FAQ: Claims and Funders

If you are encountering issues with this topic, you may be able to troubleshoot these issues yourself first. If your issue is still not resolved, you can contact Halaxy for assistance. 


Do I need to add each private health insurance company as a separate funder?

You don't need to add individual health funds as separate funders. If the client is paying the invoice themselves and claiming a private health fund rebate, then you only need to list the funder as "Private".

How do I add multiple provider numbers for different private health funds?

You can do this by adding multiple identifications to the "Private" funder on your Identifications page. This can be useful if you have different provider numbers for different private health funds. You can then choose between each of your provider numbers on any invoice with a Private fee.

To add identifications to the Private funder:

  1. Click Finances > Fees, then click the Identifications tab.

  2. In the top right, click Edit.

  3. In the Private row, add the provider number(s) for each practice location.

  4. Enter a Description (e.g. the name of the health fund). This will be shown in brackets next to the provider number on invoices. Adding the description here will make it easier for you to select the correct provider number on invoices.

  5. Click Add another identification to add another provider number (e.g. for a different health fund).

  6. Click Save.

On any invoice with a Private fee, you will be able to choose between the relevant identifications by clicking the Icon-Edit.svg edit icon in the Identifications section:

User clicks the Edit icon in the Identifications section of an invoice and selects a different ID

Image: Selecting between two different provider numbers for different health funds on an invoice

How do I change the rebate amount?

To change the rebate amount of a fee, you can edit the fee from your Fees List. You will be given a choice of whether to update all invoices that use the fee or only future-dated invoices that use the fee.

To change the rebate amount of a single invoice line:

  1. in the Fees & Charges section, click the Edit icon next to the fee the rebate is for.

    In the Fees & Charges section of an invoice, the Edit icon for an invoice line is highlighted
  2. Change the amount in the Rebate field.

    A pop-up titled Edit Invoice Line. The Amount and Rebate fields are highlighted.


Although you can change the amount entered into the rebate field, when you process the claim only the amount set by Medicare/DVA or the relevant funding body will be paid.

Can multiple practitioners use the same Medicare Location ID/Minor ID?

Yes, all practitioners claiming from a particular location will use the same Location ID. Each practitioner must register their Provider Number with that Location ID to claim successfully from that location. For more information, see Registering for Online Medicare Rebates Claiming.

How do I provide Bulk Bill Assignment Advice (DB4) to patients?

Halaxy allows you to include any Medicare statements when emailing an invoice to a patient, including the Bulk Bill Assignment Advice (DB4) form and DVA Health Practitioner Service Vouchers.

To include Medicare statements when emailing an invoice, simply click the Email (envelope) icon in the top-right of the invoice, then tick the checkboxes for the Medicare statements you wish to include.


Image: Including a Medicare statement when emailing an invoice (expand image)

How do I make all practitioner bulk bill rebates go into the same bank account?

The easiest way to do this is to configure your invoices to show a Payee Provider Number. As long as the Payee Provider Number is shown on invoices, Medicare will pay the benefit into the bank account associated with the Payee Provider Number instead of the servicing Provider Number.

Please see the article on Payee Provider Numbers for more details.

Why is my Medicare / DVA / bulk bill claim still pending?

This is most likely because your details were not registered with Medicare when you submitted the claim, or the details are incorrect.

To use bulk billing, you must complete the Online Claiming Provider Agreement, which registers your Provider Number, Location ID and bank account with Medicare for online claiming. Medicare usually takes around 5 days to process the form and does not send you a notification when they have processed it.

If you have already registered, call Medicare on 132 150 to confirm the details.

You can reset the invoice by clicking Get Report on the invoice, then clicking Reset and confirming that you want to reset the invoice. This will reset the claim status to "Not processed", allowing you to reprocess the claim.

You should also ensure that your provider number appears on the invoice:

The Practitioner Details section of an invoice, with ABN and Provider Number.

Will I be charged if the bulk bill or rebate fails?

You will only be charged for successful claims. If the claim remains pending and has not been immediately rejected, or if you only realise the transaction has failed some time later, you will be reimbursed the cost of the transaction. This will be shown on your Halaxy Credit Usage Report by a negative number in the Credits Used column.

I was overpaid or overcharged on a Medicare / DVA claim. How can I fix this?

If you overcharged or were overpaid on a Medicare or DVA claim, you will need to contact Medicare on 132 150. You may be required to refund the overpayment to Medicare.

You will then need to manually edit the claim amount in Halaxy to reconcile your invoices.

I processed a rebate but the patient record had the wrong bank account. What do I do?

You will need to contact Medicare directly on 132 150 and ask for advice. Once you submit a claim for processing, it is sent straight to Medicare for review and is out of Halaxy's control.

To avoid this happening in the future, make sure to update your patient's bank account details. Open the patient profile and click the Funding tab. Under the Bank Account section, click the Icon-Edit.svg edit icon to enter the correct bank account details. Then click Save.

Can I submit all Medicare claims at the same time?

Yes. You can run a finance report to submit all unprocessed Medicare claims.

See complete guide here: Run batch rebate processing

How do I process two Medicare rebates for a client in one day?

Medicare generally only allows one claim per item per patient per day. However, if you add explanation text in the Additional Information field when you reprocess the claim, this will be flagged for someone to check at Medicare. Note that this may delay processing by 2-3 days. You may need to confirm with Medicare what is an acceptable reason.

Once you have added the text, click Process.

How can I reconcile payments made for Medicare or DVA?

On your bank statement, you will see a Pay Run number. To find this number in Halaxy:

  1. Click Reports > Medicare.

  2. Click on any line to see more information about the payment (including the Pay Run number) and to see invoices included.

I have changed my address. What information do I need to give Medicare?

You need to register the following information with Medicare for each location:

  • Provider number

  • CLK number (CLKXXXX). This can be found on your Users page under Settings. However, you can use the same number for each location.

  • Bank account details

From the Users page, you can click the icon next to your Medicare ID to download the Online Claiming Provider Agreement form, which has some of the details pre-populated for you.

Do I need to register for a PKI certificate for Medicare claiming?

There is no need to install a PKI certificate as you are using Halaxy’s. This means you can process a Medicare rebate on any device, such as your phone or tablet. All you need to do to register with Medicare for online Medicare and DVA rebates claiming is to complete the Online Claiming Provider Agreement. In the field that asks for the PKI number, just write "N/A".

The paying organisation changes for a funder. How do I set this up?

When the default payer for a claim changes between different patients, you can leave the funder's default paying organisation empty then edit each patient's claim details to update the paying organisation when you have been notified who the payer is.

To remove the funder's default payer: Click Finances > Fees, then click the Funders tab. Open the relevant funder, delete the paying organisation, then click Save.

To edit the default payer on a patient's claim for the funder: Open the patient profile, then click the Funding tab. Under the Claims & Referrals section, for the relevant funder, click the Icon-Edit.svg edit icon next to the claim number, and enter the name of the paying organisation.

What does "There are no Medicare items to process" mean?

You may see this message when you attempt to process a Medicare claim where the appointment status has been set to Rejected, Declined, Cancelled or another status that indicates the patient did not attend.

You can change the status of the appointment by clicking the appointment on the calendar, then clicking the Icon-Edit.svg in the Appointment Information panel and editing the Status field.


Once you set the status to Attended, you should be able to process the Medicare claim.

Why does my Medicare claim have "Scheduled Failed" status?

If you use batch processing or automatic Medicare processing and your Medicare claim fails Medicare's first-level validation, the claim status on the invoice will be updated to "Scheduled Failed". Note that there is no Halaxy credit cost for a failed claim (the credit cost is reimbursed).

From the invoice, click Get Report to view the Medicare report and identify errors with the claim. You can then correct the errors and reset the claim to resubmit it.

What does the error "For Input String" mean?

This error can occur when there are difficulties in connecting to Medicare. Try processing again at a later stage.


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