Medicare Patient Claim Window

The Medicare Patient Claim window allows you to submit invoices to Medicare using Patient Online Claiming.

A Patient Claim can be created any time after an invoice has been issued for an account associated with a Patient Claim batch type. Unlike Bulk Bill and DVA claims, each Patient Claim has only one invoice associated with it, and must be created from the Accounts window.

There are two modes for Patient Claims, "Immediate" and "Store and Forward", both of which are created from the New Patient Claim window.

Whenever a new claim is being created, default values will be used to populate the fields. These values come from the patient or other Claimant record (eg parent) in Bluechip. If a claim has been previously submitted, the values from the previous claim will be used as the default. Authorisation of the claim is required prior to submission or storage in the case of a "store and forward" claim.

When viewing an existing claim, all fields will be disabled and the Send and Store buttons will be invisible.

After the user has entered all of the required information into the Patient Claim window, they can select one of the following 3 options:

  • Send: The claim is sent immediately to Medicare. This function will invoke the Medicare Processing window which will control the transmission process. Should the transmission of the claim be successful, the Patient Claim window will close and the claim will appear in the Medicare claims list. Its status will appear as "Successful".
  • Store: The claim is authorised and placed in the Medicare claims list, ready for transmission.
  • Cancel: The claim will be cancelled, and the window closed. Should the user have entered information, a prompt will be shown to confirm that the user wants to cancel the Patient Claim.

    Invoice No. Displays the File Number of the invoice.
    Invoice Amount Displays the total amount of the invoice.
    Amount Paid By Patient Displays the total amount received for the invoice at the time of making the patient claim. When the Patient has not paid any amount, the amount of 0.0 is displayed in red
    Allows the user to view the invoice items associated with the invoice being submitted.
    Claimant Allows you to select the claimant from the drop-down list. The drop-down list is populated with all valid Claimants for the Patient Claim. The claimant records available depend upon the Account Contacts types associated with the class for this account.
    Refund Method Allows you to select a refund payment type. Payment types include EFTPOS card, Cheque, and EFT (bank account details are required for this option).

    Selecting 'Cheque' as the payment type disables the EFT details fields.
    Addressee Displays the name of the claimant.
    Use Medicare Address Select this check box to use Medicare Address.This disables the address fields. Note: Address information can remain in these fields, but is not sent to Medicare. OR The Practice can elect to use the Claimant's address as held by Medicare or enter an alternative address in the address fields.

    If the payment is by cheque and the "Use Medicare Address" option is not selected, address information must exist in line 1 of the address, the address cannot be a post office box, and the suburb must be a valid suburb.
    Address Displays the claimant's address. Any cheques and statements from Medicare are sent to this address.

    This field can also be used to supply an alternative Claimant address.
    Suburb/Town The Suburb/Town field is used in conjunction with the address field to complete the Claimant's alternate address. Valid Suburbs/Towns are sourced from the Bluechip database list of suburbs.
    Phone (Bus.) The phone number field is not mandatory and is used to supply a day-time phone number for the Claimant. This phone number is obtained from the "Phone" field of the Patient's record.
    Update Addressee Record Select this check box if the address/phone details have changed and the information is to be saved back to the addressee record.
    Account Name Displays the Name of the Bank Account where the money is being electronically transferred.
    BSB Displays the BSB number of the Bank Account where the money is being electronically transferred.
    Account Number Displays the Account number where the money is being electronically transferred.
    Claimant Declaration Select this check box when the Claimant has agreed to the terms of the Claimant Declaration.
    Allows you to print a Claimant Declaration to the screen or nominated printer.
    Validates and authorises all inputs/claims on the Patient Claim window and begins the transmission process.
    Validates and authorises all inputs/claims on the Patient Claim window and places the claim in the Medicare claims list ready for later transmission.
    Cancels the claim and closes the window.