Getting Ready for Medicare Online Claiming

Please review the section below "Tips on Data Entry" as accurate data will make the claim process much smoother.  You may wish to review and update your new patient forms to collect additional information.

Tips on Data Entry

  • Practitioner and referrer provider numbers must not have any spaces.
  • All patients need a Medicare card number and reference number (the expiry is not required for claiming). There mustn't be any spaces in the Medicare number.
  • If the patient is not the Medicare claimant, then the claimant needs to be entered as a Contact.  To create a contact, go to the patient's Client Details page, click on the Contacts tab and add the claimant in as a new contact.  If the claimant is already a client or another contact, then you can simply search for them and select them from the list, instead of entering all the details again.
  • Medicare claimants need a first and last name, date of birth and their Medicare Card details.
  • All services need to have a Medicare Item Code entered into the "Code" field.  Go to Setup >> Services to edit your services.
  • Patients will need to supply their Bank account details if they wish Medicare to pay the claim into their bank account, and they do not already have their details recorded with Medicare.  The client's bank details can be entered into the Client Details page under 'Billing'.
  • You will need to set up your provider numbers by following these steps. Clients will also need 'Medicare' listed as their insurer.
  • The client must have a Referral listed and this will need to be linked to the invoice.


F.A.Qs

1. Do I still need to complete Medicare Online Claiming Provider Agreement Form given I am registered for Medicare claiming on HICAPS / ECLIPSE?

Yes, Medicare requires that the Medicare Online Claiming Provider Agreement Form be completed if even you are already registered for HICAPS /  ECLIPSE claiming.  You will not be able to process online claims with Medicare until at least one week after you return the form to Medicare.

 

2. My client has already lodged their bank details with Medicare, do I still need to enter them in Power Diary?

No.  If the client has already registered their bank details with Medicare you do not need to collect them again.  Any rebates will automatically be refunded into their bank account.  If the client does not have their bank details registered with Medicare, and you process a rebate without adding in their bank details, Medicare will snail-mail them a rebate cheque.  This could take a couple of weeks.

 

3. Do I need to Apply for a PKI Certificate?

No. The PKI certificate is used by Medicare to secure the communication between Power Diary and Medicare, however, we have already set this up on our servers and therefore you are not required to apply for a PKI. You will just need to fill out the Online Provider Agreement Form.