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Reciprocal Health Care Agreements for overseas visitors
Reciprocal Health Care Agreements for overseas visitors

More information on RHCAs and Medicare entitlements for overseas visitors

Pete Williams avatar
Written by Pete Williams
Updated over a week ago

Introduction

Tyro Health supports processing of Medicare claims and account validation/eligibility checks for overseas patients visiting Australia who are covered under Reciprocal Health Care Agreements (RHCA) - read more about the details of the scheme.

This may include patients from:

  • Belgium

  • Finland

  • Italy

  • Malta

  • Netherlands

  • New Zealand

  • Norway

  • Republic of Ireland

  • Slovenia

  • Sweden

  • United Kingdom

RHCA and Medicare cards

Importantly, for patients using the reciprocal health care arrangement, those patients must have a valid Medicare issued card number to process electronic claims. Physical cards may be yellow or blue and include the note Reciprocal Health Card or Interim Card. Services can be limited to necessary care and may not include all valid MBS items.

How to process claims

Claims can be processed on all Tyro Health Medicare channels:

  • Medicare Easyclaim enabled Tyro terminals;

  • Medicare Online via Tyro Health Online and connected partners; and

  • ECLIPSE in-patient medical claims via Tyro Health Online.

For ECLIPSE hospital services, RHCA transactions are run as in-patient medical claims - not overseas claims.


Troubleshooting

  • Eligibility checks may return the status code 9626 - "The patient is or was covered under the Reciprocal Health Care Agreement."

  • If a concession check is undertaken, it may return the result "Concession Entitlement Check not undertaken as the Medicare validation was unsuccessful." This does not necessarily note that Medicare details are invalid, but that the patient is not covered under concession.


If you have any questions, click on the pink chat bubble on our website or email our Customer Support team.

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