User Manual for Medicare Easyclaim

Transcription

1 User Manual for Medicare Easyclaim Practice A B A K I P T Y L T D

2 Contents 1 PURPOSE OF THE MEDICARE EASYCLAIM HOW IT WORKS How it works for paid patient claims How it works for unpaid and part paid claims How it works for bulk bill claims ENABLING MEDICARE EASYCLAIM IN PRACTICE EFTPOS/Easyclaim terminals and settings Configure Practice 2000 to use Medicare Easyclaim Claim Provider Setting Doctor Account Setting Medicare Online Installation CLAIMING WITH MEDICARE EASYCLAIM Fully paid patient claims Part paid patient claims Unpaid patient claims Bulk bill claims Requesting Medicare easyclaim bulk bill reports Resubmitting Medicare easyclaim bulk bill claims Transaction History MESSAGES Abaki Pty Ltd P a g e 2

3 1 PURPOSE OF THE MEDICARE EASYCLAIM Medicare Easyclaim allows you to lodge Medicare claims using your EFTPOS terminal. Payments are usually made within 24 hours, straight into your nominated bank account. You can also offer Medicare Easyclaim to your patients. Patients use it to claim their Medicare rebate once their account is settled, and have their Medicare rebate paid into their bank account almost immediately. Practice 2000 and Tyro have been integrated to provide the Medicare Easyclaim solution which links the practice management software to the EFTPOS/Easyclaim terminal. It has also been working with Medicare to provide a simple reconciliation method, especially for bulk bill claims. It is possible to reconcile in a similar way to what Medicare Online does. Practice 2000 Technical Support Melbourne (03) Sydney (02) Brisbane (07) Perth (08) Adelaide (08) support@abaki.com Web: 2 HOW IT WORKS How it works for paid patient claims 1. The patient/claimant pays as usual (eg. cash, cheque, credit card or EFTPOS) and their Medicare card details are automatically transmitted from Practice Basic details are entered using Practice The claim is sent to Medicare Australia for verification and a successfully transmitted response message is sent back to the terminal within seconds. 4. The patient swipes their EFTPOS card through the EFTPOS terminal and enters their PIN. If Medicare accepts the service the Medicare rebate is paid directly into their cheque or savings account almost immediately How it works for unpaid and part paid claims 1. Medicare card details are automatically transmitted from Practice Claim details are entered via the details stored in Practice The claim is sent to Medicare Australia for verification and an approval message is sent back to the terminal within seconds. 4. If Medicare Australia accepts the service, a pay doctor cheque will be sent to the patient, who brings it to the practice along with any outstanding balance. Abaki Pty Ltd P a g e 3

4 2.1.3 How it works for bulk bill claims 1. Medicare card details are automatically transmitted from Practice Claim details are entered via the details stored in Practice The claim is sent to Medicare Australia for verification and an approval message is sent back to the terminal within seconds. 4. The patient then presses a button on the keypad to assign their Medicare benefit to the doctor. The terminal prints a patient receipt. 5. The health care provider receives a single payment in their nominated bank account within hours. No more batching or storing claims. 3 ENABLING MEDICARE EASYCLAIM IN PRACTICE 2000 The Tyro Terminal Adapters minimum requirements are:.net 4.0 framework Microsoft operating system that supports the.net 4.0 framework Connection to the internet 3.1 EFTPOS/Easyclaim terminals and settings 1. Install the Tyro Terminal Adapter: Download and run the setup for the Tyro Terminal Adapter from: dapter).exe 2. If the computer is running on a 64-bit system, you will need to save the following text into a.reg file and import that file into the registry. Windows Registry Editor Version ,67,00,72,00,61,00,74,00,69,00,6f,00,6e,00,2e,00,74,00,79,00,72,00,6f,00,\ 2e,00,63,00,6f,00,6d,00,2f,00,00,00 3. Obtain the Merchant ID and Terminal ID for the Tyro Terminal: On the terminal, go to Menu/Settings/Terminal Info and print it out. Abaki Pty Ltd P a g e 4

5 4. Open the Windows Control Panel and start the Tyro Terminal Adapter control panel applet by double-clicking it 5. Enter the Merchant ID and Terminal ID of your Tyro Terminal into the corresponding fields of the Tyro Terminal Adapter Control Panel. The Pos System Name is sent to the Tyro Terminal and stored, allowing you to see which POS PCs are configured to use that Tyro Terminal. If more than one POS PC is to communicate with the same Tyro Terminal, then it is important to set that field to something that identifies that PC within your network. 6. Now switch to the Pairing tab. A window similar to the following will appear: Abaki Pty Ltd P a g e 5

6 7. Press the Commence Pairing button. A new window will appear that includes a timer indicating how many seconds have passed. You now have approximately 90 seconds to complete the rest of this process. 8. Now on the Tyro Terminal, go to MENU/Settings/Integrated EFTPOS/Authorise POS. Enter your Tyro Terminal's Administrator Password and press OK. 3.2 Configure Practice 2000 to use Medicare Easyclaim Claim Provider Setting On the main form of Practice 2000, go to Admin Tasks -> Setup Tab -> Tyro Setting -> Select Tyro in the drop down list and the appropriate options Doctor Account Setting On the main form of Practice 2000, go to Admin Tasks -> Setup Tab -> Doctor Accounts and enter the Merchant Number and Terminal Number accordingly. Abaki Pty Ltd P a g e 6

7 3.2.3 Medicare Online Installation Download and execute the Medicare Online installation file from It is recommended to perform this step on the Server and save the prhic611.exe file on the Practice folder. By default, Medicare Online will be installed to C:\Practice. Occasionally, setup will ask to install Java Runtime 1.4.7, follow the onscreen instruction and choose not to restart the computer when the setup completes. Check and make sure Practice 2000 is at least running version If not then download and execute the Practice 2000 online update from It is essential to perform this step on the Server and save the practicesql.exe file to the Practice database folder. For clinics that transmitting for the very first time, the location certificate must be installed from the CD provided by Medicare using the steps below: 1. Click Start -> Run then type psiapplet.cpl and press Enter to open the PKI Certificate Manager. Select Use an existing Store and click Next. 2. When asked for the location of the hic.psi file, browse to C:\Practice\HICOnline\ and select hic.psi and click on Next. 3. Occasionally, it will ask for the password, enter password00. The PKI Certificate Manager screen will open. Click on Install. 4. When asked to enter the PSI store password, enter password00 and click on Next 5. When asked to select the location of the store certificate, select the CD drive from the list box and click on Next 6. When asked to enter the PIC, type the PIC from the Medicare's letter and click on Next Close the PKI Certificate Manager. If this is the first time the clinic ever used Online Claiming, perform the following steps: 1. On Practice 2000, go to Admin Tasks -> Setup -> Medicare Online Setup and click on Reset. 2. When asked to enter the Location ID, enter the ABA number provided by Abaki and click OK. For more details, please refer to the instruction of How to Install Medicare Online in Practice 2000 user manual or from our website on 4 CLAIMING WITH MEDICARE EASYCLAIM 4.1 Fully paid patient claims 1. Ensure you have configured Practice 2000 to use Medicare Easyclaim. 2. You can bill patients via the Invoices form or the Waiting Room. The Invoices form is quicker and is recommended for specialists. The Waiting Room is more useful to large GP practices. Each consultation is to be written as one invoice. Abaki Pty Ltd P a g e 7

8 (1) In the Invoices form, click New Invoice. The Find Client form is displayed. Swipe the Medicare card to get a list of patients (or enter 3 letters for the surname and 1 letter for the first name, then press Enter). Use the Up Arrow and Down Arrow keys to select the right person, and then press Enter to accept. The Invoice Details window appears. OR: (2) With a patient selected in the Waiting Room, press Patient Leaving button. The Invoice Details window appears. 3. Modify the Invoice Date if necessary. 4. Ensure that you have a selection in the Provider, Account and Business drop-down lists. If you selected a doctor for the patient via the Waiting Room, these fields will already be populated. 5. Select Private Patient in the Sched/Type drop-down list. 6. Enter Service Items as necessary. Press Tab to get the fee number for a given item. If you are unsure of the item number, you can search the standard item list by double clicking on the Item field. You may modify the fees for individual items by clicking in the Amount column and typing new amount. 7. Press OK/Close button, the Payment Allocation window appears. Abaki Pty Ltd P a g e 8

9 8. There are 3 steps to allocate the payment: (1) Enter the payment: enter the Amount, have a selection in the Payment for dropdown list, enter Received date and select one of the Types from the drop-down list. If the patients pay by their bank account, please select eftpos in the Type drop-down list and click on Tyro Purchase button to perform the payment. (2) Allocate the invoice: Click on Auto Alloc button or double click on the Allocated field. (3) Click on one of the print button options to exit. 9. The Transmit Claim window appears to confirm about the claim details. Click on OK to process or Cancel to edit the claim. Abaki Pty Ltd P a g e 9

10 10. The Patient Claim Response window appears. The Assessment Status indicates the claim has been transmitted and the Status indicates the item has been accepted by Medicare Australia. Alternatively, the claim can be sent to Medicare Easyclaim to be processed via the Invoices window. Please note that the invoice allocated should be selected with the owed amount being Click on the Tyro Easy Claim button to transmit the claim. Abaki Pty Ltd P a g e 10

11 4.2 Part paid patient claims 1. With a patient selected in the Waiting Room, press Patient Leaving button. The Invoice Details window appears. 2. Modify the Invoice Date if necessary. 3. Ensure that you have a selection in the Provider, Account and Business drop-down lists. If you selected a doctor for the patient via the Waiting Room, these fields will already be populated. 4. Select Private Patient in the Sched/Type drop-down list. 5. Enter Service Items as necessary. Press Tab to get the fee number for a given item. If you are unsure of the item number, you can search the standard item list by double clicking on the Item field. You may modify the fees for individual items by clicking in the Amount column and typing new amount. 6. Press OK/Close button, the Payment Allocation window appears. Abaki Pty Ltd P a g e 11

12 7. There are 3 steps to allocate the payment: (4) Enter the payment: enter the Amount, have a selection in the Payment for dropdown list, enter Received date and select one of the Types from the drop-down list. If the patients pay by their bank account, please select eftpos in the Type drop-down list and click on Tyro Purchase button to perform the payment. (5) Allocate the invoice: Click on Auto Alloc button or double click on the Allocated field. (6) Click on one of the print button options to exit. 8. The Invoices window appears. The invoice allocated should be selected with the owed amount. Click on the Tyro Easy Claim button to transmit the claim. 9. The Transmit Claim window appears to confirm about the claim details. Click on OK to process or Cancel to edit the claim. Abaki Pty Ltd P a g e 12

13 10. The Patient Claim Response window appears. The Assessment Status indicates the claim has been transmitted. The Status indicates the item has been rejected by Medicare Australia and the explanation has been showed to users for further actions on the claim. Abaki Pty Ltd P a g e 13

14 4.3 Unpaid patient claims 1. With a patient selected in the Waiting Room, press Patient Leaving button. The Invoice Details window appears. 2. Modify the Invoice Date if necessary. 3. Ensure that you have a selection in the Provider, Account and Business drop-down lists. If you selected a doctor for the patient via the Waiting Room, these fields will already be populated. 4. Select Private Patient in the Sched/Type drop-down list. 5. Enter Service Items as necessary. Press Tab to get the fee number for a given item. If you are unsure of the item number, you can search the standard item list by double clicking on the Item field. You may modify the fees for individual items by clicking in the Amount column and typing new amount. 6. Press OK/Close button, the Payment Allocation window appears. Abaki Pty Ltd P a g e 14

15 7. Press Close/Print Later button to exit. 8. The Invoices window appears. The invoice allocated should be selected with the owed amount. Click on the Tyro Easy Claim button to transmit the claim. 9. The Transmit Claim window appears to confirm about the claim details. Click on OK to process or Cancel to edit the claim. 10. The Patient Claim Response window appears. The Assessment Status indicates the claim has been transmitted. The Status indicates the item has been accepted by Medicare Australia. Abaki Pty Ltd P a g e 15

16 4.4 Bulk bill claims 1. With a patient selected in the Waiting Room, press Patient Leaving button. The Invoice Details window appears. Abaki Pty Ltd P a g e 16

17 2. Modify the Invoice Date if necessary. 3. Ensure that you have a selection in the Provider, Account and Business drop-down lists. If you selected a doctor for the patient via the Waiting Room, these fields will already be populated. 4. Select Bulk Bill in the Sched/Type drop-down list. 5. Enter Service Items as necessary. Press Tab to get the fee number for a given item. If you are unsure of the item number, you can search the standard item list by double clicking on the Item field. You may modify the fees for individual items by clicking in the Amount column and typing new amount. 6. Press OK/Close button, the Invoices window appears. 7. Select the Bulk Bill invoice to transmit. Click on the Tyro Easy Claim button to send the claim. 8. The Transmit Claim window appears to confirm about the claim details. Click on OK to process or Cancel to edit the claim. 9. The Bulk Billed Claim Response window appears. This response shows the claim details, including the Benefit Estimated by Medicare Australia for each service item, is returned via the Eftpos/Easyclaim terminal. Abaki Pty Ltd P a g e 17

18 4.5 Requesting Medicare easyclaim bulk bill reports 1. Select the claims to be requested: In the Invoices form, click on Find button to filter the claims. You can filter the types of claims via the Claim State drop-down list. 2. Click on the Tyro Statemt button on the Invoices form, Payment reports are printed for the relevant claims and any claims that have been paid by Medicare Australia are automatically receipted off in the relevant account. There are 2 types of reports: 1. EFT - Payment Report: available 4 to 5 business days after transmission for any claim that is successfully submitted and paid. This report shows how much the doctors have been paid. Click on Easy EFT Paymt button to view the report. In case of Pathology claims, this report will be available after 10 business days. Abaki Pty Ltd P a g e 18

19 2. Exception - Processing Report: available 1 to 2 business days after transmission for any claim that is successfully submitted but not fully paid and/or fully paid with warnings. This report shows the list of rejected vouchers and the rejection code and explanation. Click on Easy Statemt button to view the report. Abaki Pty Ltd P a g e 19

20 4.6 Resubmitting Medicare easyclaim bulk bill claims In the Easyclaim Statements window, if the bulk bill claim is partly paid or fully rejected then select the claim and view the Exception Report. Scroll to the right to view the rejection code and explanation. If the rejection is valid and therefore it is not possible to claim for the service, click the Show Service button to display the invoice then click on Edit/Delete. Click the Adjust button and enter a negative amount to write off the service. Click the OK button to return to the Exception Report. If the rejection is due to incorrect patient details (ie. Medicare#), click the Show Patient button and adjust the details accordingly. It is strongly recommended to click on Check Medicare to confirm if the patient details can be verified by Medicare. Click the Close button to return to the Exception Report. If the rejection is due to an invalid condition on the invoice (ie. Service possibly After Care), click the Show Service button and click on Edit/Delete to adjust the condition accordingly. If other services on the invoice were paid in this transmission, note down the details of the rejected services and move them to a new invoice. In the Invoice form, select the Bulk Bill invoice to retransmit. Click on the Tyro Easy Claim button to resend the claim. The message confirming about the retransmission appears, click OK to resend it. 4.7 Transaction History You may review the transactions made by Tyro or the Medicare Easyclaims transmitted to Medicare Australia. 1. In the Invoices window, click on Tyro Transaction button and the Tyro Transactions window appears. 2. Enter the From and To Date. 3. Select the appropriate option. 4. Click on the Load button to list the transactions. 5. Double click on the row to view the transaction details (optional). Abaki Pty Ltd P a g e 20

21 5 MESSAGES 1. Invalid Medicare card number -> Modify Patient s Medicare card number. 2. Patient is eligible for Medicare claiming -> Click OK to continue. Abaki Pty Ltd P a g e 21

22 3. Patient is not eligible for claiming item > Click OK to continue. 4. Filter the invoices with status EASY SENT 5. There are new reports from Medicare for Bulk Bill claims. 6. Confirming before retransmit an invoice through Easyclaim. Abaki Pty Ltd P a g e 22