In-Patient Medical Claim Billing-PC

In-Patient Medical Claim Billing-PC

Online Patient Verification [Mandatory for IMC-PC Billing]

Cards Tab

Medicare Card
  1. Select PVM Option.
  2. Enter Earliest Date of Service. 
  3. If card is ELIGIBLE no further action is required.
  4. 8005 code returned then do PVM again and card will be ELIGIBLE.
Health Fund Card
  1. Select PVF Option.
  2. Enter Earliest Date of Service. 
  3. If card is ELIGIBLE no further action is required.
Referral Tab
  1. Patient must have a valid Referral for the Admission or enter Referral Details

Admission Tab
  1. Click Add Button [left hand side of screen]
  2. Click the Add + button in the Admissions window.
  3. Select the required Location and Provider codes.
  4. Select Fund
  5. Select Admission date. This can be a service within 2 years of the current date.
  6. Select Earliest Date of Service [Admission Date]
  7. Select Informed Consent option
  8. Click the Save √ button to save or Cancel to abort and start again.
  9. Select the OPV button [ MUST BE ELIGIBLE or do PVM and PVF]
  10. Click the Close button to return to the PATIENT DETAILS window.

In-Patient Medical Claim Billing-PC
To simplify the claiming process it is recommended that the patient pay in full and Medicare Australia reimburse that amount.
From Patient Details : Click F8
 
  1. Tick Option Invoice For IMC
  2. Loc:      Select Hospital Location
  3. Prov:    Select Provider
  4. Select Service date.   Must not be older than 2 years.
  5. F Type: IMC or MS if billing Medicare Schedule Fee only for service
  6. Select Fund B. ID [Health Fund]
  7. Select Item code:
  8. Tab. Health Fund Fee will populate if IMC fee type selected. MS fee will populate if MS fee type selected.
  9. Referral Details: Auto-populates for Specialist Provider if only one Referral for patient. 
  10. If it does not populate double click in Referral Details box, 
  11. Select Referral from list and click OK 
  12. Or Click Add to add Referral. 
  13. Complete Referral details
  14. Then select and Click OK.
  15. Select Patient Admission
  16. Down arrow to add further service line items or click New Row at bottom of screen
  17. Select Pat C Online [Payment & Receipt section ].
  18. Select Pay Full
  19. Select Account details Held by Medicare.
  20. Only select Account Details in Impulse where requested by Medicare or the reimbursement is to be sent to a person other than the patient or patient family listed with Medicare.
  21. Select Address held by Medicare.
  22. When you press Select the Payments module will open. 

Payment  

  1. Full Payment
  2. Click Receipt
  3. Methods of Payment Screen opens.
  4. Select Method by which payment is being made.
  5. Complete all Details and Click Pay Button.
  6.  Print Receipt
IMC  PC declaration must be presented to the patient (on-screen or printed) and the patient’s verbal consent received prior to the submission of IMC PC.

IMC Patient Claim Consent and Declaration
I have paid for, or am liable to pay for, or the patient has paid for or is liable to pay for, the expenses for these services which are not excluded under the Health Insurance Act 1973 (i.e. not for the purpose of life insurance, superannuation or provident account schemes, admission to a friendly society, health screening, mass immunisation or connected with employment).
 
To the best of my knowledge and belief all the information in this claim is true and all information disclosed by me to the medical practice in the lodging of this claim is true and accurate. 

I authorise or have the patient's consent to authorise this medical practice to electronically transmit this claim for Medicare benefits (including banking details) to Services Australia and for Services Australia to on forward the claim details to the nominated Private Health Insurer on my behalf or the patient's behalf.
 
I also authorise or have the patient's consent to authorise Services Australia or the Private Health Insurer to contact the referring practitioner or the provider of the services if clarification of details for this account and/or receipt is required for assessment or auditing purposes.
 
For this claim, I consent to or have the patient's consent to this medical practice sending to and /or receiving from Services Australia and/or the nominated Private Health Insurer, the following information for the purpose of verification and /or processing this Claim:
  1. patient’s Medicare enrolment information (including Medicare number, issue number and individual reference number) and 
  2. patient’s first name, family name and date of birth, 
  3. patient’s Private Health Insurer information including the patient's membership number or  membership card number
If Services Australia pays a total benefit of zero for each service within this claim, the whole claim will not be forwarded to the nominated Private Health Insurer.
 I acknowledge that it is a serious criminal offence to give Services Australia false or misleading information in relation to a Medicare claim.
 
Privacy Notice: Your personal information is protected by law, including the Privacy Act 1988, and is collected by Services Australia for the assessment and administration of payments and services.
This information is required to process your application or claim. 
Your information may be used by the agency or given to other parties for the purposes of research, investigation or where you have agreed or it is required or authorised by law. 
You can get more information about the way in which Services Australia will manage your personal information, including our privacy policy at servicesaustralia.gov.au/privacy or by requesting a copy from the agency.
Information about medical expense totals may also be disclosed to other authorised family members for taxation statement purposes and the monitoring of family safety net entitlements. Patient name and address details may be disclosed to financial institutions when the claim is paid.

Voucher is now in The Medicare Claims\000\Waiting Report view waiting batching and Transmission to Medicare Australia


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