Introduction to Medicare

Background

Medicare is the publicly-funded universal health care insurance scheme in Australia, operated by the nation's social security department, Services Australia. In partnership with Tyro Health, Medicare now supports straight-through electronic claims submission for bulk bill, patient claims and account verifications. For the latest pricing, please visit (https://medipass.com.au/pricing)

Bulk bill

With Medicare bulk bill, providers can claim eligible services billed at Medicare Benefits Scheme (MBS) rates and receive payments directly from Medicare.

Patient claims

With Medicare patient claims, providers can charge for eligible services at or above the MBS rates, and have benefits paid by Medicare to either patients or their claimants. Patients pay for the service prior to claiming but typically receive their benefit payment by the next business day. Patients will not need to submit a separate claim to Medicare.

Problematic claims, such as invalid medicare numbers, can be identified in real time expediting the invoice process. Providers can self-check the status of invoices for greater transparency.Medicare claims can be submitted electronically by partners through an approved integration method including the Tyro Health SDK , Direct API and batch file. Claim status and settlement details are provided by Tyro Health and can be obtained via a webhook set for in the claim payload or polled via an Invoice status API.