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)

nib invoices

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.
Note: This invoice reference field is a financial field, and as such we strongly recommend that you do not put patient information (like patient name) as part of this field.
• Must be unique for an invoice in a single batch file.

• Should be globally unique across the business for search and reporting purposes.
sequenceNumber Optional Up to 4 numbers 1 Row counter - unique and sequential within a batch file. Used to identify row level errors/mistakes. Leading zeros NOT permitted.
providerNumber Mandatory Up to 16 alphanumeric characters 0065431A Servicing provider number or other registration identifier which must be valid and active in Tyro Health Online for a given funder. For Medicare, DVA, HICAPS, nib and icare, a Medicare issued provider number should be used where available. Where a Medicare provider number is not applicable, use the appropriate identifier:

• WSV: WorkSafe Victoria-issued provider number

• icare: Tyro Health Provider Number for location-based providers.

• NDIS: provider registration number

• HICAPS: a Medibank or HICAPS issued provider number

• Comcare: Tyro Health Provider Number for location-based providers. Comcare WRP number for Rehabilition providers.
• 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 nib One of:

• nib: nib private health insurance claims.

• wsv: WorkSafe Victoria workers insurance claims.

• comcare: Comcare workers insurance claims.

• icare: icare NSW scheme claims, including workers insurance and other supported schemes.

• medicare: Medicare claims via Medicare Online.

• dva: Department of Veterans’ Affairs claims.

• vt: customer and patient direct payments via credit/debit cards.

• hicaps: for combined private health fund/overseas claim and payment transactions via HICAPS. Any amount not approved and payable by the health fund will be processed as a customer direct "gap" payment request.

• ndis: NDIS/NDIA claims.

• wcq: WorkcoverQLD 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 invocieReference for each part.

• Must be enabled on Tyro Health Online for selected funder.
patient._id Optional 33 alphanumeric characters 6BE1F06
53B5F4B47
A88633F3
A0DC1712		 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 patient. Otherwise, do not use.

• A unique invoice can include only one patient.
patient.refId Optional Up to 128 characters 3DE2D2BC-17CC-4978-A79D-2151DC417B2F A unique patient identifier generated by your system. If provided, future transactions can 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.

• A unique invoice can include only one patient.
patient.firstName Optional / Mandatory 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 Optional 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.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
patient.email Optional Valid values only emily@gmail.com
Any valid email address. Used for receipts and statements.
patient.mobile Optional Valid values only 0411111111 Mobile number required to send SMS claim and payment requests. Either domestic (04xxxxxxxx) or international (+614xxxxxxxx) format accepted.

• Only Australian domestic numbers are supported.
healthFundAccount.healthFundCode Mandatory Valid values only NIB For icare:

• IWC: workers insurance

Note: other schemes will be added, such as Dust Disease, Insurance for NSW, Lifetime Care, etc

For HICAPS see supported private health insurance list.

For Comcare: COMCARE

For WorkSafe Victoria: WSV

For nib: NIB (must be in upper case)
• A unique invoice can include only one healthFundCode.
healthFundAccount.membershipNumber Mandatory Up to 30 alphanumeric characters 12345678 One of:

• nib: The customer number printed in a member's card.

• WSV: claim number

• Comcare: claim number

• icare: claim number or approval number

• Medicare: medicare card number, 10 digits

• DVA: veterans number

• NDIS: participant number, up to 20 digits

• WorkcoverQLD: claim number

Note that validation on format for each funder varies.
healthFundAccount.cardRank Optional Either 1 or 2 numbers 1 One of:

• nib: individual reference number, one digit of 1-9, as noted on physical card.

• Medicare: individual reference number, one digit of 1-9, as noted on physical card.

•

• For NIB, if cardRank is not provided then membershipNumber, dobstring and firstName, lastName are used. If possible, use cardRank as it is a better matching mechanism.
nib.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
nib.facilityId Optional Up to 8 alphanumeric characters 1234567L A registered organisation provider Id.
nib.claimItems.reference Mandatory 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.
nib.claimItems.itemCode Mandatory Up to 5 numbers 23 Any valid Medicare supported MBS code or published nib code for a given date of service.
•Only valid MBS items for a given serviceDate can be processed.
nib.claimItems.customDescription Optional Up to 60 alphanumeric characters Bandages Custom item description.
nib.claimItems.price Mandatory Currency notation, up to 6 numeric and 2 decimal digits 50.67 Net change for 1 unit. If tax is applicable, set isTaxable to True and appropriate tax will be added to gross item amount.
nib.claimItems.isTaxable Optional Boolean true Default is false
• Only certain item codes can include GST.
nib.claimItems.quantity Optional Numeric 2 Default value is 1.
nib.claimItems.unit Optional Valid values only EA Default is EA.
nib.claimItems.numberOfPatientsSeen Optional 1 or 2 numbers, 1-99 2 The number of patients seen. Default value is 1.
Applicable for pharmacy claims only
nib.claimItems.prescriberFirstName Optional Up to 40 characters Tim First name of the prescriber
nib.claimItems.prescriberNumber Optional Valid values only 12324 Prescribers number
nib.claimItems.prescriberLastName Optional Up to 40 characters Bourke Last name of the prescriber
nib.claimItems.scriptNumber Optional Valid values only 1
nib.claimItems.scriptDate Optional YYYY-MM-DD 2020-08-25 The date the script is issued
Applicable for ambulance claims only
nib.claimItems.pickupDateTime Mandatory YYYY-MM-DD 2020-08-25 Date and time of pick up
nib.claimItems.pickUpAddress Mandatory 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.
nib.claimItems.pickUpAddress2 Optional Up to 40 characters Unit 808 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.

•The value must contain at least one alpha or numeric character.
nib.claimItems.pickUpAddress.city Mandatory Up to 40 characters Windsor Also known as locality.
• must be a valid city/locality

• 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.
nib.claimItems.pickUpAddress.state Mandatory Valid values only vic Must be valid
nib.claimItems.pickUpAddress.postcode Mandatory 4 numbers 3121 Postcode
Must be valid
nib.claimItems.pickUpAddress.country Mandatory Up to 40 characters
nib.claimItems.dropoffDateTime Optional YYYY-MM-DD 2020-08-25 • Date and time of drop off

• Can not be before drop of time and date
nib.claimItems.dropoffAddress Optional 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.
nib.claimItems.dropoffAddress2 Optional Up to 40 characters Unit 808 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.

• The value must contain at least one alpha or numeric character.
nib.claimItems.dropoffAddress.city Optional Up to 40 characters Windsor Also known as locality.
• must be a valid city/locality

• 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.
nib.claimItems.dropoffAddress.state Optional Valid values only vic Must be valid
nib.claimItems.dropoffAddress.postcode Optional 4 numbers 3121 Postcode
Must be valid
nib.claimItems.dropoffAddress.country Mandatory Valid values only
nib.claimItems.distanceTravelledKms Optional Up to 3 numbers 23 Indicates travelling distance by KMs traveled by the ambulance
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