Medicare Easyclaim - now available on your HICAPS terminal
What is Medicare Easyclaim?
Medicare Easyclaim is a Medicare Australia initiative that allows patients to lodge their claims and receive their rebates through the HICAPS terminal at your practice.
What type of Medicare claim can I process through my HICAPS terminal?
Medicare Easyclaim is used for bulk bill and/or patient claims including Enhanced Primary Care (EPC). There are three payment options for patient claims that can be lodged through Medicare Easyclaim. The type of claim submitted is dependent on the manner in which you have agreed with your patient to settle the account.
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Fully paid account - patient has paid their account in full.
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Part paid account - patient has paid a contribution toward the settlement of the account.
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Unpaid account - account has not been paid.
Following full account payment by your patient by cash, EFTPOS, credit card or cheque, you simply swipe your patient's Medicare card and their rebate is paid directly into their bank account almost immediately.
It is at your discretion whether to bulk bill a patient or not. If you choose to bulk bill, additional fees or co-payments should not be charged to your patient following bulk bill claims.
For a full description of Medicare claim types please turn over.
How do I process a Medicare claim transaction?
Once your patient has settled their account, you simply swipe their Medicare card and follow the prompts. For bulk bill and unpaid account patient claims, you simply swipe your patient's Medicare card from the idle screen on your terminal.
For a step by step guide, please see below to download a copy of the HICAPS Medicare Easyclaim User Guide.
How do I reconcile Bulk Bill claims?
You can access Medicare Easyclaim bulk bill claims processing and payment reports to assist with reconciliation via Medicare Australia's Health Professional Online Services (HPOS) portal. For full access to HPOS you will need to register for a Public Key Infrastructure (PKI) individual certificate. To register for a PKI certificate and for access to HPOS visit www.medicareaustralia.gov.au.
How do I find out more about Medicare Easyclaim?
For all Medicare Easyclaim enquiries call the Medicare e-Business Service Centre on 1800 700 199.
| Helpful Hints |
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- Patients IRN number - number left of the patient's name on their Medicare card.
- Allied health providers can only claim under an EPC plan if the referring GP has established the plan with Medicare Australia and then subsequently 'activated' the plan.
- Medicare rebates can only be paid directly to your patients' cheque or savings accounts.
- Bulk Bill claims will generally be paid within two to three days for providers who have Electronic Funds Transfer (EFT) details registered with Medicare Australia. Cheque payments may take longer.
- Ensure you have registered your nominated bank account with Medicare Australia to ensure faster electronic payment.
- Benefit assigned amount (Bulk Bill claim) - the amount shown on the terminal receipt is an estimated benefit only and is not the rebate amount that will be paid by Medicare Australia. Details of the actual rebate to be paid can be obtained via Medicare Australia's HPOS portal.
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General terms explained
| Term |
Description |
| Patients claims |
The benefit payment methods to providers for patient claims lodged through Medicare Easyclaim is dependent on whether the account is fully paid, part paid or unpaid. For fully paid accounts, the benefit payment will be made via EFT immediately to the patient's cheque or savings account. For part paid and unpaid account patient claims a cheque is sent to the patient, made payable to the provider from Medicare Australia.
- Fully paid account (EFT) - where the account has been paid in full, payment will be made to the patient's nominated bank account. This payment will be initiated by your patient swiping their EFTPOS card.
- Part paid account (Cheque) - where a patient has made a part payment contribution towards the account.
Where Medicare benefits are assessed as payable for a claim, a statement and/or cheque in the provider's name will be forwarded to the patient's address recorded by Medicare Australia. The cheque is then forwarded by the patient to the provider. Where no benefit is assessed as payable, a statement only will be forwarded to the claimant's address recorded by Medicare.
- Unpaid (Cheque) - where the account is unpaid.
Where Medicare benefits are assessed as payable for a claim, a statement and/or cheque in the provider's name will be forwarded to the patient's address recorded by Medicare Australia. The cheque is then forwarded by the patient to the provider. Where no benefit is assessed as payable, a statement only will be forwarded to the patient's address recorded by Medicare.
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| Bulk bill claims |
- Bulk bill claims - A bulk bill claim is where a patient who is eligible for a Medicare benefit(s) assigns his/her right to the rebate(s) to the servicing provider via the HICAPS terminal as full payment for that service(s) which is then paid directly to the provider's nominated bank account registered with Medicare Australia.
It is at the provider's discretion whether to bulk bill a patient or not.
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HICAPS Medicare Quick reference Guide
This reference guide has been developed to help you get started with using Medicare Easyclaim on your HICAPS terminal. To download a copy click here.
You will need Acrobat ® Reader to view or print the HICAPS / Medicare user guides. Click here  to download a copy.
The Acrobat ® Reader file is 6.4MB.
HICAPS Medicare Easyclaim User Guides
To download a step by step Medicare claim transaction guide for your HICAPS terminal, please select your provider type below.
| Provider type |
Specialists / Ancillary Health Care and Dental Service Providers.
Chiropractor
Clinical Psychologist
Dietitian
Endodontist
General Dentist
Occupational Therapist
Oral/Maxillofacial Surgeon
Osteopath
Paediatric Dentist
Periodontist
Physiotherapist
Podiatrist
Prosthodontist
Psychologist
Speech Therapist |
Download |
| Optometrists |
Download |
| General Practice |
Download |
| Diagnostics |
Download |
| Pathology |
Download |
For a full comprehensive guide on Medicare Easyclaim visit www.medicareaustralia.gov.au
Click Here to download a copy of the T4210 Terminal Operations Guide
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