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Process Medicare claims with Tyro Health
Process Medicare claims with Tyro Health

How to set up Tyro Health to enable Bulk Bill and Patient claims with Medicare.

Splose avatar
Written by Splose
Updated this week

Introduction

Lodge Medicare Bulk Bill and Patient claims using the Tyro Health integration. Connect Tyro Health with Splose before reading this guide.

This help guide will cover:

  • Configuring Medicare in Tyro Health

  • Setting up Medicare details in the client record

  • Process a Medicare Bulk Bill claim from an invoice

  • Process a Medicare Patient claim from an invoice

  • Checking the status of a Medicare claim


Configure Medicare in Tyro Health

Make sure to connect and configure Tyro Health with Splose to enable Medicare claims.


Add Medicare details for a client

To pass a client's Medicare details to Tyro Health, and save you from having to enter their details each time you need to process a claim for a client, you must enter the Medicare number and gender in the client details page by clicking edit, then searching the health fund and adding the client's health fund details.


Set up cases to manage referral information

In order to efficiently lodge Medicare claims, you must create a case for a client so that referral information can be passed to Tyro Health. If the following information is not provided, then you will need to add it individually each time.

Cases help you store the following referral information for clients, which will be passed to Tyro Health if entered.

Referrer

The doctor or specialist who referred the client, which is required when lodging a claim.

Referrer provider number

The referring doctors' provider number.

Issue date

The date that the referral was issued. This should the current day or a date in the past for Meciare claims.

Referral period

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.

Expiry date

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 Tyro Health, make sure your services have correct item codes in order to submit a claim, as the item code gets passed to Tyro Health for fast-claiming.

In Settings, then Services, select a service and under actions, click the three dots to edit a service.

Search item codes in Tyro Health to confirm the correct code.


Process a Medicare claim with Tyro Health

Create a Medicare appointment. Select the Medicare service and assign a case.

Then click Add invoice.

Make sure the Medicare provider number is selected on the invoice, since Medicare claims come under the Medicare provider number. 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

To process a Bulk Bill claim, click Medicare Bulk Bill under the Pay button.

The Tyro Health modal will be appear with client details, location details, referring doctor details and service items pre-filled. Review the claim and click Continue to payment.

The Medicare claim will be submitted. Check the status of a Medicare claim below.

The Medicare claim will be submitted. Check the status of a Medicare claim below.


Process a Patient claim

To process a Patient claim, an invoice must be fully paid. Add a payment using an integration, or record the payment in Splose. Once paid, you can make a Patient claim by clicking Start a patient claim.

The Tyro Health modal will be appear with client details, location details, referring doctor details and service items pre-filled. Review the claim and click Submit claim.

The Medicare claim will be submitted. Check the status of a Medicare claim below.


Check the status of a Medicare claim (Bulk Bill and Patient claim)

Review the status of the claim from the invoice, or open in Tyro Health to see more details.


Download Medicare Benefit form

Download the Medicare Benefit form to sent to clients after a session.


Tyro Health errors

As error codes change, it's best to read the Tyro Health guide for an updated explanation list of error codes.

💡Ensure that the invoice recipient is the client, not a contact added to the Invoice To field if claim options are not displaying.

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