Submit a Patient claim

Before submitting Patient Claims, you'll just need to ensure you've followed our handy Medicare setup checklist


Step 1 - Select a Patient Claim

  • Submitting a Patient Claim starts by creating a new invoice
  • As pictured above, select 'Patient Claim' from the 'Medicare Claim' drop-down list
  • The 'Service Category' may also need to be set


Step 2 - Add Consultation Information

The compulsory fields to enter at this step are:

  • Date of Consultation
  • Location
  • Provider Number


Step 3 - Billing Information

  • Enter the relevant Service Type by starting to type in the item code. The fee, owing amount and other fields should then automatically populate
  • Press the '$' symbol to record a payment against the Service Type. This will usually need to be done for a Patient Claim as the patient has paid 'up front' for the consultation
  • Tick the 'Transmit' box, to indicate that you wish to send this claim to Medicare for processing
  • Occasionally, 'Flags' may be required to supply extra information about the consultation to Medicare


Step 4 - Client Information

The client information should populate automatically, based on the information recorded in the client's file. If not, you can fill out these fields specifically for this claim.

If the client is under the age of 18, the Change Claimant button can be used to enter the details of a parent or guardian who can claim on behalf of the client.


Step 5 - Referral\Request Information

Similarly to Step 4, the referral details should automatically populate based on the Client's details. Again, these can be manually updated if needed.


Step 6 - Claim Information

  • The 'Certificate Store' should already be set by default
  • 'Authorised by Client', 'Send request now' and 'Submit claim to Medicare assessor' should all be set to 'Yes'
  • If activated within your Medicare claiming defaults, you can also alter the 'Payee provider number'
  • In this section, you can optionally specify banking details for the claim. This dictates where Medicare will send the rebate


Step 7 - Save the Invoice

Patient claims are transmitted in real-time. All going well, you should see a "Lodgement Advice" pop-up, indicating that the claim has been sent successfully. If you receive any error messages, check out our Common Medicare Errors or Medicare's Return Code page.

James Hogan -

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