Medicare Easyclaim Integration
About Integrated Medicare Easyclaim
Tyro is Australia's market leader for Integrated Medicare Easyclaim. Our implementation:
- Is 32 bit software (.Net version upto 3.5), which happily runs in a 64 bit environment
- Does not require a serial connection between the PMS and the EFTPOS terminal.
- Offers a direct integration into the PMS, eliminating the need for third party middleware and simplifying the technology stack.
- Works in a terminal services (including Citrix) environment.
Before embarking on a Medicare Easyclaim Integration with Tyro, we recommend you complete the following checklist.
| Checklist Item | Reason | Where To Go/Who to Contact for More Information |
|---|---|---|
| Identified if Medicare Easyclaim is suited to your software customer base | Medicare Easyclaim is suited to the following health practitioners: - aboriginal health workers - audiologists - chiropodists - chiropractors - dental specialists (non-dpac) - dentist - diabetes educators - dieticians - exercise physiologists - general and specialist practitioners - mental health woMedicareContactList.md"rkers - occupational therapists - osteopaths - physiotherapists - podiatrists - psychologists - speech pathologists - orthodontists - optometrist - prosthodontists - endodontists - paedodontists - periodontists - oral medical and pathology practitioners |
Medicare |
| Have implemented Medicare Online functionality in your software if you cater to GPs and Specialists | Not all claims are eligible to be processed via Easyclaim. This includes (but is not limited to): - In Hospital Items -Claims with non-standard referrals - Claims requiring non-standard text DVA and ACIR claims are not able to be claimed via Easyclaim. These must also be submitted via Medicare Online. GPs and some specialists are likely to process claims that are not eligible for Easyclaim. This means they need an alternative claiming option to Easyclaim. Medicare Online is the best available alternative channel. Your workflow should ultimately remove ambiguity from the user in terms of which channel to push a claim through, based on its eligibility for Easyclaim. |
Please refer to the Medicare Contact List under the Medicare EasyClaim section |
| Decided on the best way for your users to access Easyclaim Bulk Bill Reports | There are two methods by which practitioners can access their Easyclaim bulk bill reports: Health Professional Online Services (HPOS) and BIR HPOS – health provider logs into Medicare and views or downloads Easyclaim Bulk Bill reports in either Excel or Acrobat formats. Reconciliation between this report and the claims listed in the PMS must then be done manually by the operator BIR – Bulk Bill Integrated Reporting (BIR) allows Easyclaim Bulk Bill Payment and Processing reports to be imported directly into the users software. This method is most common for GP, Specialist, Pathology, and Radiology and is highly recommended for fully integrated reporting and reconciliation. To implement BIR your PMS must already be using Medicare Online |
HPOS Information here BIR Information To contact Medicare, please refer to the Medicare Contact List under the Medicare EasyClaim section to ensure you have all the required documentation for implementing BIR |
| Have access to the latest Medicare API | Medicare regularly update their API. If you aren't working to the current API then you may run into issues.< | Please refer to the Medicare Contact List under the Medicare EasyClaim section |
| Development Team and Business Analysts have fully familiarized themselves with the content available here | This reference guide has been developed to help you get started with Medicare Easyclaim. It explains important information you need to know about processing, payments, patient claiming definitions, bulk bill claiming definitions and return codes. |
For the Clarification on Medicare Easyclaim Business Rules, please refer to the Medicare Easyclaim Business Rules under the Medicare EasyClaim section |
| Reviewed the Medicare Easyclaim Technical Specifications | -- | Easyclaim Logic Pack Users Guide v3.1.pdf |
| If implementing BIR, have contacted Medicare regarding BIR (bulk bill integrated reporting) and have requested and/or received the latest Client Adaptor Adopter Guide (CAAG) | Building BIR: In this guide please look under the MCAMedicare logic pack section regarding bulk bill integrated reports. Tyro has also provided some guidance on the page BIR Workflow Getting Certified for BIR: A PMS needs to be certified by Medicare for BIR. This is separate to Tyro. A Pre-Integration Test Kit should be obtained from Medicare Online Technical Support Liaison. Details on how the certification process for BIR is conducted will be provided by Medicare to the vendor. |
Please refer to the BIR Workflow under the Medicare EasyClaim section |
| Reviewed the list of mandatory and highly recommended features for a Tyro Integrated EFTPOS and Easyclaim Implementation | Tyro has completed Integrated Medicare Easyclaim developments with over 7 vendors. To ensure the success of your solution we have come up with a list of features available in our TTA that must be implemented. | Criteria Document |