Online Medicare Rebates Claiming

Australian-based practitioners can claim Medicare and DVA rebates online for eligible patients including for patient rebates and bulk bill patients. Rebates are electronically processed without the need for you or patients to attend a Medicare office, with rebates received overnight directly into patients' accounts (or into your account in the case of bulk bill).

If you have any issues with Medicare and DVA online claiming, contact Medicare at any time on 1800 700 199.

Registering with Medicare for Online Medicare Rebates Claiming

Main article: Registration requirements for Online Medicare Rebates Claiming

All that is needed to register with Medicare for online Medicare and DVA rebates claiming is to complete the registration form. Medicare usually takes about 2-4 business days to register you for online claiming after they receive the completed forms. You do not need to obtain and install a PKI Site Certificate, which means that Halaxy Classic can be used on tablet devices (e.g. iPads) as well as PCs and Macs.

Please note that you need to complete Medicare's online claiming registration process even if you have already with Medicare as a provider.

Entering your patient’s claiming details in Halaxy Classic

Adding patient Medicare claim details

Main article: Adding and verifying patient and claimant Medicare details

If your patient wants to claim available Medicare rebates online (or if you would like to claim for bulk billed or DVA appointments), you only need to enter the patient’s details once to enable online Medicare rebates claiming.

Patient Medicare claiming details can be added in three ways:

  1. When when making an appointment;
  2. from an invoice; or
  3. On the patient's profile. On the patient's profile, you can also add and remove claimant details, and practitioners can also instantaneously verify patient and claimant Medicare information with Medicare to help ensure that Medicare provides rebates to you and your patients as soon as possible.

Eligible patients, appointments and invoices

If an invoice's item number is a Medicare or DVA item number, it may be eligible for online claiming. Medicare and DVA have a number of criteria which must be met, with information on invoices required to be be the same as what is registered on Medicare for a rebate to be accepted for online claiming:

Medicare rebate processing buttons
Processing patient Medicare rebates
  • Patient details: name and date of birth shown on their patient profile as well as their:
    • Medicare: Medicare card number, individual reference number and expiry date as entered on their Funding page, or
    • DVA: DVA card number, patient name and expiry date as entered on their Funding page;
  • Your details: your provider number; and
  • Referring GP if required: name and provider number with 8 digits (if their provider number has 7 digits, Medicare advises adding a 0 before the provider number).

You can only process one rebate of the same item number for the same patient and the same practitioner on the one day (if it is clinically required that you see the patient more than once in a day, you can note this under Additional Information and the rebate will be processed manually by a Medicare representative).

The Process Medicare or Process Bulk Bill button appears when the appointment for which the invoice was created is covered by a Medicare or Bulk Bill type of fee from your Fee List.

Processing rebates

Main article: Processing Medicare and DVA rebates

After you are registered for online Medicare rebates claiming, you can process Medicare and DVA rebates for eligible patients quickly and easily using Halaxy Classic, with Medicare providing the rebate electronically overnight. There are three main ways rebates can be paid:

  1. Patient Medicare rebates, where the patient pays you the fee and the rebate is provided to the patient;
  2. Bulk bill rebates, where the rebate is provided to you and the patient pays nothing; and
  3. DVA rebates, where you claim the rebate and you receive it.

You can also run reports for bulk bill and DVA rebates to confirm the next day that Medicare has paid the rebate to you.

Frequently Asked Questions

How do I verify a patient's Medicare or DVA card details (i.e. online patient and veteran verification)?

Go to the patient's Funding page, and click the Patient Verification icon to the left of the patient's Medicare or DVA number; Medicare confirms whether the number is correct within approximately 5 seconds.

My patient is a child. How do I add a claimant to Medicare rebate?

On the patient's Funding page, click the Edit icon next to the patient's Medicare card details and add the claimant's Medicare details - the claimant now receives the Medicare rebates.

How do I add a second claimant for a Medicare rebate?

On the patient's Funding page, click the New claim button, enter Medicare as the Funder and enter the patient's Medicare details. Click the Add claimant button and enter the claimant's Medicare details. You can now go to the patient's claim details and select which claimant will receive the claim. Read more information in the manual here.

I need to add additional information to my Medicare claim - how do I do it? How do I process two Medicare rebates for the same patient on the one day?

After you have clicked the Process rebate button on the invoice, enter the information in the Additional Information field, which is submitted to Medicare when you click the Process button.