Notes on Patient Claims

  • Invoice items must be receipted correctly to be eligible for Patient Claiming. Acceptable receipting methods will be:
  • All invoice items are unpaid – that is no receipt has been issued.
  • All items are partially receipted – each invoice item in the invoice must be partially paid. Receipting in this manner has implications to Medicare in respect of the "Safety Net" calculations, and the capacity to pay benefits to the Practitioner and the Patient in the same claim.
  • All items are fully paid – that is the invoice is fully paid.
  • Invoices can include the non-Medicare item MISC, but no other items from non-Medicare lists.
  • Invoices must have at least one service item that has a non-zero amount.
  • Non-MBS items contained in an invoice cannot have a zero amount.
  • The Patient must have a valid and current Medicare card to make a Patient Claim.
  • Standard referrals used for Patient Claims invoices must have the referring Doctor's provided number recorded.
  • Once an invoice has been attached to a patient claim, it cannot be attached to a second patient claim unless the previous claim has been deleted or "Same Day Deleted".
  • Invoices cannot be adjusted or deleted once they are attached to a Patient Claim.
  • If a Patient Claim already exists for the selected invoice, the Patient Claim window will be opened in "view" mode.