Make sure that you have connected Medipass and enabled Medicare before reading this help guide.
If you have already connected Medipass, then you are ready to create Medicare claims 🎉
This help guide will cover:
How to add Medicare details for a client
How to set up cases to manage referral information
How to set up item codes correctly in services
How to submit a bulk bill claim for a client
Reviewing the Medicare claim status after submitting a claim
How Splose automatically allocates the payment after the payment is approved from Medicare
How to download the DB4 benefit form
Viewing the Medicare claim details in Medipass
Connect to Medipass
Add Medicare details for a client
To pass a client's Medicare details to Medipass and save you from entering it each time you need to make a claim, then you can add the Medicare details for the client in their details page.
Set up cases to manage referral information
In order to efficiently submit Medicare bulk bill claims, you can create a case for a client so that referral information can be passed to Medipass in order to make the claim. If the following information is not provided, then it will have to be manually entered each time in Medipass when making a claim.
Cases help you store the following referral information for clients, which will be passed to Medipass if entered:
The doctor or specialist who referred the client, which is required when lodging a claim.
Referrer provider number
The referring doctors' provider number.
The date that the referral was issued. This should the current day or a date in the past for Medicare claims.
If the client has a referral, then you can enter the referral period. For General practitioners: standard is 12 months, for specialists, non-standard is 3 months and indefinite has no expiry.
Set the date that the case status will expire. This will be auto-set if you enter a referral period.
Set up item codes correctly in services
In order to pass the correct information to Medipass, you'll want to make sure your services have correct item codes in order to submit a claim, as the item code is what gets passed to Medipass.
In Settings, then Services, select a service and under actions, click the three dots to edit a service.
Check that you have the correct item code, then click Save.
You can search item codes in Medipass in Services or while creating an invoice.
Submit a bulk bill claim
You'll want to create an appointment and add the appointment to a case. You can see if an appointment is attached to a case by viewing the appointment from the appointment details side modal or the cases page.
As the appointment is connected to a case, when you invoice for an appointment, the case referral details will be passed to Medipass.
Check that the following is entered correctly as it will be passed to Medipass:
The practitioner provider number
The client name
The item code for the service
Ensure that your provider number should be set up correctly and connected to Medipass. Click + Invoice from the appointment modal.
Thanks to our auto-saving invoice feature, all you need to do is click View invoice. Then, select Add payment to bring up the payment modal.
Rather than allocate a payment, you will need to click the Bulk bill + link next to the Medicare logo.
The Medipass screen will be displayed, auto-filling the available and required information for the claim, such as location, practice, provider information, referral information and client information.
All you have to do is review the information and then click Submit claim.
Review the Medicare claim status after submitting a claim
The claim will be sent to Medicare in real-time. The Medipass screen and payment modal will be closed down and a Medicare status card will be displayed on the invoice.
The status will display pending, rejected or approved. You can refresh the page to see if the payment status has been updated.
If the claim is approved, then Add payment button will be removed and Splose will automatically allocate the payment towards the invoice and update the invoice status to paid.
You can click on the payment reference to view the payment created.
Download the Medicare benefit form
Here, you can download the Medicare DB4 benefit form the Medicare status card and view the benefit form in your browser and print it.
View the Medicare claim details in Medipass
You can open the transaction in Medipass form the Medicare status card to see the invoice overview.
That's how easy it is to process a Medicare bulk bill claim with Splose.