Service Record - Medicare

When a service is completed or paused, a Medicare claim can be submitted either by the provider or reception.

Note the following:
  • To submit Medicare claims, the Electronic Claims module must be enabled for your health service and you must belong to a user group that has the Billing system right.
  • You can submit a claim only for patients whose Medicare details are complete. If Medicare details are incomplete, expired or missing, the Medicare details incomplete icon Incomplete Medicare Details icon is displayed.
  • MBS 10990 or 10991 - Communicare automatically adds MBS 10990 or 10991 items to claims for clients under 16 or who have a valid Centrelink Card. Your Communicare Administrator can change the item to be claimed on System Parameters - Medicare Claims or disable the feature.
  • After Hours MBS Item Claims - claims for items 3, 23, 36 or 44 are changed to items 5000, 5020, 5040 or 5060 respectively automatically when the service is on a Sunday or public holiday, is before 8 AM or after 1 PM on a Saturday or after 8 PM on a weekday or the service is marked as 'after hours' for a date only service. The Public Holidays reference table must be kept up-to-date for this feature to work correctly.
  • If there multiple claiming providers, make a separate claim for each provider.
  • An offline client can only claim a service that has been entirely created offline.
  • If enabled, if you want to batch a claim with other services for the same patient from the same provider and same encounter place, select Batch claim. You cannot create a batch service if the service is not started, if there is no claimant provider selected, if the service is withdrawn, or if the service is not claimable. There can be only one active batch claim for a patient per provider per encounter place. You can submit the claim from any of the services that are batched together. Multiple providers are not allowed for batch services.