With a patient claim, the patient or claimant will pay for the the service(s) in full and they will receive their rebate directly from Medicare. This guide will aim to help you through your first Medicare patient claim!
If you have not submitted forms to Medicare to apply for Medicare Online via Tyro Health Online, you will not be able to create Medicate payment requests yet. Sign up here and we will get you up set up.
Demonstration
Here's Sophie from the Tyro Health Online Customer Success team with a detailed walkthrough of how patient claiming works. For a step-by-step breakdown, keep reading below.
Steps for creating a Medicare patient claim
To get started select the "Get paid" tab and click on the Medicare option, then select "Patient claim" when asked "how should this claim be processed?".
Under “Invoice reference”, you can optionally provide a unique reference, such an invoice number from your practice management or accounting system. This number will be retained and can be used to search for the transaction.
Provider details
You will need to select the location the service was provided at and the provider who is providing the service. Usually the "Speciality & provider number" field should auto-populate, unless the provider has two provider numbers for the same location.
Patient details
For the first time you create a patient funded Medicare claim for a new patient, you will need to manually enter in their Medicare details. The next time around, you will be able to search by their details.
Claimant details
If the patient is claiming the benefit, select "The patient". However, if someone else needs to receive the benefit, such as a parent/guardian of a minor, select "Someone else. That will enable you to fill in the patient's details and the claimant details.
Referral details (if applicable)
If the patient has a referral, enter in the details as listed on the referral provided.
Service items
Add the services provided to your patient. To do this, either type in the the relevant item code, item description, or select your service from the drop down list. (Only item codes relevant to the servicing provider and date of service will be displayed.)
The date of service defaults to the current date but can be any date within the previous two years, use you can use to backdate your Medicare claims. Enter an item price (default value is the MBS rate) and set any attributes applicable for the item.
To add any additional services, select “+ Add another item”.
Once the required fields are complete, click "Continue to payment".
Payment methods
You can either use Tyro Health Online Payments or accept cash for an out-of-pocket expense - the PDVC scheme is also available. After making a selection, click "Submit" to process the claim.
Medicare PCI claims will only be issued after the payment has been completed or was marked "paid in person" - read more about Medicare claim statuses.
If you have any questions, click on the pink chat bubble on our website or email our Customer Support team.