This page relates to DVA rebates and bulk-billed Medicare claims. Please click this link for information about patient-paid Medicare rebates.
A bulk bill rebate is where the patient assigns their right to claim a rebate directly to you, and you charge no additional fee: for example, the rebate available is $80 and your fee is $80, which you claim from Medicare (i.e. you are paid the rebate directly), and the patient pays nothing. A DVA rebate functions almost in the same way as a bulk bill rebate, except that the rebate is provided by DVA rather than Medicare, with Medicare administering the process on behalf of DVA.
A video that demonstrates invoices and how to process bulk bill and DVA rebates is available here:
To process bulk bill and DVA rebates through Halaxy, you need to do two things:
Once you have done these two things, you can process bulk bill and DVA rebates with just a few clicks in Halaxy. Bulk bill and DVA rebates are processed overnight without the hassle of going to a Medicare office, and without the expense of investing in an EFTPOS facility (which is more time-consuming to use than online claiming).
If you have any queries about a specific invoice, you can contact Medicare on 1800 700 199.
Individual claims can be processed manually, or you can set up manual batch processing or completely automated processing, saving you time.
Processing a claim costs 1 credit; there is no charge for rejected claims.
Halaxy allows you to automatically process your Medicare, bulk bill and DVA rebates for a completely hands-off approach. Please see the instructions in the linked article.
To process a bulk bill or DVA claim manually:
Go to the invoice and click Process Bulk Bill / Process DVA (do NOT mark the invoice as paid first). You will see the Declaration by Practitioner or Optometrist who Rendered Professional Services (optometrists can also select whether an Optical Script was written or not). A pop-up will appear.
From the pop-up, you can:
select which fees to process if the invoice has multiple eligible fees;
click Additional Information to add additional information if the claim would otherwise be ineligible (entering information into this field will cause the claim to be processed by a Medicare representative rather than automatically, which may delay payment by 1-2 days); and
for patients who have recently been in hospital based on Medicare's records, confirm in the drop-down menu whether the treatment was aftercare-related or not (if the treatment is not aftercare-related, Medicare pays the claim; if the treatment is aftercare-related, Medicare does not pay the claim). This is not relevant for DVA claims.
Click Process to confirm the claim and send it to Medicare/DVA (you can also leave the rebate to be processed later in a batch).
If 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 from Not Yet Paid to Pending between when you process the rebate and the rebate being paid into your bank account.
If the claim is not successful, Medicare/DVA advises you of the error code so that you can rectify the issue. The payment will show as Not Processed and can be reprocessed from the invoice.
If a rebate status remains pending after more than 3 days, you may not have registered this practice location with Medicare for online claiming purposes (you must complete the Online Claiming Provider Agreement for each provider number you have). 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 rebate.
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; 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). e.g. If you are 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 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.
There are two ways you can confirm that a bulk bill or DVA rebate claim has been paid:
by running a daily Medicare report; or
by checking an individual invoice for a specific bulk bill or DVA claim.
As rebates are processed overnight, you must wait until the following day to confirm whether or not the claim was paid.
To confirm that the a specific bulk bill or DVA claim was processed, click Get Report or View Report on the invoice, which takes you to the Processing and Payments Report. This report shows you (a) how much you were paid, (b) for what service, and (c) when. For each fee processed, the report shows whether you were paid the same amount as you claimed, whether you are paid more than you claimed, and whether you paid less than you claimed.
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 (also called an explanation code). Please see this article on bulk bill and DVA error codes for troubleshooting advice.