You can submit Bulk Bill and Patient Medicare claims directly from splose using the Tyro Health integration—streamlining your workflow and reducing manual admin.
It is important that you have connected Tyro Health with splose before claiming.
This guide covers everything you need to:
Configuring Medicare in Tyro Health
Setting up Medicare details in the client record
Setting up a Medicare claimant from the client's profile
Process a Medicare Bulk Bill claim from an invoice
Process a Medicare Patient claim from an invoice
Checking the status of a Medicare claim
Troubleshoot common issues
Before you begin
Make sure:
Tyro Health is connected via Settings → Integrations → Tyro Health
The client’s appointment is for a Medicare-eligible service
The service has the correct item code
Medicare details (for either the client or a claimant) are correctly entered
A case is created for the client with relevant referral information (Contact type for referrer is ‘Doctor’)
Configure Medicare Location IDs in Tyro Health
To enable Medicare claiming through splose, Tyro Health must be configured correctly.
Using Medicare Location IDs
Medicare providers often need a Medicare location ID (also called Minor ID or PMS Location ID).
This isn’t stored directly in splose, but you can retrieve it from the Tyro Health portal:
Log in to Tyro Health Online
Go to the Locations menu
Click on the relevant location
Locate your Medicare location ID in the location details
→ If not visible, contact Tyro Health support.
Match your provider number type correctly
Tyro Health displays your practitioners and their associated provider numbers, along with a type (e.g. Medicare).
To avoid claim errors, make sure when entering provider numbers on splose you:
Enter the exact same provider number into the practitioner’s user profile in splose
Use the same type label as shown in Tyro Health (e.g. Medicare)
✅ Correct: Type = Medicare
❌ Incorrect: Type = Medicare:, Medicare #, or any variation
Using anything other than the exact type (like adding punctuation or extra characters) can cause submission errors when processing Medicare claims.
Add Medicare details for a client
To avoid re-entering information for every claim, save your client’s Medicare details once.
Go to the client’s profile in splose
Click Edit
Search and add the client’s health fund
Enter:
Medicare number
Gender
Reference number (optional but recommended)
Expiry date (if available)
Set up cases to manage referral information
To streamline your Medicare claiming process, it’s important to create a case for each Medicare client. This allows key referral details to be saved and automatically passed to Tyro Health when submitting claims.
If you don’t use a case, you’ll need to manually enter this referral information every time you lodge a claim.
💡Edit the case title to include an identifier like [Case Number] – [Medicare Number] for easier tracking and reconciliation.
What referral information is stored in a case?
When added to the case, the following details are automatically included in the Medicare claim submission:
Referrer name
The doctor (GP) or specialist who referred the client (required for Medicare claims)🚨.
Ensure your referrer's contact-type is set to 'Doctor', as that contact type allows you to put in the referrer's provider number.
Referrer provider number
The unique provider number of the referring contact.
Issue date
The date the referral was issued. This must be today’s date or a past date.
Referral period
The duration the referral is valid for:12 months (standard) for GPs
3 months (non-standard) for specialists
Expiry date
The end date of the referral. This will be calculated automatically if a referral period is entered.
By setting this up in advance, you’ll save time, reduce claim errors, and ensure all required data is passed to Tyro Health—keeping your Medicare workflow compliant and stress-free.
Set up item codes correctly in services
Medicare claims require a valid item code for each service.
To assign an item code:
Go to Settings → Services
Find the relevant service and click the three dots → Edit
Add the Medicare item code
You can search for valid item codes in the Tyro Health portal to confirm accuracy.
Search item codes in Tyro Health to confirm the correct code.
Add or select a Medicare claimant (optional)
Some clients have Medicare claims processed under a parent, partner or guardian’s details. You can add up to one claimant to their profile.
To add a Medicare claimant:
Open the client profile and click Edit
Click Add Claimant
Enter:
Full name
Date of birth
Medicare card number
Reference number
Expiry date
Click Save
Limit: Only one claimant can be added per client.
During the claiming process:
If a claimant exists, you’ll be prompted to choose whether to submit the claim under the client or a claimant
If no claimant is added, the claim will use the client’s Medicare details
You can edit or delete the claimant at any time.
Only add a Medicare claimant if the claim will be submitted under someone other than the client. If the claim is for the client themselves, there’s no need to add a claimant.
Process a Medicare claim with Tyro Health
1. Go to the client’s appointment
2. Ensure the service selected is a Medicare appointment and is attached to a case
3. Then click Add invoice.
4. Ensure the Medicare provider number is selected/provided in the invoice draft
5. Click Create Invoice
Now that the invoice is created, you can decide to make a Bulk Bill claim, or a Patient claim.
Process a Bulk Bill claim
1. On the invoice, click the Medicare Bulk Bill button (under the Pay button)
2. The Tyro Health modal will appear, pre-filled with:
Client or claimant details
Location and provider info
Referrer details
Service item(s)
3. Review the claim, then click Continue to payment
4. The Medicare claim will be submitted
Process a Patient claim
Patient claims require a fully paid invoice.
1. Record the payment using your integrated payment method, or manually mark it as paid.
2. Click Start a patient claim
3. The Tyro Health modal will be appear with client details, location details, referring doctor details and service items pre-filled.
If claimants exist, you’ll be prompted to select who to submit the claim under
4. Review the claim and click Submit claim.
5. The Medicare claim will be submitted.
Check the status of a Medicare claim (Bulk Bill and Patient claim)
You can check claim status in two places:
On the invoice, a summary of the Medicare claim will appear
In Tyro Health Online for a full claim history and more detail
Download Medicare Benefit form
After the session, you can download the Medicare Benefit form as well to provide to the client from the invoice's Medicare field.
Troubleshooting & FAQs
Why can’t I see Medicare claim options on the invoice?
Why can’t I see Medicare claim options on the invoice?
Make sure the client is listed as the invoice recipient, not a contact added to the "Invoice To" field. Medicare claims can only be submitted when the client is the direct recipient.
How do I claim on behalf of a parent or guardian?
How do I claim on behalf of a parent or guardian?
If the claim is being made under someone else’s Medicare details, ensure they have been added as a Medicare claimant on the client’s profile. You’ll be prompted to select the claimant during the claim process.
Why is my Medicare claim failing to submit?
Why is my Medicare claim failing to submit?
Double-check that the client or claimant has all required Medicare details entered in their profile:
Medicare number
Gender
Reference number (if applicable)
Expiry date
Missing or incorrect information will cause claim errors.
What does “No provider number” mean on the invoice?
What does “No provider number” mean on the invoice?
Each Medicare claim must include a valid Medicare provider number. Go to the invoice and ensure a provider number is selected under the practitioner’s details. If it is and you're still failing to claim, you will need to go to your Tyro Health Integration settings to check that the practitioner and location are selected.
Could the issue be with my Tyro Health setup?
Could the issue be with my Tyro Health setup?
Yes—if the practitioner's provider number hasn’t been set up properly in Tyro Health and on splose, claims may not go through. Log in to Tyro Health Online and confirm your provider setup under Locations.
Where can I find more information about error codes?
Where can I find more information about error codes?
Refer to the Tyro Health Error Guide for up-to-date explanations of error messages and resolution steps.