When claiming online with Medicare, it is possible to choose between the Claim Types of Bulk Bill and Client Reimbursement. This article explains the difference between the two, as well as providing instructions on how to submit these claims through the Medicare & DVA integration.
Before you start...
For details on what must be set up prior to Medicare claiming please see Setup Guide for Medicare and DVA Claiming.
Important!
1. Claims are automatically marked as Client Reimbursement if there is at least one payment (of any value) on the invoice.
2. If there is no payment made on an invoice, the claim will be automatically marked as Bulk Bill for Medicare claims.
Client Reimbursement Claims
The Client (or the Claimant) pays the entire fee to the Practice upfront and is reimbursed in their nominated bank account set with Medicare the appropriate item fee in accordance with the Medicare Benefits Scheme.
1. Click on Generate Invoice in the appointment screen.
2. Accept the Client's payment and enter the correct amount into the applicable Payment Method field.
3. Click Add to Medicare Queue.
4. Click on Save Invoice.
5. In the pop-up box that opens, ensure the Item Code and Claim amount are correct.
6. Select the appropriate Provider Number for the Provider that matches the Location or Claiming Group (Minor ID).
7. Tick the checkbox left to the Item(s) to be claimed.
8. Then press Submit Claim.
9. In the claiming window, select Client Reimbursement as the Claim Type.
10. For Allied Health claims, select S: Specialist as the Service Type. For General Practitioner claims, select O: General.
11. Select the Location for the claim.
12. Select the appropriate Referral or select No Referral Required (or one of the other options in the drop down) if no referral is required for the claim.
13. If you select the Medicare Client Reimbursement as the Claim Type, you are able to Add a Claimant to the claim. If you add a Claimant, then any reimbursement will go to the Claimant, rather than the client who received treatment.
Claimants are required for Clients 12 years or younger, regardless of the Claim Type. The Claimant must be added as a Client in Nookal in order to be selected as a Claimant on a Clients claim.
14. Click Submit.
The claim has now been submitted to Medicare for processing.
Bulk Bill Claims
For Bulk Bill claims, the invoice is sent to Medicare and Medicare pays the practice or provider directly the appropriate item fee in accordance with the Medicare Benefits Scheme. The Client does not pay any amount for Bulk Bill claims.
1. Click on Generate Invoice in the appointment screen.
2. Expand Queue for Payment and click Add to Medicare Queue.
3. Click on Save Invoice.
4. In the pop-up box that opens, ensure the Item Code and Claim amount are correct.
5. Select the appropriate Provider Number for the Provider that matches the Location or Claiming Group (Minor ID).
6. Tick the checkbox left to the Item(s) to be claimed.
7. Then press Submit Claim.
8. In the claiming window, select Bulk Bill as the Claim Type.
9. For Allied Health claims, select S: Specialist as the Service Type. For General Practitioner claims, select O: General.
10. Select the Location for the claim.
11. Select the appropriate Referral or select No Referral Required (or one of the other options in the drop down) if no referral is required for the claim.
12. Click Submit.
The claim has now been submitted to Medicare for processing.