With a patient claim, the patient or claimant typically pays for the the service in full and receives their rebate directly from Medicare.
After selecting the "Create payment request" option, and clicking the Medicare option, 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.
If a patient/claimant has already approved a payment from this practice, you will be able to search for the patient by entering their name.
If you have not sent this patient/claimant a payment request before, you will need to enter the patient's mobile phone number in the "Patient" field.
You can then select "Send payment request to [phone number]" and enter the patient’s Medicare details manually.
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.
You can then select if the service is for an admitted patient and enter any explanatory notes in the “Services” field.
To add a service, 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. 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 "Create payment request".
The patient or claimant will then receive a SMS with a prompt for payment and approval for electronic claim lodgement.
After the payment request is created, a summary screen will be shown, including the status of the Medicare claim.
Note: Prior to attempting a Medicare transaction, providers must submit a Medicare Online Claiming Provider agreement (even if the provider has previously registered with Medicare for online claiming).
Once this agreement has been processed by Medicare, the provider can claim both bulk bill and patient claims. Medicare takes roughly five working days to process this agreement.Five business days after submitting these documents, you will be able to try submitting a Medicare claim.
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.