MyMedicare and new bulk bill incentive items
November 02, 2023
On Wednesday 1 November, new bulk billing items were introduced. Below is an update on the latest information and the work we’re doing to support the administration of MyMedicare and the new bulk billing incentives.
MyMedicare
Since the commencement of MyMedicare on 1 October, Services Australia have not released full specifications for the management of MyMedicare within health and medical software. Limited timeframes have also prevented us from developing Communicare to automate the new MBS incentive workflows.
The good news is Communicare is highly configurable and we are currently investigating ways to manage the storage of the MyMedicare information.
The best way to do this may be through a clinical item, which would be more immediate; OR it may be an option for biographics, which may ease the integration with Services Australia when it becomes available. We’re working through these options right now.
In the meantime, we suggest the following to assist you with managing MyMedicare patient information:
Letter template
Use this MyMedicare Registration Form letter template that we’ve created. You can download the XML file from here and import into your Communicare: Click to download MyMedicare registration form XML (you will need to unzip the file to access the letter template).
Alerts option for MyMedicare and report
You may also wish to use, as an interim measure, the Administration POPUP ALERT NOTES, to make providers aware of the MyMedicare status of a patient.
- To do this, type the words “MyMedicare Registered” into the POPUP ALERT NOTES (don’t cut and paste from word or pdf).
- We have provided a report to assist you in monitoring the number of patients you identify as registered for MyMedicare within the Popup Alerts. Click to download the MyMedicare Registrations Report (you will need to unzip the file to access the report).
Both the letter template and report are available in a zip file via the links above. If you require assistance, please submit a ticket to the Communicare Service Desk .
New MBS bulk bill items
From 1 November 2023, thirteen new higher bulk billing incentive items have been introduced for Commonwealth concession card holders and patients aged under 16 years of age.
The new items are:
- 75870, 75871, 75872, 75873, 75874, 75875 and 75876 (new general support service bulk billing items); and
- 75880, 75881, 75882, 75883, 75884 and 75885 (for patients enrolled in MyMedicare).
The new bulk billing incentives introduced may be co‑claimed with the following consultation items:
- MBS Levels B, C, D, and E face-to-face general attendance consultations (and out of rooms, residential aged care facilities and afterhours equivalents).
- MBS Level B telehealth (video and telephone) general attendance consultations.
- MBS Levels C, and D telehealth (video and telephone) general attendance consultations, where a patient is registered with a general practice through MyMedicare and receives the service through the practice where they are registered.
- Level E telehealth (video only) general attendance consultations, where a patient is registered with their general practice through MyMedicare and receives the service through the practice where they are registered.
Factsheets are available from the MBS Online information page: MBS Online – Bulk Billing in General Practice from 1 November 2023. Quick reference tables cover each of the MMM areas.
Accessing new MBS items
You must have the November MBS schedule downloaded to see the new MBS items in Communicare. To download go to the Help and Support page on the Communicare Customer Portal or download directly from this link.
This however creates a conflict to address, as there are now two relevant BBI items for your MMM area. The old BBI item is still relevant for some MBS items, while the new BBI item has specific items that are relevant. This is a challenge in Communicare currently because you can only have one MEDICAL default incentive item in Organisation Parameters > Medicare Claims > Incentive Items.
Options for selecting BBI item
We’ve reviewed this and summarised the three options for your consideration. The option you choose is dependent on your:
- Understanding of which MBS items are most frequently claimed in your health service and therefore which BBI item is a priority (we suggest you use Report | Electronic Claims | Items claimed count by date to review your MBS item usage); and
- Assessment of the change management required to ensure providers know to manually change and/or add the BBI item where relevant.
Option A:
Disable the MEDICAL default incentive item in Organisation Parameters > Medicare Claims > Incentive Items, and train providers to make their own decision at the point of billing to manually add the correct BBI item where relevant.
Option B:
Make no change and leave the current default incentive item in Organisation Parameters > Medicare Claims > Incentive Items, and train providers to manually change and/or add the NEW BBI item where relevant.
Option C:
Change the default incentive item in Organisation Parameters > Medicare Claims > Incentive Items to the NEW BBI item, and train providers to manually change and/or add the original BBI item where relevant.
Shortlist your new MBS incentive items
To support clinicians, it may be useful to have your Communicare Administrator identify and shortlist the new items relevant to your health service.
Do this in File > Reference Tables > Medicare Benefits Schedule > Shortlist MBS Items and add a simple short description to assist providers.
The How to change your MBS Shortlist article in the Communicare Knowledge Centre may assist you with this change.
MyMedicare status and MBS
It is not currently possible to automatically add the relevant incentives to only the applicable MBS items 91801, 91802 and 91920 Video Telehealth, and the 91900 and 91910 Phone Telehealth items, as this incentive is reliant on the patient being registered at their practice through MyMedicare.
At this stage, a patient’s MyMedicare registration is not able to be stored within a way that is linked to Services Australia, and therefore unable to be verified as part of the billing workflow.
Software vendors, the MSIA and Services Australia are working together to make this possible in the future.
For Communicare help and support
Visit the Communicare Portal Help and Support page, or submit a ticket to the Communicare Service Desk.