What's new?

July 2014

Improvements will be made to the way some PBS medicines are processed under the Highly Specialised Drugs Programme from 1 July 2015.

Medicare Easyclaim

You can offer Medicare Easyclaim to your patients to claim their Medicare benefit once their account is paid. Patients have their Medicare benefit paid into their bank account almost immediately through your practices’ EFTPOS terminal.

Key features

  • Use for patient and bulk bill claims
  • No batching or storage required for bulk bill claims
  • Single payment for providers bulk bill claims in 2-3 working days, direct into your nominated account
  • Patient claims paid almost immediately into their bank account
  • More certainty with ‘pay doctor’ cheque - speeds up the process by lodging the claim on-the-spot
  • No additional bank transaction fees - however standard EFTPOS charges still apply
  • Concession verification - instant confirmation of the patients’ concessional status
  • Available to doctors, dentists, specialists and allied health professionals

Support available for practices

  • For Medicare Easyclaim information and enquiries
  • To change contact and practice details
  • To register and update bank details for providers
  • For information about the processing of data received by the Department of Human Services (Human Services)
  • For an on-site visit by a Business Development Officer

For more support:

For technical problems with transmissions call the bank or financial institution which supplies the service.

How it works

How it works for bulk bill claims

Faster payment and less paperwork (no batching)

  1. The patient’s Medicare card is swiped through the practice’s EFTPOS terminal or details stored in the integrated practice management software.
  2. Claim details are entered via the keypad or use the details stored in the integrated practice management software. Short-cut keys can be used for provider and common item numbers.
  3. The claim is sent to Human Services for verification and an approval message is sent back to the terminal within seconds.
  4. The patient then presses a button on the keypad to assign their Medicare benefit to the doctor. The terminal will then print a patient receipt.
  5. The healthcare provider receives a single payment in their nominated bank account in 2-3 working days. Now there is no need to batch or store claims.

How it works for paid patient claims

Another value-added service to offer patients

  1. The patient/claimant pays as usual (e.g. cash, cheque, credit card or EFTPOS) and their Medicare card is either entered or swiped through the practice’s EFTPOS terminal.
  2. Basic details are entered via the EFTPOS keypad or entered using the integrated practice management software. Short-cut keys can be used for provider and common item numbers.
  3. The claim is sent to Human Services for verification and an approval message is sent back to the terminal within seconds.
  4. The patient swipes their EFTPOS card through the EFTPOS terminal and enters their PIN. If Medicare accepts the service the Medicare benefit is paid directly to their bank account, almost immediately.

How it works for unpaid and part paid accounts

More certainty that ‘pay doctor’ claims are lodged

  1. The patient’s Medicare card is swiped through the practice’s EFTPOS terminal or details stored in the integrated practice management software.
  2. Claim details are entered via the keypad or use the details stored in the integrated practice management software. Short-cut keys can be used for provider and common item numbers.
  3. The claim is sent to Human Services for verification and an approval message is sent back to the terminal within seconds.
  4. If Human Services accepts the service, a ’pay doctor’ cheque will be sent to the patient, who brings it to the practice along with any outstanding balance.

Frequently asked questions

Which financial institutions have signed on to deliver Medicare Easyclaim?

Currently there are five financial institutions that have signed on to deliver Medicare Easyclaim, they are:

Are there any fees associated with using Medicare Easyclaim?

There are no additional bank transaction fees for either patients or practices using Medicare Easyclaim. However, standard EFTPOS charges will still apply, including the cost of renting a terminal. Contact your EFTPOS provider to find out more.

What equipment is needed for Medicare Easyclaim?

Medicare Easyclaim uses the EFTPOS terminal which is available in most practices. As a result, practice staff will only need minimal training in how to use this claiming channel.

Some practices have asked if they will need a second EFTPOS terminal—this is up to the practice and depends on how it runs and which claiming solutions are in place.

If you don’t already have an EFTPOS terminal, contact your financial institution.

Are other patient claiming methods still available?

Patients can claim online, by phone or at Medicare Service Centre.

Do I need to choose between Medicare Easyclaim and Medicare Online?

Medicare Easyclaim is simply another claiming channel for practices to choose from. If you currently use Medicare Online you might decide to continue to use it to lodge some types of claims and use Medicare Easyclaim for other types. It depends which works best for you and your practice.

For patient claiming, Medicare Easyclaim involves swiping the patient’s Medicare card and EFTPOS card to enable payment of the Medicare benefit to their bank account almost immediately.

For bulk billing, Medicare Easyclaim involves swiping the patient's Medicare card and payment is made to the healthcare provider in 2-3 working days.

View Compare claiming methods on our website.

Is there anything I can’t claim through Medicare Easyclaim?

There are some medical services that can’t be claimed using Medicare Easyclaim, including services for veterans (Department of Veterans’ Affairs claims), childhood immunisation (Australian Childhood Immunisation Register information), in-hospital services and complex pathology. These services can be claimed using other claiming channels, including Medicare Online.

I’m an allied health professional/dentist/dental specialist. What does this mean for me?

Allied health professionals, dentists and dental specialists are able to use Medicare Easyclaim and Medicare Online to submit bulk bill and patient claims.

Allied health professionals include:

  • aboriginal health workers
  • audiologists
  • chiropodists
  • chiropractors
  • dentists
  • dental specialists (non-dpac [Medical Benefits (Dental Practitioners) Advisory Committee])
  • diabetes educators
  • dieticians
  • endodontists
  • exercise physiologists
  • mental health workers
  • occupational therapists
  • oral medical and pathology practitioners
  • orthodontists
  • osteopaths
  • physiotherapists
  • podiatrists
  • psychologists
  • prosthodontists
  • endodontists
  • paedodontists
  • periodontists
  • social workers
  • speech pathologists

Find out more about the allied health initiative.

Will I need to change my computer software?

Medicare Easyclaim can be used as a stand-alone system, so you don’t have to change your computer software to use it.

Will I have to collect patients’ bank account details?

The patient simply swipes their Medicare and EFTPOS cards through your EFTPOS terminal, and the information is automatically sent.

Will patients’ privacy be protected?

Yes patient privacy is protected. All information sent via EFTPOS is encrypted and sent through a secure network. As part of the accreditation agreement for Medicare Easyclaim, financial institutions are not permitted to collect, store or use any health claiming information.

What happens if a claim is rejected?

Patient claims lodged through Medicare Easyclaim are assessed instantly so if a claim is rejected, the EFTPOS terminal displays a 4-digit error code that explains why the claim was rejected. Patients can then take their account invoice or receipt to their local Medicare Service Centre, or use any of the other claiming options available.

How do I reconcile payments?

Human Services encourages practices to choose the claiming option, or combination of options, that best suit their business needs. One consideration for practices in making this choice is how they do, or would like to, reconcile bulk bill claims.

For Medicare Easyclaim, operating as a stand-alone solution, medical practices obtain their bulk bill processing and payment reports through Health Professional Online Services (HPOS). You then download and print a PDF or excel file and reconcile this report against their claims. Due to the information contained in these reports, their size and the need to print the reports, it is not possible to retrieve these via the EFTPOS terminal.

There is no requirement for medical practices to reconcile patient claims in either Medicare Online or Medicare Easyclaim. Medical practices could therefore choose to use Medicare Online for their bulk bill claims and automatic reconciliation. Then use Medicare Easyclaim for their patient claims and real-time payment of patient benefits.

Is automatic reconciliation available with Medicare Easyclaim?

Automatic reconciliation is available for financial institutions to integrate with the Medicare Easyclaim solution through their practice management software.

If it’s not integrated with my software, will there be more keying errors?

For some practices there is a chance of data entry errors because of the need to double key some claim data—first on the EFTPOS terminal, then on the practice management software. However Medicare Easyclaim enabled EFTPOS terminals will have some claim data hard-coded in, such as provider numbers and common item numbers, which will speed-up transactions and reduce the chance of errors.

Swiping Medicare and EFTPOS cards through the EFTPOS terminal instead of keying these numbers will also save time and reduce error rates.

Medicare Easyclaim is a claiming channel that works best for simple claims, such as those with one item number, where less data is involved.

How do I ‘switch on’ Medicare Easyclaim at my practice?

If you already have an EFTPOS terminal, contact your financial institution to ask if they offer Medicare Easyclaim.

If you don’t have an EFTPOS terminal, contact your financial institution to ask if they offer Medicare Easyclaim, and to see about having a terminal installed.

How is Human Services supporting the system?

  • We are working with peak medical bodies in each state and territory to help explain the choice offered by Medicare Easyclaim
  • Human Services Business Development Officers are contacting practices to offer one-on-one presentations about the system
  • Participating financial institutions will offer training materials and technical support

Call the eBusiness Service Centre on 1800 700 199 for more information and to arrange a visit by a Business Development Officer.

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Last updated: 22 April, 2014