Submitting batch files with Tyro Health Online

Tyro Health Online supports bulk transmission of invoices to healthcare funders. Batched invoices are processed individually according to funder rules.

A single batch file can support multiple invoices and claimed items. For all invoices, it’s important to note:

  • Files must be in a CSV format. Double quoted fields (i.e. using quotes as text qualifiers) are optional, but recommended when dealing with text columns (like descriptions).
  • Template and example CSV files for each funder are posted on Tyro Health Online.
  • The first row must be a header record and must conform to template values provided.
  • Each row’s columns must be ordered according to the header record.
  • Up to 10,000 rows can be included in a single file.
  • Fields listed as mandatory for each funder must be complete and valid for successful upload.
  • After uploading to Tyro Health Online, invoices that pass business rule validation will be created as a Draft in a Ready to submit status. Select those invoices and click submit to process.
  • Invoices that fail validation will be in an Incomplete status and require attention prior to submission.

Importantly, if you create, open or save the file using Microsoft Excel or other spreadsheet programs, please note that date and time fields may be automatically updated to a format that is not accepted - be sure to save the file in the formats defined below.

Invoice guidelines:

  • An invoice will result in a single unique Tyro Health Online transaction identifier, invoice date and status;
  • An invoice will have a single unique invoiceReference as nominated by you;
  • An invoice will have a single patient and health fund account;
  • An invoice will have a single provider and payee;
  • An invoice will have one or more claimed items;
  • Each item will have at least a unique reference , serviceDate , itemCode and price ; and
  • Additional item attributes can be set.

To support invoices with multiple claimed items:

  • Invoices with the same invoiceReference will be grouped into a single invoice for submission to a funder.
  • Rows for a unique invoice should be grouped together sequentially and each item should use a unique claimItems.reference for that invoice.
  • For invoice level (but not item level) attributes that repeat, only the first instance of those values will be used.

For those that create batch files using Microsoft Excel, Apple Numbers or Google Sheets:

  • All fields should use a format of “Plan Text” or “Text” .
  • Special care should be taken while entering serviceDate , time of service and other date/time numbered fields as these tools may apply an automatic format different from expected.
  • Files must be saved/exported as:
    • Microsoft Excel - Windows: CSV Comma delimited ( * .csv)
    • Microsoft Excel - Mac: Comma-separated Values (.csv)
    • Apple Numbers: CSV, Text Encoding: Unicode (UTF-8)
    • Google Sheets: Comma-separated values (.csv, current sheet)

DVA invoices

DVA invoices/claims are supported for batch submission. After successful upload, claims will be stored as a draft invoice. When labeled as Ready for Submission, claims can be submitted in bulk. Certain fields may be listed as optional. However, for certain scenarios, these optional fields may be conditionally required, such as a referrals or non-referral reason codes for specialist, pathology or diagnostic imaging claims.

Field Required? Format Example value Notes Key constraints
invoiceReference Mandatory Up to 16 characters 20200901ABCD Your unique invoice/transaction reference. Typically generated from a practice management or accounting system. This value will be traced through to settlement reporting and is separate from any funder defined transaction identifier or claim reference.

Where multiple service items exist for an invoice, all rows for a unique invoiceReference will be grouped into a single invoice and the first occurrence of repeating invoice level (but not service level) details will be used. Note: these rows should be grouped sequentially.
providerNumber Mandatory Up to 16 alphanumeric characters 0065431A Servicing provider number which must be valid and active in Tyro Health Online for a given funder. A Medicare issued provider number is required for DVA claims. Medicare registered providers are also registered for DVA claims by default. • A unique invoice can include only one provider.

• must be registered on Tyro Health Online and enabled for selected funder.
funder Mandatory Valid values only dva Set to dva for DVA Medical or Allied health claims. Note use of lowercase dva. • A unique invoice can include only one funder.

• Must be enabled on Tyro Health Online for selected funder.
patient._id Optional 33 alphanumeric characters 6BE1F0653B5F4B47
A88633F3A0DC1712		 Tyro Health Online generated value to represent a unique patient. Can be used as an alternative to submitting patient and health fund account details but only if a previous successful transaction processed against a patient. Otherwise, do not use. • A unique invoice can include only one patient.

Use either patient.refId or patient._id, but not both in submission.
patient.refId Optional

But highly recommended		 Up to 128 characters 3DE2D2BC-17CC-4978-A79D-2151DC417B2F A unique patient identifier generated by your system such as a UUID. By setting this value you can uniquely search and sort transactions by patient in Tyro Health Online. Future transactions can also be processed using refId rather than providing patient and health fund account details. Any differing patient details for a given refId will update the patient record on Tyro Health Online.

To prevent creation of duplicate patient records in Tyro Health Online, set a unique refId per patient.		 • A unique invoice can include only one patient.

Use either patient.refId or patient._id, but not both in submission.
patient.firstName Optional Up to 40 characters Mila Patient first / given name as registered with funder. If patient has only one name, use "Onlyname" as placeholder in firstName field. • A unique invoice can include only one patient.

• Can only contain alpha (A-Z and a-z), numeric (0- 9), space ( ), apostrophe (') and hyphen (- ) characters.

• Spaces must not appear before or after apostrophes, hyphens, other spaces or the supplied value.

• At least one alpha or numeric character required.
patient.lastName Mandatory Up to 40 characters Willis Patient last / family name as registered with funder. A unique invoice can include only one patient.

• Can only contain alpha (A-Z and a-z), numeric (0- 9), space ( ), apostrophe (') and hyphen (- ) characters.

• Spaces must not appear before or after apostrophes, hyphens, other spaces or the supplied value.

• At least one alpha or numeric character required.
patient.email optional Email address mw@Tyro Health Online.io Any valid email address. Used for receipts and statements if sent from Tyro Health Online portal or to create a patient record. Note - Email is not sent to DVA and is only used for Tyro Health Online patient records, search and optional send of printed statements.
patient.mobile optional Mobile number 0411111111 Mobile number required to send SMS claim and payment requests. Either domestic (04xxxxxxxx) or international (+614xxxxxxxx) format accepted. Also used for receipts and statements if sent from Tyro Health Online portal or to create a patient record.
patient.dobString Mandatory YYYY-MM-DD 2010-09-01 Date of birth in YYYY-MM-DD format. • must be a valid date

• must not be a date in the future

• must not be after each serviceDate
healthFundAccount.healthFundCode Mandatory Valid values only DVA For DVA claims set to DVA. Note use of UPPERCASE DVA. • A unique invoice can include only one healthFundCode.
healthFundAccount.membershipNumber Mandatory 3-9 alphanumeric including space NX400749 The value supplied must be 3-9 alphanumeric and conform to the DVA Veteran File Number (VFN) check.

Space characters are supported.		 • A unique invoice can include only one membershipNumber.
healthFundAccount.sex Optional Valid values only F One of:

M: Male

F: Female

O: Other

Null/not set: not determined (default)
healthFundAccount.acceptedDisability Optional 1-100 characters PTSD Provides details of the condition treated. Used where condition treated relates to a condition of a White Card holder. •If any values are set, then the field acceptedDisabilityIndictor will be set to true.

• Must be a valid value. First character must be alpha or numeric.

• The value supplied must be alpha (A-Z), numeric (0-9), space ( ), and special characters : ; , . -. First character must be alpha or numeric and spaces must not appear before or after other spaces or the supplied value.
dva.lspNumber Optional Numeric 1-999999 45600 Location Specific Provider Number. Used by Medicare for diagnostic imaging and radiation oncology services. Can have leading zeros. • Not valid for pathology providers.

• LSPN and Number of Patients Seen must not be set against the same service.

• LSPN and Time Duration must not be set against the same service.
dva.facilityId Optional 8 alphanumeric characters 9988770W The Commonwealth Hospital Facility Provider Number. A unique identifier of a Registered Hospital or Day Care Facility. The value supplied must be in the format of Provider stem (6 digit number), 1 Practice Location character, 1 Check Digit (similar to medicare provider numbers). Must be filled with leading zeros if the provider number is greater than 2 characters but less than 8 characters. • If isInHospital is set to true (In Hospital) then facilityId must be supplied.
dva.treatmentLocation Optional Valid values only R For medical providers, all service items must have the same treatment location for a given patient and service date. Valid values:

• V = Home Visit (residential care facility, community health centre or hostel)

• H = Hospital

• R = Rooms (default)

Only used for Medical claims - not applicable for Allied health claims.		 • If Referral Override Code is set to H (Hospital) then Treatment Location Code must be set to H (Hospital).

• Ignored for Allied health claims.
dva.isInHospital Optional boolean true Hospital Indicator - whether or not the service(s) rendered to the patient was admitted for treatment provided within a hospital facility. Valid values:

true = In Hospital		 • If Referral Override Code is set to H (Hospital) then Hospital Indicator must be set to true (In Hospital)
dva.benefitPayee.providerName Optional Up to 30 alphanumeric characters & select special characters Dr. Dominic Smith Full name of provider including or excluding title. Will appear on printed statements (DS1216).
dva.benefitPayee.providerNumber Optional Up to 8 alphanumeric characters 3452232B Where the payee provider is different from the servicing provider. Benefits will be paid to the benefitProvider's bank account. Note: this provider number must also be registered with Tyro Health Online. • A unique invoice can include only one benefitPayee.

• Provider number must be registered with Tyro Health Online and enabled for dva.

benefitPayee is the servicing provider by default.
dva.claimItems.reference Optional Up to 128 alphanumeric characters 01 Line item reference as nominated by you. Assists with reconciliation where multiple of the same item code and service date claimed. This reference should be unique within a given invoice.
dva.claimItems.serviceDate Mandatory YYYY-MM-DD 2020-08-25 Date of service in YYYY-MM-DD format. • must be a valid date

• must be within 2 years as at date of submission

• must not be future dated

• must not be before patient date of birth
dva.claimItems.itemCode Mandatory Up to 8 alphanumeric characters AA020 Any MBS or DVA supported item code. Only valid item codes for a given serviceDate and provider registered profession can be processed.
dva.claimItems.price Mandatory Currency notation, up to 6 numeric and 2 decimal digits 50.67 Item charge amount. Must be =>1.00.

Note that some allied health items (OT81, OT81, OT82) related to travel may require no item price. These claims must be processed in the Tyro Health Online portal.
Applicable (and required) for referred services
dva.referral.issueDateString Optional YYYY-MM-DD 2020-07-23 Date of referral/request issuance in YYYY-MM-DD. Only used where referral is required. • must be a valid date

• must be greater than or equal to the Patient dob

• must be present if Referral details supplied

• must not be a date in the future

• must not be after each serviceDate

• must be present for referred services
dva.referral.periodType Optional Valid values only S Period type code as defined by dva and only used where referral used.

Valid values:

• S: Standard – 12 months for GP or 3 months for Specialist referrals (Default value)

• N: Non-standard, if set must supply duration in serviceText field

• I: Indefinite		 • must be present if Referral details supplied

• If I, details may required in serviceText.

• If N, must specify period of months in dva.referral.period .
dva.referral.period Optional 1-98 numeric 24 For (N) non-standard referral periods only, the number of months for referral validity. Numeric two digits.

Note: referral period is not applicable for Pathology or Diagnostic Imaging referrals and should not be set for those claims.		 • Note limit of up to 98 months.

• must be present if non-standard referral details supplied, unless for Pathology or Diagnostic Imaging claims.

• If N or I, details are required in serviceText.

• Do not set for Pathology or Diagnostic Imaging claims.
dva.referral.providerFullName Optional Up to 30 alphanumeric characters Dr Emily Tay Full name of referring provider, with or without title. Will appear on printed statements. • must be present if Referral details supplied.
dva.referral.providerNumber Optional Up to 8 alphanumeric characters 4452232B Referring provider number. Note this must be a valid provider number, but the provider number does not need to be registered with Tyro Health Online. • must be present if Referral details supplied.

• must be a valid provider number.
dva.referral.referrerType Optional Valid values only GP Either:

GP: General Practitioner

S: Specialist		 • must be present if Referral details supplied.
dva.referral.referralTypeCode Optional Valid values only S Referred service type. Set as one of:

• A: Allied health (note different to Medicare and specific to DVA)

• D: Diagnostic Imaging, including Radiology

• P: Pathology

• S: Specialist		 • must be present if Referral details supplied.
dva.nonReferral.reason Optional Valid values only H Only for exception claims normally requiring a referral. One of:

E: Emergency

H: Hospital in-patient referral (isInHospital should be Y for all services)

L: Lost

N: Not required, non-standard referral
O: referral object is omitted from claim and not set		 • Only used where referral normally required and replaces referral details.

• If Referral Override Code is set to H (Hospital) then Hospital Indicator must be set to true (In Hospital), Treatment Location Code must be set to H (Hospital). and a facilityId should be set.
dva.nonReferral.description Optional Up to 40 alpha characters Royal Melbourne Hospital Description of non-referral reason. Where:

L: text		 • must be present if nonReferral details supplied
Optional attributes and overrides for each claimable item
dva.claimItems.accessionDate Optional Date 2021-02-21 Date for pathology test. Only for pathology services. The format is YYYY-MM-DD. • Must not be equal to or less than service date

• Must not be prior to patient date of birth

• Must not be future dated

• Value must be Australian time zone
dva.claimItems.accessionTime Optional HH:MM 17:30 Time for pathology test. Only for pathology services. The format is HH:MM • Must not be equal to or less than service date

• Must not be prior to patient date of birth

• Must not be future dated

• Value must be Australian time zone
dva.claimItems.accountReferenceNumber Optional 1-9 alphanumeric characters 191125B Account Reference (ACRF). A reference used by the claim submitter to identify a claim with DVA. • The value supplied must be alpha (A-Z and a-z), numeric (0-9), space ( ), and special characters @ # $ % + = : ; , . - only.

• Spaces must not appear before or after other spaces or the supplied value.
dva.claimItems.afterCareOverride Optional boolean true Indicates whether the service was performed as part of normal aftercare for the patient. Valid values:

True = Not Normal Aftercare

Default is not set.		 • Only applicable for General or Specialist Services.
dva.claimItems.collectionDate Optional Date 2021-02-26 Date the pathology sample was taken from patient. The format is YYYY-MM-DD. • Must not be after accession date time

• If set, Accession date time must be set

• Must not be prior to patient date of birth

• Must not be prior to referral issue date

• Value must be Australian time zone
dva.claimItems.collectionTime Optional HH:MM 17:30 Time the pathology sample was taken from patient. The format is HH:MM • Must not be after accession date time

• If set, Accession date time must be set

• Must not be prior to patient date of birth

• Must not be prior to referral issue date

• Value must be Australian time zone
dva.claimItems.distanceTravelledKms Optional 2-3 numbers 23 Indicates travelling distance by KMs involved in a Home, Nursing Home or Hospital visit. At least 11 KM or more must be travelled to claim for travel. • 11 or more KM must be claimed
dva.claimItems.duplicateServiceOverride Optional boolean true Indicates whether multiple services performed on the same day, by the same Service provider and should be treated as separate services. Valid values:

true = duplicate service override

Default is not set.		 • If Duplicate Service Override Indicator is set to true (Not Duplicate) then Medical Event Time or additional information in serviceText is required to support the reason for the override.

• Only applicable for General or Specialist Services.
dva.claimItems.duration Optional 3 numbers 060 Time duration in minutes. • Only applicable for General or Specialist Services.
dva.claimItems.fieldQuantity Optional 1 or 2 numbers, 1-99 4 The number of fields irradiated or the quantity of (15 minute) time blocks or derived fee intrathecal or epidural infusion services (e.g. items 18219 and 18227). • Only applicable for General or Specialist Services.

• Field Quantity and Number of Patients Seen or Time Duration must not be set against the same service.
dva.claimItems.jawCode Optional Valid values only UPR Dentistry claims only. Identifies if the dental service relates to the upper or lower jaw. Valid values:

• UPR = Upper Jaw

• LWR = Lower Jaw
dva.claimItems.multipleProcedureOverride Optional boolean true Indicates whether the multiple services rule must or must not be applied to the service being claimed. Valid values:

true = Not Multiple

Default is not set.		 • Only applicable for General or Specialist Services.

• If Multiple Procedure Override Indicator is set to true (Not Multiple) then must list serviceText providing the reason.
dva.claimItems.numberOfPatientsSeen Optional 1 or 2 numbers, 1-99 2 The number of patients seen. Must be set for group attendance items (e.g. counselling) or visits (home, hospital or institution) to ensure the correct payment is made. • Only applicable for General or Specialist Services.

• Number of Patients Seen and Time Duration must not be set against the same service.
dva.claimItems.numberOfTeeth Optional 2 numbers 02 Dentistry claims only. Identifies the number of teeth within the item. Valid values: 01-16
dva.claimItems.opticalScript Optional Valid values only LS Optical claims only. Identifies the type of override of restrictions for Optical Scripts. Valid values:

• LS = Lost

• BR = Broken

• RC = Significant Refraction change
dva.claimItems.restrictiveOverride Optional Valid values only SP This code is used to allow payment for services where the account provides indication that the service is not restrictive with another service either within the same claim or on the patient history. Valid values:

SP = Separate Sites

NR = Not Related to consult

NC = Not for Comparison		 • Only applicable for General or Specialist Services.
dva.claimItems.rule3ExemptIndicator Optional boolean true Indicates if the pathology service is exempt from Rule 3 in the MBS. When set to true, the item is yes, exempt.

Default is not set.		 • Must only be set when provider is Pathology.

• If Rule 3 Exempt Indicator is set, serviceTime must be set.
dva.claimItems.s4b3ExemptIndicator Optional boolean true Indicates if the pathology service is exempt from assessing in accordance with the S4b3 requirements in the MBS. When set to true, the item is yes, exempt.

Default is not set.		 • The value supplied must be set to true to indicate Pathology Service is exempt from S4b3 assessing requirements.

• Must only be set when provider is Pathology.

• If set, Hospital Indicator must be set to true.

• Must not be set if Rule 3 Exempt Indicator is set.
dva.claimItems.scpId Optional 3-5 alphanumeric values 014 The Specimen Collection Point ID is used to identify the site where the pathology specimen was collected. The value supplied must be alpha (A-Z) or numeric (0- 9) and three to five characters long. Value must not be set to or equal zero.

Leading zeros for values less than 5 characters are acceptable e.g. 001, 0001 or 00001 and may be required.		 • Specimen Collection Point Id (SCPId) must only be set when provider is Pathology.
dva.claimItems.secondDevice Optional boolean true Required for select Allied Health professions. This field identifies the provision of a second medical grade footwear service. Valid values:

true = Yes

false or omitted = No (default)		 • must only be set when provider professional registration is for Allied health.

• must not be set with Distance Kilometres.
dva.claimItems.selfDeemed Optional Valid values only SD A Self Deemed service is an additional service to a valid request. A substituted service is a service provided that has replaced the original service requested..

Valid values:

SD = Self Deemed

SS = Substituted Service		 • Self Deemed Code must not be set when Referral Override Code other than O (omitted) is set.
dva.claimItems.serviceText Optional Up to 50 alphanumeric characters Not duplicate Free text for additional information on claim assessment. • The value supplied must be alpha (A-Z and a- z), numeric (0-9), space ( ), and special characters @ # $ % + = : ; , . -.

• Spaces must not appear before or after other spaces or the supplied value.
dva.claimItems.serviceTime Optional HHMM 14:25 Time of service in in 24 hour format: HH:MM as in Australian time zone. Used if multiple of same items claimed on same day, by same provider, for same patient. • The time supplied must reflect the time zone in Australia, the transaction was created in.
dva.claimItems.toothNumber Optional 2 numerics 11 Dentistry claims only. Identify the tooth number and will allow the provider to enter the tooth number for the service within the item. Must be 2 numerics. Valid values:

11-18

21-28

31-38

41-48

51-55

61-65

71-75

81-85
Support
Copyright © Tyro health and Tyro 2022. All right reserved.