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Medicare Easyclaim

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Medicare Easyclaim video

Provider using EFTPOS terminal for Medicare Claims Medicare Easyclaim lets you lodge Medicare claims using your EFTPOS terminal. Payments are usually made within 24 hours, straight into your nominated bank account.

You can also offer Medicare Easyclaim to your patients. Patients use it to claim their Medicare rebate once their account is settled, and have their rebate paid into their bank account almost immediately. Our research shows that more than 84% of patients who pay their doctor want to use this system.

Find out more about what Medicare Easyclaim means for patients.

Find out more about the support package for electronic Medicare claiming.

To talk to a Medicare Australia staff member about Medicare Easyclaim or to arrange for a visit to your practice, please call eBusiness service centre on 1800 700 199.

Key features

Can be used for patient and bulk bill claims
No batching or storage required for bulk bill claims
Single payment within 24 hours, direct into your nominated account
More certainty with ‘pay doctor’ cheques - speeds up process by lodging claim on the spot
No additional bank transaction fees - though standard EFTPOS charges still apply
A service preferred by over 80% of paying patients
Concession verification - instant confirmation of patients’ concessional status
Available to doctors, specialists and allied health professionals (including dentists and dental specialists).

Support for practices

Contact the eBusiness Service Centre:

for Medicare Easyclaim information and enquiries
to change contact and practice details
to register and update banking details for providers
for information regarding the processing of data received by Medicare Australia
to organise an on-site visit by a Business Development Officer.

For Further Support:

The eBusiness Service Centre can be contacted on 1800 700 199 (call charges apply from mobiles or pay phones only)

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

How it works

Watch a short video to see how Medicare Easyclaim works.

How it works for bulk bill claims:

What’s different - faster payment and less paperwork (no batching)

The patient’s Medicare card is swiped through the practice’s EFTPOS terminal.
Claim details are entered via the keypad. Short-cut keys can be used for provider and common item numbers.
The claim is sent to Medicare Australia for verification and an approval message is sent back to the terminal within seconds.
The patient then presses a button on the keypad to assign their Medicare benefit to the doctor. The terminal prints a patient receipt.
The health care provider receives a single payment in their nominated account within 24 hours. No more batching or storing claims

How it works for paid patient claims:

What’s different - another value-added service to offer patients

The patient/claimant pays as usual (eg. cash, cheque, credit card or EFTPOS) and their Medicare card is swiped through the practice’s EFTPOS terminal.
Basic details are entered via the keypad. Short-cut keys can be used for provider and common item numbers.
The claim is sent to Medicare Australia for verification and an approval message is sent back to the terminal within seconds.
The patient swipes their EFTPOS card through the EFTPOS terminal and enters their PIN. The Medicare rebate is paid directly into their cheque or savings account almost immediately.

How it works for unpaid accounts

What’s different - more certainty that ‘pay doctor’ claims are lodged

The patient’s Medicare card is swiped through the practice’s EFTPOS terminal.
Claim details are entered via the keypad. Short-cut keys can be used for provider and common item numbers.
The claim is automatically sent to Medicare for verification and an approval message is sent back to the terminal within seconds.
Medicare sends a ’pay doctor’ cheque to the patient, who then brings it back to the practice along with any outstanding balance.

Frequently asked questions

When does Medicare Easyclaim start?

Medicare Easyclaim is being rolled out gradually. The Commonwealth Bank is the first EFTPOS provider accredited to offer Medicare Easyclaim, and is currently rolling out across Australia . The other EFTPOS providers signed-on to offer Medicare Easyclaim are expected to start their rollouts early-mid 2008.

Which financial institutions have signed on to deliver Medicare Easyclaim?

Currently, four financial institutions have signed on to deliver this new service. 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. Talk to your EFTPOS provider to find out more.

Is there a support package available for Medicare Easyclaim?

Yes - a transitional support package is being provided for GPs and specialists to use Medicare Easyclaim and Medicare Online. Find out more about the support package.

What equipment is needed for Medicare Easyclaim?

Medicare Easyclaim uses the EFTPOS terminal already in most surgeries. As a result, practice staff will only need minimal training in how to use this new claiming channel. Commonwealth Bank, National Australia Bank (NAB), ANZ and Tyro Payments have signed up to deliver Medicare Easyclaim.

Tyro Payments is a new provider of EFTPOS services and has delivered a Medicare Easyclaim solution that is fully integrated with HCN’s practice management software (PracSoft). Other EFTPOS and software providers are likely to offer their own integrated solutions over time.

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

If you don’t already have an EFTPOS terminal, talk to your financial institution. (See also: 'Which financial institutions have signed on to deliver Medicare Easyclaim')

Will traditional patient claiming methods still be available?

Yes - patients will still be able to claim through the current claiming options. This includes the 238 Medicare offices around Australia, which will all remain open. Medicare Easyclaim gives both patients and practices more choice.

Will there be an advertising campaign for the public about Medicare Easyclaim?

Our priority is to give health care providers a chance to find out more about the system first, before starting an advertising campaign aimed at the broader community. A low-level public information campaign through Medicare offices is underway. It is important to remember that patient claiming is only one aspect of Medicare Easyclaim - many practices will also use this channel to process bulk bill claims.

Do I need to choose between Medicare Easyclaim and Medicare Online (HIC Online)?

Medicare Easyclaim is simply another claiming channel for practices to choose from. If you currently use Medicare Online you might decide to continue using it to lodge some types of claims and to use Medicare Easyclaim for other types. It depends which works best for you and your practice. Currently around 7,100 practices use Medicare Online and around 2,097 of these use it for patient claims - you can choose to use Medicare Online for patient claiming instead of Medicare Easyclaim if this suits you better.

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

For bulk billing it involves swiping the patient's Medicare card - payment is made to the practitioner usually the next working day.

Compare claiming methods

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 (DVA claims), childhood immunisation (ACIR information) and pathology. These services can be claimed using other claiming channels, including Medicare Online.

I’m an allied health practitioner/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 are:

aboriginal health workers
audiologists
chiropodists
chiropractors
diabetes educators
dieticians
exercise physiologists
mental health workers
occupational therapists
osteopaths
physiotherapists

podiatrists
psychologists
speech pathologists
dentists
orthodontists
prosthodontists
endodontists
paedodontists
periodontists
oral medical and pathology practitioners
dental specialists (non-dpac).

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 run it.

Tyro Payments, a new provider of EFTPOS services, has delivered a Medicare Easyclaim solution that is fully integrated with HCN’s practice management software (PracSoft). Other EFTPOS and software providers are likely to offer their own integrated solutions over time.

Will I have to collect patients’ bank account details?

No - a paying patient simply swipes their Medicare and EFTPOS cards through your EFTPOS terminal, and the information is automatically transmitted.

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 store or use any 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 four-digit error code that explains why the claim was rejected. Patients can then take their account invoice or receipt to their local Medicare office, or use any of the other claiming options that are available.

I’ve read transactions can take up to four minutes. Is this true?

It’s hard to give an exact time estimate because of the number of different factors involved, including the type of claim and how comfortable the patient or practice manager is with EFTPOS. Based on our trials, we expect most transactions will be processed in one or two minutes using a standalone solution, and less using an integrated solution.

How do I reconcile payments?

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

For Medicare Easyclaim, operating as a standalone solution, medical practices obtain their bulk bill processing and payment reports by accessing the Provider Directory System (PDS), via the Medicare Australia website. They then download and print a PDF 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.

For Medicare Online, which is integrated into practice management software (PMS), practices obtain their bulk bill processing and payment reports by submitting an electronic request to Medicare Australia. The reports are sent by Medicare Australia in real-time and the PMS will, generally, automatically reconcile your bulk bill claims.

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, for automatic reconciliation, and Medicare Easyclaim for their patient claims, for real-time payment of patient benefits.

Is automatic reconciliation available with Medicare Easyclaim?

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

See also: ‘How do I reconcile payments’

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 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 terminal instead of keying these numbers will also cut time and 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.

Note: About 70% of all Medicare claims have just one item on them.

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

Medicare Easyclaim is now gradually rolling out as participating EFTPOS providers become accredited and start to offer the system to practices. (See also: ‘Which financial institutions have signed on to deliver Medicare Easyclaim’)

If you already have an EFTPOS terminal contact your financial institution to ask if they will be offering Medicare Easyclaim.

If you don’t have an EFTPOS terminal contact your financial institution to ask if they will be offering Medicare Easyclaim, and to see about having a terminal installed (standard EFTPOS fees apply).

How is Medicare Australia supporting the introduction of the new system?

For practices

Transitional support package
Medicare Australia is working with peak medical bodies in each State and Territory to help explain the choice offered by Medicare Easyclaim.
Medicare Australia’s business development officers are contacting practices to offer one-on-one presentations on the new system.
Participating financial institutions will offer training materials and technical support.
Practices that choose to offer Medicare Easyclaim will receive a starter kit with support materials including user guides, waiting-room posters and brochures.

For patients

A low level public information campaign is likely to start mid-2008.
Information brochures are available from participating doctors.

What are the contract documents for tenders

Each financial institution involved in delivering Medicare Easyclaim is required to sign identical contracts. The contract will be a standard form agreement with all providers who agree to deliver electronic Medicare claiming via the EFTPOS network. The contract ensures:

all financial institutions that enter into a contract and achieve accreditation will be paid 23 cents per transaction
no costs are passed on to doctors or patients for using Medicare Easyclaim
the banks will not be able to access any medical information related to the service for which the claim is being made through Medicare Easyclaim

Financial Institutions who wish to request copies of the contract and/or associated documents, please send an email to:
easyclaimaccreditation@medicareaustralia.gov.au

Some documents on this page may require the free Adobe PDF reader.

Last updated: 11 December, 2008