Adding and Verifying 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 secondary claimants where required and verify both patient and claimant Medicare details instantaneously to ensure rebates are paid as soon as possible.

Adding 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:

  • The patient’s profile: go to the Funding page on the patient's profile. Under Claim & Referrals, Medicare will be 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 bodies by clicking New Claim.

    PatientProfile_FundingMedicareClaim.png
  • From the calendar: click an appointment on your calendar to access the appointment details. 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.

    AppointmentInformation_MedicareClaim.png
  • On an invoice: go to the invoice. 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.

    Invoice_MedicareClaim.png

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

Editing patients' Medicare claiming details

To edit or update patient Medicare claiming details, go to the Funding page of the patient's profile. In the Claim & Referrals section, expand the Medicare claim by clicking the Expand (+) icon, then click either the Medicare card number or the Edit (pencil) icon. Make the changes necessary and click Submit.

PatientFunding_EditClaimMedicare.png

You can edit the following information:

  • Medicare card number

  • Individual reference number (IRN)

  • Expiry date (which is optional)

  • Claimant information (i.e. where someone other than the patient makes the claim and receives the rebate)

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

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.

To verify Medicare claim details, go the Funding page on the patient's profile and expand the patient's Medicare claim in the 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.

PatientFunding_VerifyClaimMedicare.png

If the details are correct, the icon changes to a tick icon. If the details are incorrect, Medicare provides you with a message saying why the details are not correct so you can obtain the correct Medicare details from the patient.

Adding claimant details

A claimant is someone who claims a patient Medicare rebate on behalf of the patient. You can enter claimant details as part of a patient's Medicare claim information so that the claimant receives the rebate instead of the patient. This is useful in situations such as a parent claiming a rebate on behalf of a child, or where one person in a couple is responsible for all financial matters.

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 to a patient's claim details:

  1. Go to the Funding page of the patient's profile.

  2. In the Claim & Referrals section, expand the patient's Medicare claim by clicking the Expand (+) icon, then click the Edit (pencil) icon next to the patient's Medicare card number.

  3. Click Add Claimant. The form will expand to allow you to add the claimant details.

  4. In the Claimant field, enter the claimant’s name. If the claimant is an existing patient, click the claimant's name in the drop-down menu that appears. Otherwise click to add the claimant as a new claimant/patient (this will create a new patient profile for the claimant).

    PatientFunding_AddClaimant.png
  5. Add the claimant's Medicare details and click Submit.

RESULT: The claimants' details are recorded on all Medicare-covered invoices and appointments for the patient, as well as on the patient's profile. When you process the Medicare claim, the rebate will go to the claimant.

Adding a second claimant

Each Medicare claim allows you to add one claimant. If you need to add a second claimant (for example, where two parents alternate claiming for a child patient), you can add a second Medicare claim using the same patient Medicare information but with different claimant details.

From any invoice with a Medicare fee, you can then choose which claim to use, allowing you to select which claimant receives the rebate.

Removing claimant details

To remove claimant details from a patient profile (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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