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 how you will do it!
First you will need to start a payment request via "+ Payment request", and select the "Medicare" tile. You will be asked, “Will this transaction be bulk billed?”, select "No" to create a patient claim.
You can then select the servicing practice and provider.
The “Modality” (profession) will auto-populate based on the selected provider.
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.
Next, you can enter the patient's details under the “Patient and claimant details” section.
If the patient is claiming the benefit, select “The patient will claim the benefit” and enter the patient’s name (if they have transacted with you before) or full mobile phone number in the “Patient” field.
Note: If someone else, such as a relative of the patient, will claim the benefit, select "Someone else will claim the benefit". You can then fill in the patient's details also send the payment request to the claimant via SMS.
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 required, add referral details such as the referring provider name, number, issue date and period. Referral details are typically not required or shown for General Practitioners.
Before moving on to completing the payment request, you will need to 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".
Lastly to finalise the payment request, you will have the choice of whether you want to process the payment using Medipass or just lodge the Medicare claim for your patient/claimant.
- Send to patient's mobile - your patient/claimant will be sent an SMS with a prompt for payment and approval for electronic claim lodgement.
- Do not process with Medipass - the medicare electronic claim will be lodged. However, 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 firstname.lastname@example.org.
Wanting to know what the status of a Medicare claim means? Click here.