V5 - Medicare FAQ's (from Masterclasses)

Q: What do we need to do to register with Medicare?

A: Let us know so that we can organise the Minor ID and Medicare Certificate for you. You need to provide your Practice Name and address, phone number, email address, website and number of Minor ID’s you require.

 

Q: If I am already registered with Medicare Online do I just provide those details?

No. You will still need to contact us to get a new Minor ID from us.

 

Q: Does it cost for us to upgrade to use the Medicare Online Claiming option?

A: As long as you have current Software Assurance or you are a hosted customer then there is not cost to upgrade. However, there is a cost to do claiming. It is 30 cents per claim.

 

Q: If it is 30cents per claim will you bill us monthly or how will that work?

A: We will bill you monthly.

 

Q: Is there another annual cost for claiming.com.au?

A: No

 

Q: How does a Medicare gap show up on an invoice?

A: For a patient claim, where we are processing a Medicare refund on behalf of the client then the client pays the full amount of the invoice. This invoiced amount will include any gap fee on top of the rebate amount. The gap fee is not specifically stated.

 

Q: Will we have to check this report each day to see if claims have gone through or not or is there a way that it pops up to tell us?

A: You will need to, have to, check the report each day.

 

Q: I thought you had to have a different provider number for each location?

A: Historically, yes, however, this doesn’t appear to be the same in all situations now. If you wish to know more about this then please discuss with Medicare.

 

Q: How long are the certificates valid for?

A: 12 Months at this stage. Although this may change in the future.

 

Q: If a client's bank account is not registered with Medicare, can they still do a 'patient claim'?

A: A client would need to have their bank account details registered with Medicare to be able to do the patient claim, otherwise Medicare has no place to send the rebate.  This doesn't apply for bulk billing or DVA/VAA though.

 

Q: What happens if a claim is rejected?

A: You will be notified in the Medicare Claim History Report

 

Q: Do you always have to print the voucher and have the patient sign it? Then do we need to keep those signed vouchers?

A: It is our understanding that it is a requirement from Medicare and DVA that the client assign the payment to the practice by signing the vouchers included in the software. In terms of whether those vouchers need to be kept, you would need to direct that question to Medicare.

 

Q: If a patient is being claimed under TCA and they have already used the 5 for the year, are we informed by the system that the visit cannot be claimed?

A: When you make an appointment, it would be at that point that you would be reminded that there's no referrals left for that client.  If you don't have a valid referral in the appointment you would not be able to process the claim.

 

Q: Sometimes clients have used their TCA's and we don't know that they have - will this just be knocked back by Medicare?

A: Yes, but only when the payment is processed at Medicare’s end. Not when we validate the claim for processing as we have no means of comparing that data at the time of lodging a claim. 

 

Q: Can you have the same provider number attached to multiple locations? E.g. we have schools listed as separate locations but all are claimed from the one provider number

A: Yes, that's totally fine. If Medicare are currently accepting claims using this arrangement, then we have no reason to think that this will change being processed via our system.

 

Q: How do these changes to client layout appear when we have customised the layout heavily?

A: We will add these fields in for anyone that has a customised layout.  So, we would update your layout prior to the update rather than giving you this new layout.

 

Q: If you find an error, can you update prior to typing confirm or do you need to back out and update in the client details area?

A: Yes, you can.

 

Q: Do the claims all get sent as a batch at the end of the shift?

A: The claims get sent to Claiming.com immediately, but they are processed in a batch style at Medicare. Claims are processed overnight and money is transferred the next day for any accepted claims.

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