Step 4: Billing for Part-Paid Patient Claims

Before you begin

A Patient Claim account is required for billing claims for the Private Patient. The patient pays part of their account (gap only). Then the Practice provides the service of submitting the claim to Medicare on the patient's behalf.

Procedure

  1. Within the patient's record, select the Accounts margin menu, and then locate and double-click the account you want to bill to. Click

    to begin issuing a new invoice.
  2. The Medicare Verification prompt appears.
    • Click OK if required to verify.
    • Click Ignore if already verified.
  3. Select the Service Type if required. There will only be multiple service types if you have pre-configured in setup.
  4. Enter the appropriate Service Date and Item Number as desired. A Service Item's fee will appear automatically. Ensure the fee is correct.
  5. Tab to the Service Text field, and then double-click the field to reveal the

    button. Click this to add text for Medicare if required, and then click OK. Repeat steps 4-5 if additional Service Items are required on the invoice.
  6. Because the patient is paying this account, click

  7. When prompted, select the associated Referral, and click OK.
  8. You will be prompted to enter the date-of-issue for the invoice. The default is the current date, click OK.
  9. The New Receipt window appears. Select the Payment Method Type (Cash, Cheque, Direct Debit, EFTPOS Manual or EFTPOS Auto (TYRO), Bank/Card Type, and enter the Gap Amount only from the Patient.
  10. Allocate the invoice to the part payment amount by ticking into the Owing tick box in the Allocations area.
  11. Click

  12. You will be prompted to enter the date-of-issue for the receipt. The default is the current date, click OK.**Important: If your Practice does not use a TYRO Terminal, bypass the next Step and proceed to Step 15**
  13. If the Practice has a TYRO terminal and has selected the Receipt Payment Method as EFTPOS Auto, the TYRO terminal (Patient Easyclaim) window will appear. Have the Patient swipe their card, select the appropriate account type and enter their PIN. The online payment process commences and TYRO will print a receipt for the patient.
  14. The Print Report window will appear. It is recommended to ask the patient "Would you like me to submit the claim to Medicare on your behalf?"
    • If Yes: Patient does not require copy. Click the File button to cancel printing.
    • If No: Patient decides to claim with Medicare directly. Click the Print button to print an invoice/receipt.
  15. On the Invoice tab, click the Patient Claim button (located at the bottom right). The New Patient Claim window will appear.
  16. The default (and only) Refund Method available is Cheque, due to the Patient's part payment; Medicare will reimburse by a cheque that is sent to the Patient, with the Payee the Practitioner. The Patient is required to forward the cheque to the Practice.
  17. Select the check box for the Claimant Declaration and click



  18. The Patient Claim Results window appears. Click

    This will transmit the claim to Medicare.
  19. A Lodgment Advice prompt will appear to print report if required.
  20. On the Invoice tab, the invoice indicates a Claim > ID confirming submission and a rebate balance outstanding to the Practitioner.

    The claim has also generated into the Medicare > Australia module with a Successful Status. The Patient Claim appears on the current date range window waiting for Medicare Rebate Cheque.

Results