Process bulk bill and DVA claims

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*Credits will only be charged for successful transactions.

In bulk billing, a practitioner doesn't charge a gap fee, so Medicare pays the rebate directly to the practitioner, and the patient doesn't pay anything. A DVA rebate functions similarly, except the rebate is provided by the DVA instead of Medicare, with Medicare only administering the process on behalf of DVA.

In Halaxy, you can easily process bulk bill and DVA claims with just one click of a button on any invoice.

Bulk bill rebates are processed overnight, while DVA rebates may require an extra day.

Tip

You can set up automated claims processing for a completely hands-off approach.

Note

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

Prerequisites

Before you can begin processing bulk bill and DVA claims, you must first:

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

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

Note

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

Manually process bulk bill and DVA claims

To process a bulk bill or DVA claim, follow the steps below:

  1. Go to the relevant invoice.

  2. Under the Payments section, click Process Bulk Bill or Process DVA. Do NOT mark the invoice as paid first.

    Claims-DVA-Claim-01.png
  3. A pop-up appears with the Declaration by Practitioner or Optometrist who Rendered Professional Services. Optometrists can also select whether an optical script was written or not.

  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 to confirm the claim and send it to Medicare/DVA.

Bulk bill or DVA claim results

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

Result

Details

The claim is successfully submitted.

You receive the Bulk Bill Assignment Advice / DVA Health Practitioner Service Voucher. Halaxy allows you to include these documents when emailing the invoice to the patient. The invoice status also changes to Pending until the rebate is paid into your bank account.

The claim is unsuccessful.

Medicare or DVA advises you of the error code so that you can make amendments or corrections. The claim will show as Not processed and can be reprocessed from the invoice.

The invoice status remains pending for more than 3 days.

You may not have registered this practice location with Medicare for online claiming.

You can call Medicare on 1800 700 199 to confirm whether the location is registered for online claiming purposes. If it is not, complete the registration form and send it to Medicare. After the location is registered, you can then reset and resubmit the claim.

Confirm bulk bill or DVA rebate payments

There are two ways to confirm that a bulk bill or DVA rebate has been paid:

  • Run a daily Medicare report.

  • Go to an individual invoice for a specific bulk bill or DVA claim then click Get Report or View Report. This report shows you how much you were paid, for what service and when you were paid.

If there is a difference between the amount you claimed and the amount you received, the invoice is updated with the actual amount you received, and Medicare provides you with a reason code (or explanation code). See this article on bulk bill and DVA error codes for troubleshooting information.

Note

Please allow 1 day for bulk billing and 2 days for DVA claims to be processed before confirming rebate payments.

Special rules for DVA claims

Medicare has a small number of special rules that relate only to DVA rebate claiming:

  • Travel claims to DVA can only be submitted on an invoice with an appointment fee, so travel claims cannot be submitted on an invoice by themselves.

  • Because DVA does not pay for the first 10 km travelled (or 50 km in the case of item number OT80), Halaxy automatically calculates the amount you are claiming for you minus the first 10 km (or 50 km for OT80).

    For example: if you have driven 30 km to see a patient and enter 30 into the Quantity field at a rate of $0.90 per km, Halaxy automatically calculates the claim as $18.00 (i.e. 20 km x $0.90), not $27.00. This automatic calculation ensures that the invoice balances after DVA has paid the claim.

  • If the fee's item code is eligible for out-of-room loading paid to the practitioner, you do not have to do anything additional to the invoice and fee. DVA automatically works it out for you.

  • If the patient has a white DVA card and you are an allied health practitioner, you may need to specify the accepted disability in the Accepted Disability field, which you can do when you add or edit the patient's DVA claim details.

  • You can add the accepted disability when you add the patient's DVA card details. This can be done either on the patient's Funding page, on the invoice, or on the appointment.

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