Take-up of Medicare electronic claiming
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The claiming channel your practice chooses can have a big impact on productivity, cash flow and patient service.
Medicare Australia understands that all practices are different and that there is no 'one size fits all' way to claim. Medicare electronic claiming makes it easier and more convenient for you and your patients to lodge claims on the spot with Medicare Australia.
Medicare Australia offers three Medicare electronic claiming channels:
- Medicare Online
- Medicare Easyclaim
- ECLIPSE, an 'extension' of Medicare Online for use with private in-hospital claims.
Why switch to electronic claiming?
Medicare Australia is encouraging practices to consider switching to electronic claiming to take advantage of benefits like faster payment and less paperwork.
Electronic claiming removes the need to batch bulk bill claims at the end of the day and simplifies your banking. Funds are paid into the health professional's nominated bank account within two to three working days (instead of waiting up to 14 days for a cheque).
Electronic claiming channels also make it easier for practices that privately bill to help their patients claim their Medicare rebate when they pay their account. Electronic patient claiming is available through Medicare Online and Medicare Easyclaim.
There are lots of other reasons practices choose electronic claiming. It offers:
- more certainty around lodgement of 'pay doctor' claims through the 90 day pay doctor scheme for electronic Medicare claiming
- Medicare eligibility checking
- an easier way to help patients lodge their claims with Medicare Australia
- support from Medicare Australia and software providers
- Department of Veterans’ Affairs (DVA) payments through Medicare Online.
- Australian Childhood Immunisation Register (ACIR) data through Medicare Online.
Take-up of the three Medicare electronic claiming channels is as follows:
Total Medicare services processed by provider group and channel for the period 1 October 2011 to 31 December 2011
| Channel entry type | |||
|---|---|---|---|
| Electronic Bulk Bill Services (BB) | Electronic Patient Claim Services (PC) | Electronic Simplified Billing Services (SB) | |
| Provider Group | % Medicare Online BB + Easyclaim BB + SMTP BB Services of Total BB Services | % Medicare Online PC + Easyclaim PC + CMBO PC Services of Total PC Services | % ECLIPSE SB + SMTP SB Services of Total SB services |
| General practitioners | 91.4% | 55.2% | 96.9% |
| Specialists | 92.8% | 21.0% | 99.6% |
| Pathologists | 99.5% | 2.0% | 99.1% |
| Optometrists | 85.6% | 45.2% | 0.0% |
| Dentists/Orthodontists | 80.5% | 9.6% | 100.0% |
| Other practitioners | 73.8% | 25.0% | 99.4% |
| Totals | 93.4% | 34.4% | 99.2% |
Note:
- As of June 2011, to be consistent with the Annual Report, the calculations used in this report have been amended as follows:
- SMTP BB has been included in the Electronic Bulk Bill Services
- CMBO PC has been included in the Electronic Patient Claim Services
- SMTP SB has been included in the Electronic Simplified Billing Services
- Provider group is based on the derived major specialty for the current processing quarter.
- Report includes approved services processed for the quarter. The services may have been rendered in a previous quarter.
- DVA claims are not included in the report.
View the take-up progress in the Medicare claiming channel graphs
- Electronic Bulk Bill Services - December 2009 to December 2011 [PDF, 12Kb]
- Electronic Patient Claim Services - December 2009 to December 2011 [PDF, 12Kb]
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Last updated: 31 January, 2012