Medicare Online Claiming: Full Detail

Medicare Online Claiming: Full Detail

Medicare Online Claiming 

Accessing Medicare Online

  1. Main Menu\Medicare\Claims
  2. Bulk Claims speed button
Billing has been completed with a 'Bulk Bill' Fee Type [Payer Type: MR, MH, VR, VA] or MS or IMC Fee Type for In-Patient Medical Claims.
The saved Voucher [Invoice] will appear in the Medicare Online Claiming module in the Unprocessed View for the Payer Type.
A Right Mouse Click on Any selected Voucher or Claim will allow the view in any screen to be narrowed to
  1. Narrow to Selected Fee\Payer Type Location Provider
  2. Narrow to Selected Location Provider
  3. Narrow to Selected Location
View Voucher tab on the bottom taskbar of all medicare Claim status screens allows you to 
  1. Journal a Voucher
  2. Journal an item in a voucher
  3. Journal part of an item [used mainly when claim returned with action amount]
  4. Print The voucher list

Service Date Range In Unprocessed View

  1. Select Date Range Period from the top left hand corner box.
  2. Claims are now selected by service date for the date range selected.
  3. Please be aware that only service items within this date range will appear in the unprocessed list.

Payer type

Identifies the Type of Claim.
  1. MR: Bulk Bill
  2. VR: DVA
  3. 000: All Funds
  4. By Fund brand id eg MPL

Medicare Claim Status

Impulse has 6 different folder options that identify the status of a claim.
  1. Unprocessed
  2. Processed
  3. Waiting Tx
  4. Waiting Report
  5. Reported
  6. Action File

Unprocessed View

  1. Default is Payer Type Medicare Bulk Bill [MR]. All Others can be selected from the drop down list.
  2. Sorted By Payer Type and Date Range Period
  3. The Unprocessed view list all the vouchers [Invoices] billed for a patient For the selected Payer Type and Period. 
  4. The vouchers can be further filtered by Provider or Location or a combination of both. 
  5. Changes can be made to demographic details in the Patient Details screen and will be picked up when the voucher is processed.
  6. Vouchers can be viewed and journalled in full or specific items within a voucher can be journalled.
  7. Vouchers can also be put in the action file if further consideration is required prior to processing.
Tabs on bottom taskbar
Process Button:       Will process vouchers and move the voucher to the processed view
Action Bin Button:   Will move voucher to Action Bin for correction or approval
Vouchers View:        Will open window to show detail of voucher as entered during billing
Print List:                   Will print summary of all listed vouchers
Close:                        Will close Medicare Online module

Processed  

  1. Default is Payer type Medicare Bulk Bill [MR]. All Others can be selected from the drop down list.
  2. The processed view allows you to view the batches of vouchers that have been created for each Payer Type\Location\Provider for transmission to Medicare. 
  3. If details are incorrect the voucher can be put back to the unprocessed view or journalled.
1-Close Button:        Closes the batch to transmit to Medicare. Can be closed with Online or Manually
Unprocess Button:  Allows a batch to be selected and returned to the Unprocessed view
Vouchers View:       Will open window to show detail of voucher as entered during billing
Print List:                  Will print summary of all listed batches
Close:                       Will close Medicare Online module.

Waiting Tx  

  1. Default is Payer Type Medicare Bulk Bill [MR]. All Others can be selected from the drop down list.
  2. The Claim has now been generated ready to Transmit to Medicare and will have a Claim ID.
  3. The individual voucher within the claim can still be excluded or journalled at this time if details are incorrect by selecting View Voucher, selecting the voucher and clicking EXCLUDE or Journal voucher.
  4. Excluded Vouchers will be sent to the unprocessed view.
Transmit Button:    Transmits all closed online batches to Medicare for processing
Vouchers View:       Will open window to show detail of voucher as entered during billing
Print List:                  Will print summary of all listed batches
Close:                        Will close Medicare Online module

Waiting Report   

  1. Default is Payer Type Medicare Bulk Bill [MR]. All Others can be selected from the drop down list.
  2. These are claims that have been transmitted to Medicare and are waiting Online Processing and Payment reports. 
  3. Medicare will usually process Bulk Bill Claims within 24-48 hours.
  4. In Patient-Medical Claims [IMC] have to have a Status Request of COMPLETE and READY before Processing reports can be retrieved.
  5. Please note: Do not retransmit without contacting Medicare Australia to determine the status of the claim.
Request Reports:      Will request reports for the selected payer type, department, location and provider selected
Display:                     Will display claims in a batch
Print List:                   Will print summary of all listed batches
Close:                        Will close Medicare Online module

Reported view   

  1. These are claims that have had either payment reports or exception returns returned by Medicare and processed into Impulse. 
  2. A payment report is processed and allocated a run number. 
  3. Exceptions are placed in the Action File view.
Transmission Status
This will allow claims to be narrowed to the option selected

Transmitted Status
  1. <3 Months
  2. <6 Months
  3. <1 Year
  4. >1 year
Narrow Selection To
  1. Paid but waiting Processing Report
  2. Reported but waiting ERA/Payment
  3. Rejected Claims
  4. Paid and Reported Claims
  5. Non-Zero Action Amounts
  6. Excluded Claims
  7. Zero Balance Claims
Search Claim   
  1. A claim number or series of claim numbers comma separated,  can be entered into this option to narrow the reported view to only have these claims displayed.
  2. Click Search to display
Vouchers View:   Will open window to show detail of voucher as entered during billing
Print List:              Will print summary of all listed batches
Close:                    Will close Medicare Online module

Action File  

  1. These vouchers have an error and an exception error has been returned by Medicare associated with the service.
  2. Do not automatically journal these services.
  3. If demographic, referring doctor or Medicare card details are the issue, these can be corrected.
  4. A voucher can be put back to Unprocessed View to Resubmit the claim.
Release Button:    Allows vouchers where attached to a claim and not paid to be released to  Returned view.
Vouchers View:   Will open window to show detail of voucher as entered during billing
Print List:               Will print summary of all listed batches
Resubmit Button:  Found Under Process Status allows vouchers that are in action to be released to UnProcessed View after details have been changed or corrected.
Close:                     Will close Medicare Online module

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