Process Medicare patient rebates

Who can do this?

*Credits will only be charged for successful transactions

This article is about processing Medicare patient rebates, which is different to practitioner rebates from processing bulk bill and DVA claims.

When a patient pays a full fee amount, a Halaxy practitioner can submit the patient's claim to Medicare and have the patient's rebate processed - all in just one click of a button on an invoice.

With Halaxy, patient rebates can be processed in 24 hours without the hassle of going to a Medicare office, without time-consuming submissions on the Medicare website, and without the expense of investing in an EFTPOS terminal.

Processing a Medicare patient rebate on Halaxy costs 1 credit.

Tip

Want a more hands-off approach? Set up manual batch processing or automated claims processing to save you extra time.

Prerequisites

Before you can begin processing Medicare patient rebates, you must first:

  1. Add your provider number for the Medicare funder on the Identifications page.

  2. Set up Medicare online claims processing for your practice.

  3. Add a patient's deposit account details to receive rebates from Medicare.*

*Rebates may also be deposited into the patient's bank details they have listed in their Medicare account, however not all patients do this, so adding their bank account details to their Halaxy profile is recommended.

Note

You may also be required to verify a patient's Medicare/DVA details before being allowed to process a claim.

Manually process Medicare patient rebates

To process a Medicare patient rebate, follow the steps below:

  1. Go to the relevant invoice.

  2. Under the Payments section, process the payment:

    Claims-Medicare-Rebate-01.png
    • If you are receiving payment electronically through the patient's stored payment details, click Process Now.

    • If you received payment outside of Halaxy, click Mark as Paid.

  3. Under the Patient Rebates section, click Process Rebate.

    Claims-Medicare-Rebate-02.png
  4. In the pop-up, you can:

    • Select which fees to process if the invoice has multiple eligible fees.

    • Click Additional Information to add further details in case the claim would be ineligible based on the general details. (Note: Entering information in this section will cause the claim to be processed by a Medicare representative rather than automatically, which may delay the patient rebate by 1 to 2 days.)

    • Indicate whether the treatment was aftercare-related or not for patients who have recently been in hospital, according to Medicare's records. (Note: Medicare does not pay the rebate if the treatment is aftercare-related. This is irrelevant for DVA claims.)

  5. Click Process.

Patient rebates are processed electronically and deposited overnight directly into your patients' bank accounts.

Caution

The invoice should be marked as Paid in Full before you process the rebate. If there is only partial payment or no payment marked, Medicare will send the rebate as a cheque in your name to the patient's address, which is inconvenient for both practitioners and patients.

Medicare claim results

When you submit the claim for processing, there are different possible outcomes and steps you can take.

Result

Details

The claim meets Medicare's criteria and is successfully submitted.

A confirmation message appears that the claim was successfully submitted to Medicare, along with the Statement of Claim and Benefit, which you can provide to the patient.

Medicare accepts the claim but cannot immediately process the claim.

You receive the Lodgement Advice (which you may provide to the patient), and the claim goes through an extra level of checking by a Medicare officer with the rebate processed approximately up to three days later.

The claim is unsuccessful.

Medicare advises you with one or more error codes on why the claim cannot be processed.

You can either:

  • Click Accept to continue submitting the claim to Medicare for a case officer to review (you will be provided with Lodgement Advice), or

  • Click Reject to stop the claim from being processed so that you can rectify any errors before submitting the claim again. The claim status will show as Not processed and can be reprocessed from the invoice.

You can also reset, edit and resubmit your claim to Medicare.

See our troubleshooting guide: Troubleshoot Medicare error codes

Tip

Try to resolve the issue yourself first by following any instructions the error code/s provides. If that is still unsuccessful, you may contact the Medicare eBusiness Service Centre at 132 150.

Updated

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