Online Claiming for Medicare or DVA

Online claiming allows you to quickly submit claims to the Medicare and DVA services.

To submit online claims, we use a pre-paid credit system - each successful transaction costs 1 Claiming Credit and you can combine multiple claims for a single client to reduce costs.

Credits can be purchased from Practice > Setup > Claiming Credits.

Setting up Online Claiming

To begin using online claiming with Medicare or DVA, you will need to:

  1. Contact Medicare/DVA eBusiness on 1800 700 199 for the online claiming/banking form(s) relevant to your business.
    Setting up a new online claiming integration? Ask your Medicare representative:

    "I would like to set up Online Claiming for my business. We use software that submits claims via a centralised site certificate - I need to set up banking details and also add my provider number(s) to a new Location ID. What forms do I need to complete?"
  2. Fill in the Medicare online claiming paperwork excluding the Location ID / Minor ID field.
  3. Submit a support ticket with the completed form.
    • We'll notify you of the Location ID / Minor ID for your business.
  4. Add the Location ID / Minor ID to the Medicare form and submit it to Medicare for processing.
  5. Notify us when Medicare has approved the claiming form that you have submitted and we'll activate online claiming for your account.

Submitting an Online Claim

To submit an online claim, you will need to ensure that each client has a Medicare and/or DVA number that has been saved and verified to their account (This is done from Client > Details > Misc Details)

Online claims are added to a queue, and are generally processed overnight.

To add a claim to the queue, you can either:

  • While generating a new invoice, tick the "Add to Medicare Queue" field.
  • Open an existing invoice and click the Submit Online Claim button.

Bulk Bill vs Client Reimbursement

Claims are automatically marked as Client Reimbursement if there is at least one payment (of any value) on the invoice.

If there is no payment made on an invoice, the claim will be automatically marked as Bulk Bill.

Part Payment and Gap Payments

A client 'part payment' or 'gap' cannot be charged in addition to the amount claimed from Medicare. Bulk bill claiming must be submitted to Medicare for the final value of the service.

Cancelling an Online Claim

Claims can only be cancelled while they are in the queue to be processed - once processing begins, you will need to wait for Medicare / DVA to process the request.

To cancel a claim that has been placed in the queue, open the client's invoice, click the View Online Claim Status button, select the items to cancel, and click "submit".

Reviewing Online Claims

To see a list of the claims you have submitted for a specific period, simply visit Practice > Reports > Online Claiming and run the report for your chosen time period.

Remember: The status of each claim is generally updated overnight.

This information is correct at the time of writing. Always check with Medicare as to how your clinic should make its claims.