Medicare - Alternate Claimants
In this article, you will learn how to process a Medicare claim using Bill to Patient with an Alternate Claimant.
*NOTE: This process strictly relates to invoices and payments where the patient is claiming the rebate from Medicare.
Bill to Patient with Alternate Claimant means that the invoice is issued to the patient, however the Medicare rebate for the services is refunded to an alternate claimant. The patient still is responsible for the payment of the whole invoice. If the alternate claimant has provided Medicare with their bank details, then they will automatically be refunded directly into their account. If the claimant has not provided their bank details to Medicare, or a cheque will be forwarded to their registered mailing address from Medicare.
To process an invoice using Bill to Patient with Alternate Claimant, navigate to the Accounts section of the patient record, and then click Invoices.
Click New Invoice to open the invoice form.
Complete the invoice with all the required details, and make sure that the Bill To field is set to Patient. Click the Print Medicare Claim tick-box to print a copy of the invoice with details of the rebate. You may need to print a copy for the claimant and the patient.
The Total is the total amount being billed to the patient. The GAP does not apply in this case because the rebate is going to an alternate claimant.
Once you have completed the invoice form, click More Pay to open the payments form.
At the top of the payment form, click Claimant and use the search box to lookup the Name of the Claimant (the name of the claimant must be registered in your clinical software).
Click Type and select the payment type. Click the field under Amount and enter in the amount being paid. If you want to do a split-payment (Cash+EFT), or something similar, you can add multiple payments to the form by click the + icon next to the Type.
Click the Tick-box next to the name of the invoice below, and click Allocate to allocate the payment funds to it.
Once you have completed the form, click Pay and Claim.
Once the claim is submitted to Medicare, it may take up to 10 or 15 seconds to process. The speed of processing claims is dependent on your internet connection, and the amount of claims being submitted to the Medicare server at that moment.
*NOTE: If you have enabled Medicare PCS (Patient Claim and Store) in your practice settings, and you process claims individually or in a nightly batch, then you will receive this message prompting you to store the message for processing later.
Once the claim has been processed, you will be returned to the patient record, where the newly created invoice will be visible in the Invoices list.
A copy of the invoice will open in a new tab, where it can be printed to given to the patient. You can also print a copy for the claimant, for records keeping purposes, or in case they need to make a claim with it.
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