Claiming choices
The Medicare claiming channel your practice chooses can make a big difference to productivity, cash-flow and patient service. Medicare Australia understands that practices have different needs, which is why we’re offering more ways to make Medicare claims. In this section, you’ll find information to help you compare the different Medicare claiming options available, and work out which is the right one for you and your patients.
Did you know… A Transitional Support Package is available to support practices taking up electronic Medicare claiming.
Did you know… allied health professionals, dentists and dental specialists are able to submit claims electronically using either Medicare Easyclaim or Medicare Online.
- Tell me more about:
- Medicare Online (patient and bulk bill claims)
- Medicare Easyclaim (patient and bulk bill claims)
- Stand-alone (does not require PC or Internet connection)
- Integrated (‘talks to’ practice management software)
- Paper claiming (patient and bulk bill claims)
- Registering for quick EFT payment [PDF, 190Kb]
Complete this form to register your bank account details for EFT payments
- Easy ways to help your patients claim
- More information for practice managers:
How different channels compare
Help your patients claim on the spot at your practice
The claiming channel your practice selects can make a big difference to your business’ cash flow and customer service.
80 per cent of patients expect the system to be in place at their doctor’s surgery within the next 12 months.
Patients are now being encouraged to register their bank account details with Medicare Australia so there is no need for you to collect these details.
Electronic patient claiming
Instead of completing a form, practice staff can send patient claim information directly to us through a secure internet connection using Medicare Online. Rebates are paid directly into the patient’s nominated cheque or savings account within two to three working days (sometimes even sooner). Claims submitted using Medicare Online can also be paid by cheque. If the claim information is sent using Medicare Easyclaim, patient rebates are paid directly into the patient’s nominated cheque or savings account that day.
Find out more about these claiming channels:
Did you know… if you already use Medicare Online, it’s easy to ‘switch on’ patient claiming. To find out more, contact your software vendor or call 1800 700 199 to talk to one of our Business Development Officers.
Did you know… practices using Medicare Online for patient claiming don’t have to ask their patients for their bank account details. Patients can register their bank details with us instead and still claim their rebate on the spot at your practice.
Did you know… Medicare Online lets you submit patient claims even if you don't have the patient’s bank account details. Simply select 'cheque' as the payment method and we will take care of the rest.
More information
Find out more about patient claiming through Medicare Online and Medicare Easyclaim, or call 1800 700 199 to talk to one of our Business Development Officers.
Electronic Medicare claiming testimonials
Electronic Medicare claiming makes a difference to productivity, cash flow and patient service.
Below are two testimonials that show that electronic Medicare claiming really does make it 'better for your patients and better for your business'.
'Medicare Online makes good business sense. It provides an integrated solution for patient claiming including paid claims, bulk bill and Veterans' affairs. With ECLIPSE, an extension of Medicare Online, you can have direct communication with Medicare Australia and private health funds all in the one transaction. Your practice will reap the benefits of fewer rejections, increased cash flow and streamlined billing processes, and your patients will appreciate the service.'
Colleen Sullivan
Practice Consultant and past National and State President, AAPM
'Four years ago we introduced Medicare Online to our practice. It has proved to be a rewarding decision for both our practice and our patients. Initially, I was concerned that there would be problems introducing a new system. Once we had settled in, and trained the staff, the claiming process ran very smoothly. Importantly, it has not increased the workload for our reception staff.'
Jan Chaffey
Practice Manager, Camp Hill Medical Centre and past National and State President, AAPM
Transitional Support Package for electronic Medicare claiming
On 31 December 2009, the Transitional Support Package (TSP) one-off lump sum and 18 cents incentive payments ended. Final payments were made in mid January 2010.
For more information call 1800 700 199* (option 4) or email tsp.payments@medicareaustralia.gov.au
What is the Transitional Support Package?
The Transitional Support Package comprises a range of incentives for GPs, specialists, pathologists and software vendors to support the take up of electronic Medicare claiming.
About the package
| Eligible target group | Incentive |
|---|---|
| GPs and specialists |
|
General practitioners and specialists
Background
This component of the Transitional Support Package was to support practices of GPs and specialists to take up electronic Medicare claiming—either Medicare Online or Medicare Easyclaim.
There were two main elements to the package:
- a one-off, lump sum payment of $750 for metropolitan areas and $1000 for regional/rural areas for practices taking up Medicare Online or Medicare Easyclaim between 1 September 2007 and 31 December 2009
- an incentive of 18 cents per transaction for electronic bulk bill and patient claims transmitted between 1 September 2007 and 31 December 2009.
One-off, lump sum payment
Who was eligible?
The one-off, lump sum payment was available to GP and specialist practices using:
- Medicare Online for bulk bill and taking up patient claiming either through Medicare Online or Medicare Easyclaim
- Manual claiming (paper) and taking up either Medicare Online or Medicare Easyclaim for bulk bill and/or patient claiming.
An eligible practice was considered to be the registered location of a GP or specialist provider where services and claiming were undertaken at that same location.
Practices that started using Medicare Easyclaim before 1 September 2007 were eligible for the practice payment.
Practices that were using Medicare Online before 1 September 2007 for bulk bill were only entitled to a practice payment if they also used Medicare Online or Medicare Easyclaim to transmit patient claims in addition to transmitting bulk bill claims.
Practices only received one lump sum payment under the Transitional Support Package. For example: if a practice received a payment for Medicare Online and then took up Medicare Easyclaim, they did not receive a second payment.
Note: practices that received an incentive under the previous Medicare Online grant scheme and did not transmit a patient claim after 1 July 2007 were eligible for the one-off, lump sum payment if they began or restarted transmitting patient claims using Medicare Online from 1 September 2007.
Who was not eligible?
Allied health professionals, optometrists, pathologists, dental practitioners and accredited dentists were not eligible for the one-off, lump sum payment.
Optometrists and accredited dentists were eligible for a payment under the Medicare Online grant scheme, which closed on 30 June 2008.
Practices who received a payment under the Medicare Online grant scheme after 1 September 2007 were not eligible for the one-off, lump sum payment.
How was the one-off, lump sum payment calculated?
The amount a practice was entitled to was determined by the eligible practice’s Rural Remote Metropolitan Area (RRMA) index. A one-off, lump sum payment of $750 was available for practices in metropolitan areas and $1000 for practices located in regional/rural areas.
| RRMA | Practice payment |
|---|---|
| 1-2 | $750 |
| 3-7 | $1000 |
If the practice was not eligible for the one-off, lump sum, did they still receive the 18 cents transaction incentive for electronic claims?
Yes.
How was a one-off, lump sum payment made?
The one-off, lump sum payment was paid by electronic funds transfer (EFT) into the bank account nominated by the practice.
18 cents incentive payments
An 18 cents incentive payment, calculated with reference to each electronic bulk bill and patient claim transmitted between 1 September 2007 and 31 December 2009, was paid to GPs and specialists between 1 September 2007 and 31 December 2009. The incentive payments applied to bulk bill and patient claim transactions through Medicare Online, Medicare Easyclaim and ECLIPSE.
Who was eligible?
GPs and specialists practices that transmitted electronic bulk bill and patient claims between
1 September 2007 and 31 December 2009 were eligible for the 18 cents incentive payment.
Who was not eligible?
Allied health professionals, optometrists, pathologists, dental practitioners and accredited dentists were not eligible for the incentive. Department of Veterans’ Affairs (DVA) payments were not eligible under the Transitional Support Package.
What was a transaction?
For the purpose of the 18 cents incentive payment, a transaction is defined as a successfully assessed electronic Medicare claim (a single transmission). The claim may have included one or more services for an individual patient.
How were 18 cents incentive payments made?
The first instalment of the 18 cents incentive was paid in June 2008 for transmissions received between 1 September 2007 and 31 March 2008. This instalment was paid into the account nominated by the provider for the payment of Medicare bulk bill claims.
A second instalment was paid in December 2008. This was for transmissions received between 1 April and 30 September 2008. This and further instalments were paid by EFT into the account nominated by the practice.
The 18 cents incentive for Medicare Easyclaim transactions was paid by EFT into the account nominated by the provider for the payment of Medicare bulk bill claims.
A third instalment was made at the end of January 2009 for transmissions received between 1 October and 31 December 2008.
Thereafter the 18 cents incentives was paid quarterly—April 2009, July 2009, October 2009 and January 2010.
Could vouchers still be sent in batches?
Yes—the 18 cents incentive payments were based on the number of vouchers transmitted per batch. Payments were calculated on the number of batches sent, so there was no need for practices to change the way they sent in their claims. Medicare Online bulk bill claims should still have been sent through in batches. For example: if a practice sent one voucher in a batch, this only attracted one incentive. If they sent through 20 vouchers in a batch, this attracted the 18 cents incentive 20 times.
Did the incentive payments apply to in-hospital services using ECLIPSE?
Yes—electronic transmissions involving ECLIPSE attracted the 18 cents incentive.
Some documents on this page may require the free Adobe PDF reader.
Last updated: 26 February, 2010