Medicare is a beta feature.
The following feature is currently in beta, and is therefore made available to select providers at no cost. You will be advised of any pricing changes in advance of them coming into effect, and you are able to cease using the feature at any time.
If you would like to join the waitlist for this feature, please register your details here. We will be in touch when it's time to get set up.
How Medicare works.
Medipass enables you to send bulk billed and private patient claims to Medicare. This is ideal for providers who want to automatically claim with Medicare, without the need for a terminal or their patient's physical Medicare card.
With Medicare bulk bill, providers can claim for eligible services billed at Medicare Benefits Scheme (MBS) rates and receive payments direct from Medicare.
With Medicare private patient claims, providers can charge for eligible services at or above the MBS rates and have benefits paid by Medicare to patients or claimants. Patients must pay for the service prior to claiming, but typically receive their benefit payment by the next business day and do not need to submit a claim to Medicare.
Important things to note before you begin.
Our Medicare integration is made available to providers who are registered with Medicare and hold an active Medicare issued provider number for each practice location.
If you are NOT registered with Medicare or do not have an active Medicare issued provider number, please first complete a Medicare registration:
- Medicare registration for allied healthcare professionals
- Medicare registration for medical practitioners
Our Medicare integration supports General Practitioners, Medical Specialists, Dentists and Allied Healthcare Professionals, and provides the ability to lodge claims for:
- General and referred services;
- Permitted telehealth scenarios;
- Dental scenarios (Child Dental Benefits Scheme) - please ensure you're familiar with DHS rules applicable to this scheme;
- Permitted remote, regional, residential aged care facility, in-home, after-hours and other out of consultation room scenarios;
- Hospital inpatient (admitted) scenarios;
- Simple pathology services by qualified providers; and
- Overrides and exceptions: duplicate service overrides, aftercare overrides, restrictive overrides and multiple attendance
As the solution is currently in beta, there are a couple of limitations:
- Department of Veteran Affairs (DVA) claims are not currently supported.
- While bulk billing is fully supported, private patient claiming is only available to providers who have enabled HICAPS Go. This is because HICAPS Go provides you with the required Merchant facility to process Visa and Mastercard payments.
- Note: Enabling HICAPS Go will also enable you to raise allied health claims for private health insurance.
Lastly, you are required to have a Medipass account with your:
- Business claimed;
- Practice locations that you would like to use Medicare added (instructions here); and
- Healthcare providers that you would like to use Medicare added.
If you do not already have a Medipass account, create one here.
Important: If you are already using Medicare Online to process Medicare and DVA claims via your practice management software, please talk to our team before signing up as you may not be able to use both Medipass and your existing system at the same time.
Step 1: Request Online Claiming with Medicare
Sign into Medipass and navigate to Documents and select ‘Medicare - Online Claiming Provider Agreement’. This document will enable you to use Medipass to raise Medicare claims.
For detailed instructions on how to complete this form, please click here.
Medipass is not advised by Medicare when this agreement has been approved, but Medicare typically takes 5 working days. We suggest you keep an eye out for correspondence from Medicare.
Step 2: Complete an identity check
Once you submit your Online Claiming Provider Agreement, you will be contacted by Medipass to complete an identity check. This is to ensure that payments are being made to the correct provider.
In order to complete this, Medipass will contact you and request various identification.
If you have any questions about this process, please speak with your support consultant at the time.
Step 3: Sign up for your Payment Facility (optional)
While in beta, private patient claims will be processed via a HICAPS Go payment facility. Note, HICAPS Go is not required to process bulk-bill claims.
If you do not already have HICAPS Go, please follow these instructions.
You’re ready to raise a claim!
Once the above steps have been completed, you’re ready to send a Medicare claim. In order to do this, navigate to medipass.com.au and sign in with your Medipass Provider Account.
- Select ‘Create Payment Request’
- Select the ‘Medicare’ payment option.
- Complete the form and hit Submit
Please let us know if you have any questions.