The following information is an overview of the steps and processes required for sending Bulk Bill claims to Medicare Australia Online or Department of Veterans' Affairs (DVA) claims.

1.      Ensure you have an active Internet connection.

2.      Ensure you have recorded your Practice's Details.

3.      Ensure you have enabled Online Claiming. This is a global setting; once you have enabled it on one Pracsoft computer, everyone using the same Pracsoft database will also have this functionality enabled.

You may also consider enabling EFTPOS/Medicare Easyclaim if you wish to take advantage of these services at your practice. This option should only be enabled if you have already installed the EFTPOS machine.

 

4.      Ensure you have installed and setup your Location Certificate and (if desired) individual practitioner PKI Certificate(s).

5.      A mandatory requirement for using Medicare Australia Online is that all patients have their Medicare Card personal reference number recorded in Pracsoft. Once Medicare Australia Online has been activated, this requirement will be enforced whilst recording any new visits.

6.      If you offer bulk-billing for services provided at a hospital, you must record a Facility ID for each hospital you visit.

7.      A patient is then added to the Waiting Room, and a visit recorded for them.

Alternatively, when conducting a home visit (or similar), you can record the visit without actually adding the patient to the Waiting Room, by selecting Account > Add Visit from either the patient's record or the Waiting Room.

o      When recording the patient's visit, indicate on the Record Visit window whether the visit is to be invoiced to Bulk Bill or DVA. Detailed information is available for recording Bulk Bill visits.

o      On the Record Visit window, click the Claim button to create a (claim) voucher for this visit. Detailed information is available for recording DVA visits.

Vouchers are not immediately sent to Medicare upon clicking the Claim button. Rather, Pracsoft holds the vouchers first, bundling them into individual 'Claims'; a single 'Claim' can contain multiple 'Claim Vouchers' (one for each visit recorded), up to a maximum of 80, specified via the Online Claiming tab of Pracsoft's Global Settings.

 

8.      Before Claims (bundles of claim vouchers) can be sent to Medicare they must first be 'batched'. Batching a Claim involves you analysing (or processing) the Claim to determine whether there are any inconsistencies that might prevent Medicare from accepting the Claim, and assigning a Claim number to each Claim. Claim numbers can be added manually, but it is recommended that you have Pracsoft generate these numbers automatically for you by ticking the 'Auto-Claim No. Generation' check box via the Online Claiming tab of Pracsoft's Global Settings.

9.      Once a Claim has been batched it can be sent to Medicare with other batched claims immediately via Online Claiming. However, common practice is to send claims in bulk, once a day, towards the end of the day.

This process differs slightly for sites taking advantage of Medicare Easyclaim. For these sites, claims are processed immediately via Medicare Easyclaim; it is not necessary to process the claims in Pracsoft first, nor then batch them and send them manually in bulk lots.

 

10.   A request is sent to Medicare periodically (usually once per day) to provide you with exception reports or payment reports about previous claims you have sent. Reports cannot be requested on the day you transmit the claim.

o      An exception report contains information as to why particular vouchers within a given claim were rejected, or perhaps why the refund Medicare issued differs from what you claimed. It is also possible (although rare) for an entire claim to be rejected.

o      A payment report contains the amount of benefit paid by Medicare. If you have a batch that has had all the vouchers rejected, there will not be a corresponding payment report, and once you resolve the exceptions, that batch will no longer exist.

Reports are requested via the Request Reports tab of the Online Claiming window - the same window used to select, prepare and transmit claims to Medicare.

 

11.   Afterwards, payment reports can be compared with your actual banking, and exception reports can assist you with resolving the exceptions.

12.   (Optional) Normally payments are auto-receipted. However there may be occasions where you must manually receipt a bulk payment.