With a patient claim, the patient or claimant will pay for the the service(s) in full and they will receive their rebate directly from Medicare. This guide will aim to help you through your first Medicare patient claim!
Please note: If you have not submitted forms to Medicare to apply for Medicare Online via Medipass, you will not be able to create Medicate payment requests yet. Sign up here and we will get you up set up.
Here's Sophie from the Medipass Customer Success team with a detailed walkthrough of how patient claiming works. For a step-by-step breakdown, keep reading below.
Steps for creating a Medicare patient claim
To get started select the "Get paid" tab and click on the Medicare option.
Select "Patient claim" when asked how should this claim be processed.
Under “Invoice reference”, you can optionally provide a unique reference, such an invoice number from your practice management or accounting system. This number will be retained and can be used to search for the transaction.
You will need to select the practice the service was provided at and the provider. Usually the "Speciality & provider number" field should auto-populate, unless the provider has two provider numbers for the same practice,
For the first time you create a patient funded Medicare claim for a new patient, you will need to manually enter in their Medicare details. The next time around, you will be able to search by their details.
If the patient is claiming the benefit, select "The patient". However, if someone else needs to receive the benefit, such as a parent/guardian of a minor, select "Someone else. That will enable you to fill in the patient's details and the claimant details.
Referral details (if applicable)
If the patient has a referral, enter in the details as listed on the referral provided.
Add the services provided to your patient. To do this, either type in the the relevant item code, item description, or select your service from the drop down list. (Only item codes relevant to the servicing provider and date of service will be displayed.)
The date of service defaults to the current date but can be any date within the previous two years, use you can use to backdate your Medicare claims. Enter an item price (default value is the MBS rate) and set any attributes applicable for the item.
To add any additional services, select “+ Add another item”.
Once the required fields are complete, click "Continue to payment".
Assisted card payment - You can enter the patient's payment card details into Medipass to take the payment from their account.
You also have the option to save these details to their patient record so you can use these card details for their next appointment.
SMS payment request - Your patient/claimant will be sent an SMS with a prompt for payment and approval for electronic claim lodgement (the patient/claimant will have 24 hours to complete the payment once the SMS link has been opened. If this is not done, the link will expire and the payment will need to be processed again).
Other - The Medicare claim will be lodged. However, full payment for the services will need to be taken outside of Medipass. For example, using a EFPTOS machine or taking cash.
Select "Submit" after you are happy with which payment option you are going to use and you're done! Woo!
If you have any issues submitting a Medicare claim, please contact support via the chat bubble in your Medipass portal or at email@example.com.
Wanting to know what the status of a Medicare claim means? Click here
Do your patients need help setting up their bank account with Medicare? Click here