Online Claiming for vendors
Medicare's online claiming uses the latest developments in internet technology to provide an eBusiness environment that streamlines practice management systems (PMS), increases efficiency, reduces costs and saves time.
Medicare is working with software vendors and other health industry bodies to build this channel to deliver business efficiencies to the health sector.
Also included in online claiming are DVA veteran treatment accounts and the Australian Childhood Immunisation Register (ACIR).
Over 4300 practices are currently using online claiming and these numbers continue to grow at about 200 practices per month.
Online Technical Support Helpdesk
1300 550 115
Online claiming software is integrated directly into the practice management software (PMS) and uses the internet to lodge claims with Medicare so health care providers can know immediately if the transmission has been delivered or not. Online claiming offers:
- patient claiming (both real time and store and forward)
- same day delete request (for real time patient claims only)
- bulk bill claiming
- Department of Veterans' Affairs (medical and pathology)
- Australian Childhood Immunisation Register notifications
- online Patient Verification (for both Medicare and a number of connected private health funds)
- status reports to allow practices to see where their claim is
- In-hospital medical claiming to Medicare and health funds
- Online eligibility checking
These online options remove the need for the practice to lodge paperwork with Medicare.
Online claiming solution uses Public Key Infrastructure (PKI) to ensure the security of communications across the health sector. This technology ensures data transmitted to Medicare Australia can be identified, and that the data will be secure and private. PKI secures online communications using digital certificates, which are electronic identity documents used to digitally sign and encrypt electronic transmissions.
Since December 2003 online claiming has supported an additional security option allowing claims to be lodged in a new way. Providers may now choose to use either, or a combination of the following security options:
- A location and individual certificate
- A location certificate only. For bulk bill claims this option requires that the provider then sign a post-claim declaration from time-to-time for substantiation purposes
Patient claim submissions now only require a Location certificate. For bulk bill claims the provider will be required to sign a post-claim declaration each quarter for substantiation purposes. This substantiation will not be required when a provider uses the current method of using both an individual and location certificate.
- Online Claiming for Medicare Software Developer Agreement 2010 [PDF, 116Kb]
- Software vendor customer profile [PDF, 33Kb]
For further information please contact the Online Technical Support Helpdesk on 1300 550 115 or email firstname.lastname@example.org.
Additional information is also available on this site including:
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Last updated: 25 September, 2013