Get Medicare Participant

The Get Medicare Participant function in MediRecords helps practices keep their ECLIPSE billing information up to date. By refreshing details directly from Medicare, practices can ensure that their list of private health insurers is current and accurate. This includes retrieving essential information such as fund brand IDs and contact numbers, which are required for successful electronic claiming.

Keeping this data updated reduces the risk of claim errors, saves time for staff, and supports smoother payment processing.

Using the Get Medicare Participant Function

Follow these steps to use the Get Medicare Participant function:

1. Click More, select Resources, and choose Contacts.
    
2. Click Service Providers.
    
3. You will be taken to the Service Providers screen.

4. Click More and select Get Medicare Participant.

   ℹ️ Note:
   • This action will communicate with Medicare to refresh the list of health funds participating in ECLIPSE Medicare billing. 
   • To verify the update, click on a Health Fund to view its profile.

   • If successful, you will see updated details such as fund brand IDs and contact numbers.

Troubleshooting

The OPV button isn't available for a patient or invoice

Cause: The Online Patient Verification (OPV) option is only available in certain contexts, for example, from the Unclaimed grid, or against a specific service date on an invoice. It won't appear where it doesn't apply.

Resolution: Check that you're attempting OPV from a supported location (the Unclaimed grid, or a specific invoice service date). If you believe OPV should be available and it isn't, contact MediRecords Support.

OPV says the patient's details don't match Medicare's records

Cause: OPV checks the patient's details in MediRecords against what's recorded with Medicare. A mismatch (for example, a misspelled name, wrong date of birth, or outdated Medicare number) will cause verification to fail.

Resolution: Check the patient's demographic details in MediRecords against their Medicare card and correct any discrepancies, then try OPV again.