2016 Health Communication Network Limited. DVA Claiming

Transcription

1 2016 Health Communication Network Limited DVA Claiming

2 Overview DVA Claims are streamlined, paperless, electronic claims to Medicare. The Patient Details window provides for the recording of the following DVA membership details: o White Card holder (condition-specific) o Verification of Patient DVA details with Medicare o Indicate whether you wish to verify Patient DVA details prior to invoicing (billing) o Whether the Patient Name differs from that recorded on their DVA Card This handout describes the steps required to record, invoice, and batch DVA Claims. The following steps are performed: 1. Add DVA details to the Patient Details window 2. Create a DVA Account, and bill a DVA Claim 3. Batch the DVA Claim to Medicare MedicalDirector Blue Chip provides a number of Medicare reports that can assist with claiming. Two such reports that can assist with DVA claims are: 1. Debtor Detail Report - outstanding DVA claims. a) To access, select Reports > Print > General Financial Reports. b) Enter required date range. c) Select Practitioner if required. d) Clear All Classes, and then select the DVA Class only. 2. Medicare Claim Payment Report - processed and paid DVA claims. a) To access, ensure you have the Practice Explorer open. b) Within the Practice Explorer, select the Medicare Australia margin menu item. c) Select Reports > Print > Medicare Payment & Processing Reports. d) Enter required date range. e) Select Practitioner if required. f) Select DVA as the Class Health Communication Network Limited 2

3 Step 1 - Patient Details Overview Patient DVA card membership details are recorded within the Patient Details window for verification and assist the DVA claim with Medicare. Procedure 1. Within MedicalDirector Blue Chip, from the Patient Details window select the Veteran option to change the default from Medicare to Veteran. Enter the patient s DVA number. 2. Tick the White Card check box if the patient is a White Card holder. 3. If the patient s name as recorded in MedicalDirector Blue Chip differs from that recorded on their DVA card, enter the DVA card details in the Alias Given Name and Alias Surname fields provided. 4. Click the Verify with Medicare Australia/DVA button. 5. A prompt appears, confirming the difference in name. o Click Yes to update the information in MedicalDirector Blue Chip with that on the card. o Click No to leave the name in MedicalDirector Blue Chip as-is. This prompt will display for each verification. 6. You will be alerted to the successful verification. 7. Click the OK button Health Communication Network Limited 3

4 Step 2 - Create a DVA Account and Bill a DVA Claim Overview A DVA account is required to bill the claim for the DVA patient. This verifies DVA details and fees with Medicare/DVA. Procedure 1. Within the Patient Details window, select the Accounts margin menu, and locate an existing DVA account. o If one exists, double-click it to open it. Proceed to Step 3. o If one does not exist; create a new account by clicking the Create New Account button. Proceed to Step The New Account window appears. Select the required Practitioner, Class as DVA, and then click the OK button. The new DVA account is added to the list of accounts in the Patient s Record. 3. Open the DVA Account by double-clicking it. 4. Click the New Invoice button to begin issuing a new invoice. 5. The DVA Verification prompt appears. o Click OK if required to verify. o Click Ignore if already verified. 6. Select the Service Type if required. There will only be multiple service types if you have pre-configured them. 7. Enter Item Numbers as desired. A Service Item s fee will appear automatically. Ensure the fee is correct Health Communication Network Limited 4

5 8. Tab to the Service Text field, double-click the field to reveal the button, and then click it to add additional text for Medicare if required. The Service Text window appears. 9. Select the appropriate Service Flag via the associated drop down menu. 10. Select the appropriate Explanation via the associated drop down menu. If the explanation you want does not exist, manually-enter a new one as a once-off explanation, or click on the Add button to add a new one to the list. 11. Enter the Time of Service, and then click the OK button. 12. On the New Invoice window, add DVA White Card Text if the patient is a White Card holder. White Card text is mandatory if selected. 13. Click the Issue button Health Communication Network Limited 5

6 14. When prompted, select the associated Referral, and click the OK button. 15. You will be prompted to enter the date-of-issue for the invoice. The default is the current date. 16. Select Print To screen or printer, and then click the Next button. Service Text and DVA White Card text details are added to the invoice Health Communication Network Limited 6

7 Step 3 Batch the DVA Claim to Medicare Overview DVA Claiming When DVA claims are invoiced within the patient s account, the claim is added to the Medicare Australia Claim section of MedicalDirector Blue Chip s Practice Explorer ready to be batched to Medicare. The Medicare Australia Claim section automatically displays the claims not yet batched, unprocessed and ready to action, or available to troubleshoot depending on the status. You can view claims associated with individual or all practitioners. You can examine claims within a specific date range, individual or all claim types, and indicate to display finalised claims. When changes are made to these options, ensure you click the Refresh button to view this changes in the window. The status of claims determines the action required on the claim. The following statuses will display once a DVA claim has been batched to Medicare. Claim Status Awaiting Submission Awaiting Processing Report Awaiting Authorisation Awaiting Payment Report Ready to Receipt Description & Action Claim is waiting to be sent to Medicare. Click the Transmit button. Waiting for the processing report for the claim. It can take up to 3 business days to process. Click the Transmit button to retrieve the process report. Claim requires authorisation. Open the claim and send to Medicare from the edit screen. Claim has been successfully processed, and is awaiting payment report. It can take up to 6 business days to process. Click the Transmit button to retrieve the payment report. Claim has been successful in processing and payment with Medicare. It is ready to receipt. Click the Receipt button. Note: For additional Medicare Australia claim statuses, refer to the Help file in MedicalDirector Blue Chip and search for Medicare Claim Status. Procedure 1. Ensure you are viewing the Practice Explorer. 2. Select Medicare Australian from the margin menu Health Communication Network Limited 7

8 3. Select a Practitioner, Claim Type as DVA, and Date Range if required. Note: If not selected, can be selected when sending the DVA batch (next step). 4. To batch the new DVA claims; click onto the New button. 5. Select Claim Type as DVA (if not selected in the previous step), appropriate Practitioner, Service Type (if multiple types are available) and the Service Location if required. 6. Click the button to select a single claim, or the button to select all claims. 7. Click the Send button. 8. The Claim Authorisation window appears, prompting for an Authorisation Method. Select one if required. Click the OK button. 9. The batch has been sent to Medicare. The Medicare Claiming window displays the batch with the status of Awaiting Process Report. MedicalDirector Head Office Level 5, 72 Christie Street, St Leonards NSW, 2065 Tel: Fax: A.B.N Copyright Health Communication Network Limited 8