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.
Using Medicare Location IDs
Medicare providers often need a Medicare location ID (also called Minor ID or PMS Location ID). While splose does not store this ID directly, it can be retrieved through the Tyro Health portal. Follow these steps:
Log in to Tyro Health Online.
Navigate to the Locations menu.
Click on the desired location.
Your Medicare location ID will be displayed along with location details. If the ID is not visible, please contact Tyro Health Online support for assistance.
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 you submit a claim.
Edit the case number inside their profile to include identifiers such as "[case number]-[Medicare number]" for easier tracking. This ensures streamlined tracking and documentation.
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. If errors persist, ensure the client's Medicare details, such as the correct Medicare number and gender, are entered correctly in the client details page. Check if the Medicare provider number is assigned to the invoice to avoid submission errors.