Creating a transaction
Use function:medipassTransactionSDK.renderCreateTransaction()
To process a DVA insurance claim, the following fields apply. Any required field not passed to the SDK will be prompted at the TyroHealth submission page.
Required column values:
| Value | Description |
|---|---|
| M | Mandatory |
| O | Optional |
| C | Conditional |
| Field | Type/Format | Required | Description | Example |
|---|---|---|---|---|
funder | Valid values only | M | Set to dva in lowercase | dva |
providerNumber | 8 alphanumeric characters | M | Servicing provider number or other registration identifier which must be valid and active in Tyro Health Online for a given funder. For DVA claims, a Medicare issued provider number should be used where available.Must be unique for an invoice | 0065431A |
| patient {} object | ||||
patient.refId | Up to 128 characters | highly recommended | A unique patient identifier - such as a UUID - generated by your system. Used for searching and reporting on transactions by patient in Tyro Health Online and for support purposes. Setting a unique refId per patient is highly recommended.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. | 3DE2D2BC-17CC-4978-A79D-2151DC417B2F |
patient.firstName | Up to 40 characters | M | Patient first / given name as registered with DVA. If only one name, set field to "Onlyname". 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.• Spaces must not appear before or after apostrophes, hyphens, other spaces or the supplied value. • At least one alpha or numeric character required. | Mila |
patient.lastName | Up to 40 characters | M | Patient last/ family name as registered with DVA 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. • If patient has only one name, use "Onlyname" as placeholder in firstName field. | Willis |
patient.dobString | YYYY-MM-DD | M | 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 required. | 2010-09-01 |
patient.mobile | Mobile number | O | Mobile number required to send SMS claim and payment requests. Either domestic (04xxxxxxxx) or international (+614xxxxxxxx) format accepted. | 0411111111 |
patient.email | Email address | O | Any valid email address. Used for receipts and statements.Only Australian domestic numbers supported. | mw@tyro.io |
patient.acceptedDisabilityIndicator | Y or N | O | When set to Y acceptedDisabilityText must be set too | Y |
patient.acceptedDisabilityText | Up to100 characters, UPPERCASE | C | For DVA claims. Provides codified details of the condition treated. Required for White Card holders. When set, this will also set the DVA Accepted Disability Indicator to True, indicating the service relates to a known and accepted condition for a White Card holder. Values should be uppercase. • 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.• Alpha characters must be UPPERCASE | MENTAL HEALTH |
| healthFundAccount {} object for Medicare account details | ||||
healthFundAccount.healthFundCode | Valid values only | M | Set to DVA for DVA patients | DVA |
healthFundAccount.membershipNumber | 3 to 9 alphanumeric characters | M | For DVA use veterans number as shown on card. | QX901543 |
| DVA specific values | ||||
dva.isInHospital | boolean | O | 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) | true |
dva.lspNumber | Numeric 1-999999 | O | 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. | 01 |
dva.facilityId | 8 alphanumeric characters | O | 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 | 9988770W |
dva.treatmentLocation | Valid values only | C | 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) If Referral Override Code is set to H (Hospital) then Treatment Location Code must be set to H (Hospital) | R |
dva.benefitPayee.providerNumber | 8 alphanumeric characters | O | Generally 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 and active 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. | 3452232B |
dva.benefitPayee.providerFullName | Up to 30 alphanumeric characters & select special characters | O | Full name of provider including or excluding title. Will appear on assignment of benefit statement. | Dr. Jane Smith |
| For claims with referral requirements | ||||
dva.referral.issueDateString | YYYY-MM-DD | C* | 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 | 2020-07-23 |
dva.referral.periodType | Valid values only | C* | Period type code as defined by Medicare 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, 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 Note: referral period is not applicable for Pathology or Diagnostic Imaging referrals and should not be set for those claims. | S |
dva.referral.period | 1 or 2 numeric | C* | 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. • Must be present if 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. | 10 |
dva.referral.providerNumber | Up to 8 alphanumeric characters | C* | 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 | 4452232B |
dva.referral.providerFullName | Up to 30 alphanumeric characters | C* | Full name of referring provider, with or without title. Will appear on printed statements. Must be present if Referral details supplied | Dr Emily Tay |
dva.referral.referrerType | Valid values only | C* | Either:• GP: General Practitioner• S: Specialist Must be present if Referral details supplied | GP |
dva.referral.referralTypeCode | Valid values only | C* | 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 | A |
dva.nonReferral.reason | Valid values only | C* | 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 • R: Remote exception • 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) and a facilityId should be set | H |
dva.nonReferral.description | Up to 40 alpha characters | C* | Description of non-referral reason. Where:• H: name of hospital• L: supporting text Must be present if nonReferral details supplied | Lost referral letter |
| For claimed service items | ||||
| dva.claimItems [] | Array | M | **One or more claimItems must be specified for a claim ** | - |
dva.claimItems.accessionDate | Date | O | 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 | 2021-02-21 |
dva.claimItems.accessionTime | Time | O | 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 | 17:30 |
dva.claimItems.accountReferenceNumber | 1-9 alphanumeric characters | O | 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. | 19-1125B |
dva.claimItems.afterCareOverride | boolean | O | 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. | true |
dva.claimItems.collectionDate | Date | O | 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 | 2021-02-26 |
dva.claimItems.collectionTime | Time | O | 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 | 17:30 |
dva.claimItems.duplicateServiceOverride | boolean | O | 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 serviceTime or additional information in serviceText is required to support the reason for the override.• Only applicable for General or Specialist Services. | true |
dva.claimItems.duration | 3 numbers | O | Time duration in minutes. In 15 minute intervals only.Only applicable for General or Specialist Services. | 060 |
dva.claimItems.fieldQuantity | 1 or 2 numbers, 1-99 | O | 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. | 4 |
dva.claimItems.itemCode | Up to 5 numbers | M | Any valid Medicare supported MBS code or DVA code for a given date of service.Only valid MBS or DVA items for a given serviceDate can be processed. | 23 |
dva.claimItems.jawCode | Valid values only | O | Dentistry claims only. Identifies if the dental service relates to the upper or lower jaw. Valid values:• UPR = Upper Jaw • LWR = Lower Jaw | UPR |
dva.claimItems.multipleProcedureOverride | boolean | O | 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 | true |
dva.claimItems.numberOfPatientsSeen | 1 or 2 numbers, 1-99 | O | 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 | 2 |
dva.claimItems.numberOfTeeth | 2 numbers | O | Dentistry claims only. Identifies the number of teeth within the item. Valid values: 01-16 | 02 |
dva.claimItems.opticalScript | Valid values only | O | Optical claims only. Identifies the type of override of restrictions for Optical Scripts. Valid values:• LS = Lost• BR = Broken• RC = Significant Refraction change | LS |
dva.claimItems.price | Currency notation, up to 5 numeric and 2 decimal digits | M | Item per unit pricing in $XX.XX format. Net (excluding GST) price each unit in $XX.XX format. Charge amount for the service. | 50.67 |
dva.claimItems.reference | Up to 128 alphanumeric characters | O | 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. | 01 |
dva.claimItems.restrictiveOverride | Valid values only | O | 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. | SP |
dva.claimItems.rule3ExemptIndicator | boolean | O | 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. | true |
dva.claimItems.s4b3ExemptIndicator | boolean | O | 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 | true |
dva.claimItems.scpId | 3-5 alphanumeric values | O | 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. | 014 |
dva.claimItems.secondDevice | boolean | O | Required for select Allied health professions. This field identifies the provision of a second medical grade footwear service. Valid values:true = Yesfalse or omitted = No (default) • Must only be set when provider professional registration is for Allied health• Must not be set with Distance Kilometres. | true |
dva.claimItems.selfDeemedCode | Valid values only | O | 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 | SD |
dva.claimItems.serviceDate | YYYY-MM-DD | M | 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 | 2020-08-25 |
dva.claimItems.serviceText | Up to 50 alphanumeric characters | O | Free text for additional information on claim assessment. Usually used for claims with exceptions - will be reviewed by Medicare staff.• 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. | Consultation for hearing assessment |
dva.claimItems.serviceTime | HH:MM | O | 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. | 14:25 |
dva.claimItems.toothNumber | 2 numbers | O | Dentistry claims only. Specify the tooth number. Must be 2 numerics and may be required for certain dental items. Valid values:11-1821-2831-3841-48 51-55 61-65 71-75 81-85 | 11 |
dva.claimItems.extras.distanceTravelled | 2-3 numbers | O | 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. | 45 |