May 2010 - Checking a patient's eligibility for a contact lens service
Medicare Australia has been asked by optometrists if the Interactive Voice Response (IVR) system can be used to check a patient’s eligibility for a contact lens service under Medicare Benefits Schedule (MBS) item numbers 10921–10929. Currently the IVR system can check a patient’s eligibility for an Item 10900 service but it cannot check a patient’s eligibility for a service under items 10921–10929.
However, if you call Medicare Australia on 132 150* a service officer will be able to confirm the eligibility for a contact lens consultation item number. You will need the patient’s permission before requesting this information. Alternatively, the patient can call Medicare Australia to have this information provided to them.
Medicare Australia uses an established set of criteria to make sure the optometrist’s and the patient’s privacy is protected. There are three guidelines that must be adhered to when contacting Medicare Australia. You must make sure:
- the patient has been advised of the need to seek the information
- the patient has granted permission to release the information
- the patient's records verify the patient's consent to release the information.
If the patient is not eligible for a Medicare benefit on their contact lens service, you cannot claim a Medicare item number for fitting the contact lens but you can charge a private fee—this is a matter between you and your patient.
For more information call:
- Medicare Australia on 132 150*
- Medicare Australia’s dedicated IVR service for optometrists on 1300 652 752*.
* Call charges apply.
Last updated: 20 May, 2010