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Process bulk bill and DVA claims

Bulk bill from the invoice. Medicare pays the rebate overnight.

In bulk billing, you don't charge a gap fee, so Medicare pays the rebate directly to you and your patient pays nothing. DVA claims work the same way, with DVA providing the rebate and Medicare administering it. In Halaxy, you process the claim straight from the invoice: Halaxy sends it to Medicare or DVA and adds the assignment of benefit your patient confirmed in Halaxy.

Note

This article covers bulk bill and DVA claims. For patient-paid rebates, see: Process Medicare patient rebates

Before you start

What Halaxy handles for you

  • Claims sent electronically. Send the claim to Medicare or DVA electronically, straight from the invoice, by clicking Process.

  • Overnight rebates. Medicare pays bulk bill rebates overnight. DVA rebates can take an extra day.

  • Assignment of benefit added. Assignment of benefit you have already collected through Halaxy goes onto the claim automatically.

  • Status kept current. The invoice shows Pending until the rebate reaches your bank account, which makes outstanding claims easy to spot.

  • Invoices match what was paid. The invoice updates to the actual amount paid when it differs from what you claimed.

  • DVA travel calculated. DVA travel claims are worked out for you, minus the distance DVA doesn't pay.

Process a bulk bill or DVA claim

Process the claim from the invoice, before the invoice is marked as paid.

  1. Open the relevant invoice.

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

    Claims-DVA-Claim-01.png

  3. In the pop-up, read the Declaration by Practitioner or Optometrist who Rendered Professional Services. Optometrists can also select whether an optical script was written.

  4. In the pop-up, you can:

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

    • Click Additional Information to add details if the claim might be ineligible based on its standard details. Note: Entering information here sends the claim to a Medicare officer instead of processing it automatically, which can delay the rebate by 1 to 2 days.

    • (Optional) For Medicare-only in-patient claims, set Hospital Service to Yes and add the practice location's Facility ID.

    • Indicate whether the treatment is aftercare, for patients recently in hospital according to Medicare's records. Note: Medicare doesn't pay bulk bill rebates for aftercare, but DVA claims aren't affected.

    • Select how you confirmed your patient's assignment of benefit. If you have already received confirmation, Halaxy fills in this field for you.

  5. Click Process to confirm the claim and send it to Medicare or DVA.

Medicare pays bulk bill rebates overnight. DVA rebates can take an extra day.

Process a Medicare in-patient claim

Process Medicare in-patient claims as bulk bill claims.

  1. Follow steps 1 to 3 in the procedure above.

  2. In the pop-up from step 4, set Hospital service to Yes.

  3. In Hospital Facility Provider, enter your Facility ID. Note: If ECLIPSE billing is turned on, you can set the Facility ID in Personal > Locations.

  4. Click Process to confirm the claim and send it to Medicare or DVA.

Bulk bill and DVA claim results

When you submit a claim, Halaxy shows one of these results.

Result

What happens

The claim is successfully submitted.

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

The claim is unsuccessful.

Medicare or DVA shows an error code so you can make amendments or corrections. The claim shows as Not processed and you can reprocess it from the invoice. See Troubleshoot bulk bill and DVA error codes.

The invoice status remains pending for more than 3 days.

You may not have registered this practice location with Medicare for online claiming. Call Medicare on 132 150 to confirm. If the practice location isn't registered, complete the registration form and send it to Medicare. After Medicare registers the practice location, reset and resubmit the claim.

Confirm bulk bill and DVA rebate payments

Allow 1 day for bulk bill claims and 2 days for DVA claims to be processed, then confirm the rebate payment in one of two ways:

  1. Run a daily Medicare report.

  2. Open the individual invoice for the bulk bill or DVA claim, then click Get Report or View Report. The report shows how much you were paid, for what service and when.

If the amount you claimed differs from the amount you received, Halaxy updates the invoice with the actual amount, and Medicare gives you a reason or explanation code. See: Troubleshoot bulk bill and DVA error codes

Special rules for DVA claims

A few special rules apply only to DVA claims, and Halaxy handles most of them for you:

  • Travel claims: Submit travel claims to DVA on an invoice with an appointment fee. You can't submit a travel claim on an invoice by itself.

  • Distance DVA doesn't pay: DVA doesn't pay for the first 10 km travelled (or 50 km for item number OT80), so Halaxy calculates your claim minus the first 10 km (or 50 km for OT80). Example: if you drive 30 km to see a patient and enter 30 in the Quantity field at a rate of $0.90 per km, Halaxy calculates the claim as $18.00 (20 km x $0.90), not $27.00. This keeps the invoice balanced after DVA pays the claim.

  • Out-of-room loading: If the fee's item code is eligible for out-of-room loading paid to the practitioner, you don't need to do anything extra on the invoice or fee. DVA works it out for you.

  • White DVA card: If your patient has a white DVA card and you are an allied health practitioner, you may need to enter the accepted disability in the Accepted Disability field. You can add it when you add or edit the patient's DVA claim details, on the patient's Funding page, on the invoice or on the appointment.

Get more from bulk billing in Halaxy

Claims connect to the setup behind them: provider numbers, Medicare Location IDs and assignment of benefit.

Updated

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