claiming details is added to their profile regardless of which method you use to add their details.

Adding and editing patient Medicare claiming details

After you have clicked Update Claim Details from the patient's profile, or the Edit icon next the claim details section on an appointment or an invoice, add the following information on the form that appears:

  • Medicare card number
  • Individual reference number (IRN)
  • Expiry date (which is optional)

Click submit to save the information to the patient's profile.

To edit or update patient Medicare claiming details, go to the Funding page of the patient's profile. Under the Claim & Referrals section, click either the patient's name or click the edit (pencil) icon. Make the changes necessary and click Submit.

Verifying patient Medicare claiming details: OPV and OVV

Practitioners can verify patient (or claimant) Medicare claiming details using Halaxy's integrated Medicare Online Patient Verification (OPV) process, which is called Online Veteran Verification (OVV) for DVA purposes. Go to the Funding page on the patient's profile, where the patient's Medicare number is shown under Claim & Referrals section. If you have not yet verified the details, a circle with a line is shown next to the Medicare number (this does not mean that the Medicare details are incorrect, it only means that you have not verified them yet). Click the icon to instantaneously verify the details with Medicare. The icon changes to a tick icon if the details are correct; if the details are incorrect, Medicare provides you with a flash message saying why the details are not correct so you can obtain the correct Medicare details from the patient.

Adding claimant details when required

The patient and the person who claims the rebates (the claimant) are often the same person, but not always - for example, when a patient is a child a parent might claim and receive the rebate, or when one partner in a couple is responsible for all financial and/or health costs, that person would claim the rebate regardless of who sought treatment. Wherever someone is claiming a patient Medicare rebate on behalf of someone else, you can enter a that person as a claimant, so that they claim and receive the rebate from Medicare in the same way that patients can directly do so.

Claiming as a claimant is available for patient Medicare rebates but not available for bulk bill claims or DVA claims, as these rebates are usually paid directly to the practitioner. The only limitation that Medicare imposes on who can be a claimant is that the claimant cannot be under the age of 18.

To add a claimant, enter the patient's details in one of the three ways listed above and click Add Claimant. Enter the claimant's name in the Claimant field. If the claimant is already listed on your Patients List, their name appears and you can select them as claimant; their Medicare details are automatically populated in the fields below. Click Submit to save them as claimant. If the claimant is not already listed on your Patients List:

  1. Enter the claimant’s name and, when prompted, the claimant's date of birth;
  2. Add Medicare card number (not all patients have the same number as the claimant);
  3. Add their Individual Reference Number (IRN); and
  4. Enter the expiry date.
  5. Click Submit to save them as a claimant. For your convenience, the claimant is also saved in your Patients List as a Claimant.

The claimants' details are recorded on all Medicare-covered invoices and appointments for the patient, as well as on the patient's profile.

Adding a second claimant

You can add a second claimant by clicking New Claim and entering the patient's Medicare details, then the second claimant's Medicare details. You can choose between claimants when you process a Medicare claim for the patient.

Removing claimant details

To remove claimant details (for example, when a child patient begins to pay for treatment themselves), go to the Funding page on the patient's profile. The claimant is listed in the Claims and Referrals section under the patient's name. Click the Delete (trash) icon next to the claimant's name, then confirm whether you want to:

  • Archive the claimant: which keeps a record that the claimant had been used as a claimant on this patient's claim but removes the claimant from the patient's future claims; or
  • Delete the claimant from the patient's claim: which removes the record that the claimant was used on this patient's claim (which makes deleting the claimant the appropriate option if you added the claimant by mistake) as well as removing the claimant from the patient's future claims. The claimant remains listed on your Patient List.

 

 

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