When attempting to process and claim a patient's appointment you will need to insure that the following is set up already:
Practitioners will need to have their provider numbers setup.
Your groups / businesses will need to have their Medicare details added.
GPs / Referrers will need to be added and link to the patient.
Patients will need to have their personal and Medicare details added.
Stock will need to be setup and linked to your groups to successfully create a claim.
If you are missing any of these, you can find how to get them added here.
To start a claim you'll first need to book an appointment for the patient, this can be done either through the diary by clicking on an available time slot or through the patient's record. When booking the appointment there are a few key things that it will need to have. It is a vital there is a valid group set against the appointment that has Medicare details, the stock item being used needs to be an approved stock item that is accepted by the group and finally an authorization needs to be added to the appointment.
Authorizations - This will be code that will be provided to you by the group you are billing through Medicare, it gives an allocated amount of sessions that the patient will receive for their treatment and can be added either through the patient's record here:
Or through the appointment here:
Once you have added the authorization and the patient has completed their appointment simply click 'Complete' on the appointment to bring up the quick bill screen. If everything is set up correctly you should get the option to bill through Medipass:
Once this is selected, the Medipass billing screen should appear to review the claim. It should automatically pull through all of the details that are needed to fulfill the claim as it will use the pre-existing information on TM3. Please review the information on the claim to make sure everything looks correct then continue by pressing 'Submit claim'.
Once you have submitted the claim you can check that the invoice has been submitted correctly under your finance section of TM3:
Reviewing the claim's amount and status
If you need to check on your claim you can login to Medipass or check how much the patient can claim, you can find it on the invoice, after you've submitted the claim:
The claim's status will show up there, too.
You can download/print the benefit form to provide it the patient, and you can also give the patient a copy of their invoice, which should have all their Medicare claim details.
Once you submit your patient claim, it means that it has been pre-approved and will be sent to the relevant 3rd party for final approval. If your claim is denied at this point please see the reasoning that goes along with this on Medipass to resolve.
Depending on the type of claim and payment method, the invoice will be credited back with what is expected from the 3rd party. The invoice can either be paid or part paid in combination with submitted or completed. You can check this within the invoice section of TM3, the reference numbers here will line up with the invoices that are submitted in your Medipass portal. If you open a Medipass claim from the finance section within TM3, you can re-submit and change elements that might of been missed when submitting the first time around.
If you have any questions about TM3 and Medicare please get in touch with our support team using the 'chat' icon at the bottom left of your TM3, we will be happy to help with any of your queries!