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)
Medicare invoices
Both Medicare Bulk Billed and Patient Claims are supported for batch submission. However, it is more typical for Patient Claims to be submitted immediately post consultation so that patients/claimants can understand their Medicare benefit status.
Request attributes have been listed in below table as mandatory, optional or conditional
Value | Description |
---|---|
R | Required? |
M | Mandatory |
O | Optional |
C | Conditional |
Field | R | Format | Example Values - Notes and Key Constraints |
---|---|---|---|
invoiceReference |
M | 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 |
M | Up to 8 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 Medicare claims. A unique invoice can include only one provider. Must be registered on Tyro Health Online and enabled for medicare. |
funder |
M | Valid values only | medicare - Set to medicare for both Medicare bulk billed and patient claims. A unique invoice can include only one funder. If multiple funders are required, such as a customer payment request for a Medicare patient claim, use a different invoiceReference for each part. Must be enabled on Tyro Health Online for selected funder. |
patient._id |
O | 33 alphanumeric characters | 6BE1F0653B5F4B47A88633F3A0DC1712 - 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. |
patient.refId |
O | Up to 128 characters | 56565656MBL - A unique patient identifier/number from your practice/patient management system. By setting this value you can uniquely search and sort transactions by patient. Future transactions can also be processed using refId rather than providing patient and health fund account details. Any differing patient details in subsequent transactions 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. |
patient.firstName |
O | Up to 40 characters | Emma - 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 |
M | Up to 40 characters | Knowles - 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.dobString |
M | 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. For Medicare patient claims, if patient is <15 years old as at each serviceDate, an adult =>18 years old claimant is also required. |
healthFundAccount.sex |
O | Valid values only | F - Required for DVA claims and Medicare patient checks, Medicare ECLIPSE claims.One of: M : Male F : Female O : Other Null: Not stated/inadequately described (default value) |
patient.email |
O | Valid Email address | mavis@gmail.com - Any valid email address. Used for receipts and statements. |
patient.mobile |
O | Valid mobile phone number | 0419123456 - Mobile number required to send SMS claim and payment requests. Either domestic (04xxxxxxxx) or international (+614xxxxxxxx) format accepted. Only Australian mobile phone numbers can be used. |
healthFundAccount.healthFundCode |
M | Valid values only | MDC - For Medicare set to MDC. A unique invoice can include only one healthFundCode. |
healthFundAccount.membershipNumber |
M | 10 numeric | 2953878061 - Patient Medicare Card Number. The value supplied must be 10 numeric and conform to the Medicare Card check digit routine which will be validated in Tyro Health Online. A unique invoice can include only one Medicare card Number. |
healthFundAccount.cardRank |
M | 1 numeric | 2 - The Medicare individual reference number, one digit of 1-9, as noted on physical card. |
medicare.claimType |
M | Valid values only | bulkbill - One of the following : • bulkbill or • patientclaim . All claimed service items for a given invoice must be bulkbill or patientclaim |
medicare.lspNumber |
O | 654542 - A Location Specific Practice Number (LSPN) is a six-digit number used by Services Australia to uniquely identify practice sites providing diagnostic imaging and/or radiation oncology services for Medicare claims. Applies only to diagnostic imaging and radiation oncology services. 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. |
|
medicare.facilityId |
O | 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. Hospital referrals usually require a FacilityId |
Applicable for bulkbill- type claims only | |||
medicare.isInHospital |
O | boolean | true - Hospital Indicator - whether or not the service(s) rendered to the patient was for treatment provided within a hospital facility. Valid values:true = In Hospital. Default is false. If Referral Override Code is set to H (Hospital) then Hospital Indicator must be set to true (In Hospital) |
medicare.benefitPayee.providerNumber |
O | Up to 8 alphanumeric characters | 3452232B - Only valid for bulk billed claims, 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 Medicare. benefitPayee is the servicing provider by default. |
medicare.benefitPayee.providerFullName |
O | Up to 30 alphanumeric characters & select special characters | Dr. Jane Smith - Full name of provider including or excluding title. Will appear on assignment of benefit statement (DB4). |
Applicable (and required) for referred services | |||
medicare.referral.referrerType |
O | Valid values only | specialist - Either: GP for General Practitioner Or specialist - must be present if Referral details supplied |
medicare.referral.providerNumber |
O | 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 |
medicare.referral.providerFullName |
O | 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 |
medicare.referral.issueDateString |
O | 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 |
medicare.referral.periodType |
O | Valid values only | S - Period type code as defined by Medicare and only used where referral items/services 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 referral.period field (below), I: Indefinite. Note: referral period type is not applicable for Pathology or Diagnostic Imaging referrals and should not be set for those claims. |
medicare.referral.period |
O | Valid values only | 2 - Medicare referral period length has to be 1 or 2 digits. It Is the amount of time in months that a non-std referral period is set to be valid. Only used when periodType set to 'N'. For non-standard referral periods only, the number of months for referral validity. Numeric two digits. Note: not applicable for Pathology or Diagnostic Imaging referrals and should not be set for those claims. |
medicare.referral.referralTypeCode |
O | Valid Values only | S - Medicare referral type has to be either D - diagnostic imaging, P - pathology or S - specialist. Must be present if Referral details supplied |
For non-referred services | |||
medicare.nonReferral.reason |
O | 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. 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 Y (In Hospital) |
medicare.nonReferral.description |
O | Up to 40 alpha characters | Royal Melbourne Hospital - Description of non-referral reason. Where: H: name of hospital, L: text. Must be present if nonReferral details supplied |
Applicable for patientclaim type claims only | |||
paymentMethod |
O | Valid values only | in-person - Flag used for Patient Claims to indicate that the patient has already paid for the service. Valid for Patient Claims only. Must be either blank or "in-person". |
medicare.claimant.patient._id |
O | 33 alphanumeric characters | 6BE1F0653B5F4B47A88633F3A0DC1712 - 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. |
medicare.claimant.patient.refId |
O | 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. 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. |
medicare.claimant.patient.firstName |
O | Up to 40 characters | Lulu - 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. |
medicare.claimant.patient.lastName |
O | Up to 40 characters | Harris - 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. |
medicare.claimant.patient.dobString |
O | YYYY-MM-DD | 2010-09-01 - Date of birth in YYYY-MM-DD format. For Medicare patient claims, if patient is <15 years old as at each serviceDate, an adult =>18 years old claimant is required. Must be a valid date. Must not be a date in the future. Must not be after each serviceDate |
medicare.claimant.patient.mobile |
O | Valid mobile phone number | 0419123456 - Mobile number required to send SMS claim and payment requests. Either domestic (04xxxxxxxx) or international (+614xxxxxxxx) format accepted. Only Australian domestic numbers supported. |
medicare.claimant.healthFundAccount.membershipNumber |
O | 10 numbers | 1234567890 - Medicare card number - 10 digits. A unique invoice can include only one membershipNumber. Value must adhere to Medicare Card check digit routine. |
medicare.claimant.healthFundAccount.cardRank |
O | 1 number | 1 - Medicare individual reference number, one digit of 1-9, as noted on physical card. |
medicare.claimant.postalAddress.address |
O | Up to 40 characters | 4 Duke Street - A valid street address. The value supplied must be alpha (A-Z and a-z), numeric (0-9), space ( ), apostrophe ('), hyphen (-) and other special characters (/ , . : ; ) only. Spaces must not appear before or after other spaces or the supplied value. The value must contain at least one alpha or numeric character. |
medicare.claimant.postalAddress.addressLine2 |
O | Up to 40 characters | Unit 827 - Address line 2, typically unit or apartment number. The value supplied must be alpha (A-Z and a-z), numeric (0-9), space ( ), apostrophe ('), hyphen (-) and other special characters (/ , . : ; ) only. Spaces must not appear before or after other spaces or the supplied value. |
medicare.claimant.postalAddress.city |
O | Up to 40 alphanumeric characters | Windsor - Also known as locality. Must be a valid city/locality as defined by Medicare. The value supplied must be alpha (A-Z and a-z), numeric (0-9), space ( ), apostrophe ('), hyphen (-) and other special characters (/ , . : ; ) only. Spaces must not appear before or after other spaces or the supplied value. The value must contain at least one alpha or numeric character. |
medicare.claimant.postalAddress.postcode |
O | 4 numbers | 3181 - Postcode. Must be valid. |
medicare.claimant.bankAccount.bankName |
O | Up to 30 characters | NAB - Bank name not processed by Medicare, but we use for validation to show in claim |
medicare.claimant.bankAccount.accountName |
O | Up to 30 characters | Charles Willis - Name of account holder. The value supplied must be alpha (A-Z and a-z), numeric (0-9), space ( ), apostrophe ('), hyphen (-) and other special characters (.,/) only. Spaces must not appear before or after the supplied value. |
medicare.claimant.bankAccount.bsb |
O | 6 numbers | 023456 - Six digit BSB number. Must be a valid BSB. |
medicare.claimant.bankAccount.accountNumber |
O | Up to 9 numbers | 987654321 - Account number. The value supplied must be alpha (A-Z and a-z), numeric (0-9), space ( ), apostrophe ('), hyphen (-) and other special characters (.,/) only. Spaces must not appear before or after the supplied value. |
Claim Item-Level details - all item codes/services | |||
medicare.claimItems.reference |
O | Up to 128 alphanumeric characters | 1 - 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. |
medicare.claimItems.serviceDate |
M | 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 |
medicare.claimItems.itemCode |
M | Up to 8 alphanumeric characters | AA020 - Any MBS supported item code. Only valid item codes for a given serviceDate can be processed. |
medicare.claimItems.price |
M | Currency notation, up to 6 numeric and 2 decimal digits | 50.67 - Item charge amount. Must be =>1.00. |
medicare.claimItems.patientContributionAmount |
O | Currency notation, up to 5 numeric and 2 decimal digits | 30.67 - Amount paid by claimant, if not full payment. The value supplied must be less than the chargeAmount. If set to <price (charge amount), then this will initiate a Pay Doctor Via Cheque (PDVC) request to Medicare. |
Optional attributes and overrides for each claimable item | |||
medicare.claimItems.serviceText |
O | 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. |
medicare.claimItems.selfDeemedCode |
O | 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 is set |
medicare.claimItems.accessionDate |
O | 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 |
medicare.claimItems.accessionTime |
O | Time | 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 |
medicare.claimItems.collectionDate |
O | 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 |
medicare.claimItems.collectionTime |
O | Time | 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 |
medicare.claimItems.scpId |
O | 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. Specimen Collection Point Id (SCPId) must only be set when provider is Pathology |
medicare.claimItems.rule3ExemptIndicator |
O | 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. |
medicare.claimItems.s4b3ExemptIndicator |
O | 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 |
medicare.claimItems.serviceTime |
O | Time | 14:25 - Time of service 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. |
medicare.claimItems.numberOfPatientsSeen |
O | 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 |
medicare.claimItems.duration |
O | 3 numbers | 060 - Time duration in minutes. In 15 minute intervals only. Only applicable for General or Specialist Services. |
medicare.claimItems.restrictiveOverride |
O | 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. |
medicare.claimItems.afterCareOverride |
O | Valid values only | Y - Indicates whether the service was performed as part of normal aftercare for the patient. Valid values: Y = Not Normal Aftercare. Only applicable for General or Specialist Services. |
medicare.claimItems.duplicateServiceOverride |
O | Valid values only | Y - Indicates whether multiple services performed on the same day, by the same Service provider and should be treated as separate services. Valid values:Y = duplicate service override. If Duplicate Service Override Indicator is set to Y (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. |
medicare.claimItems.multipleProcedureOverride |
O | Valid values only | Y - Indicates whether the multiple services rule must or must not be applied to the service being claimed. Valid values:Y = Not Multiple. Only applicable for General or Specialist Services. If Multiple Procedure Override Indicator is set to Y (Not Multiple) then must list serviceText providing the reason |
medicare.claimItems.accountReferenceNumber |
O | 1-9 alphanumeric characters | 19-1125B - Account Reference (ACRF). A reference used by the claim submitter to identify a claim. 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. |
medicare.claimItems.fieldQuantity |
O | 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. |