Medicare attributes

For all Medicare transactions, it’s important the patient and/or claimant details match exactly to that listed on a Medicare card rather than what may be recorded in your system. Tyro Health Online will prompt the user to verify and update details where account details vary from those registered with Medicare.

Creating a transaction

Use function: medipassTransactionSDK.renderCreateTransaction()

To process a Medicare insurance claim, the following fields apply. Any required field not passed to the SDK will be prompted at the TyroHealth submission page.

Attributes table:

Field	Type	Required	Description	Example
`funder`	String	Yes	Set to Medicare for Medicare claims	Medicare
`providerNumber`	String	Yes	Medicare Provider Number. Should be 8 characters alpha-numeric	2429591L
`invoiceReference`	string	Yes	Provider nominated unique transaction reference number, such as an invoice number from the practice management or accounting system. Up to 16 characters	20200901ABCD
benefitPayee	Object		Only applicable for bulk bull claims
`benefitPayee.providerFullName`	String		Full name of the payee provider.Only applicable for bulk bull claims. The servicing provider and payee provider cannot be the same.	Dr Jane Smith
`benefitPayee.providerNumber`	String		Medicare Provider Number of the payee provider. Should be 8 characters alpha-numeric	2409661B
Patient	Object
`patient.firstName`	String	Yes	Patient first name as registered with Medicare. Middle name is not supported. If the patient has only one name, then set name in lastName field and set firstName to "Onlyname".Up to 40 characters	Emily
`patient.lastName`	String	Yes	Patient last name as registered with Medicare.Up to 40 characters	Harris
`patient.mobile`	String		The mobile phone number of the patient. Can be either international notation:	+61411111111 or national notation: 0411111111
`patient.dob`	String	Yes	Patient/employee's 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 serviceDateFor Medicare patient claims, if the patient is <15 years old as at each serviceDate, an adult =>18 years old claimant is required.	1988-03-29
`patient.accountNumber`	String	Yes	Unique Medicare issued account number for patientMaps to: medicareNumber
`patient.reference`	String		Unique patient reference with MedicareMaps to: medicareReferenceNumber (Medicare),
`patient.email`			Any valid email address. Used for receipts and statements.	mw@medipass.io
`patient.usePatientPaymentMethod`	Boolean		If set to true the patients payment method will be used	True
OR
`patient.refId`	String		An optional but recommended patient unique reference as set by you, such as a UUID. This value is used to uniquely identify a patient in Tyro Health Online . Omitting refId will cause duplicate patient records to be created and could make patient searches more difficult for providers who also use the Tyro Health Online portal to check on status of a claim and remittance. If supplied and valid, this value will pre-populate patient details from the patient record in the business as set in any prior claim. Any patient details sent for an existing patient record will update those values.	5AD5E2AF-69D2-43D3-9321-428495205E5E
claimableItems	Array{Object}		Array of fund claimable items
`claimableItems[].itemCode`	String	Yes	Medicare supported pay code which include MBS items.Item code must be valid for Medicare, the provider registered profession and service date.Up to 8 characters	104
`claimableItems[].serviceDate`	String	Yes	Date of the service in 'YYYY-MM-DD' format.	2022-01-12
`claimableItems[].item.price`	String	Yes	Item per unit pricing in $XX.XX format. Net (excluding GST) price each unit in $XX.XX format. Charge amount for the service. For bulk bill, this is normally the same as MBS benefit amount. Note that in bulk bill claims, Medicare will pay the MBS benefit amount which can be greater than the amount charged. The minimum charge amount is $1 Note that in bulk bill claims, Medicare will pay the MBS benefit amount which can be greater than the amount charged.	$15.95
funderData	Object
funderData.medicare	Object
`funderData.medicare.claimType`	String		bulkbill claim or patient claim Up to 8 characters.	bulkbill
`funderData.medicare.lspNumber`	String		Location Specific Practice Number. lsp Number may be required for diagnostic imaging items. When set, this value will be set on all claimed items.	01
`funderData.medicare.isInHospital`	Boolean		Set to true for admitted patient services. Defaults to false. Value applied for all claimed item.	True
`funderData.medicare.facilityId`	String		When isInHospital set to true, the Commonwealth Hospital Facility ID must be supplied which shares same format as a Medicare issued providerNumber.	9988770W
`funderData.medicare.referral.providerNumber`	String		Referring provider number - usually a Medicare issued number.	2054781W
`funderData.medicare.referral.providerName`	String		Name of the referring provider.	Dr Jane Smith
`funderData.medicare.referrerType`	String		Type of the referring provider. 'gp' or 'specialist'.	GP
`funderData.medicare.referral.issueDateString`	String		Issue date of the referral in YYYY-MM-DD format. Example "2019-01-25"	2019-01-25
`funderData.medicare.referral.period`	String		Period of the referral. Can be: 'standard', 'non-standard', 'indefinite'	standard
`funderData.medicare.referral.periodDescription`	Number		Number of months if referral.period is set to 'non-standard'	2
`funderData.medicare.nonReferral.reason`	String		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) and a facilityId should be set	E
`funderData.medicare.nonReferral.description`	String		Up to 40 alpha characters Description of non-referral reason. Where:• H: name of hospital• L: supporting textMust be present if nonReferral details supplied 'non-standard'	Lost referral letter
`funderData.medicare.claimant.firstName`	String		Claimant first name as displayed on Medicare card. Middle name is not supported. If a patient has only one name, set the first name field to 'Onlyname' and set name in lastName.	Dominic
`funderData.medicare.claimant.lastName`	String		Claimant last name as displayed on Medicare card.	Harris
`funderData.medicare.claimant.mobile`	String		Mobile Phone number of the claimant
`funderData.medicare.claimant.dob`	String		Claimant Date of Birth in 'YYYY-MM-DD' format.	1967-11-22
`funderData.medicare.claimant.accountNumber`	String		Claimant Medicare card number.
`funderData.medicare.claimant.reference`	String		Claimant Individual Reference Number from Medicare card eg 1, 2 etc. This number appears on the left of the cardholder's name on the medicare card and distinguishes the individuals named on the card.	1
Or
`funderData.medicare.claimantPatientId`	string

Claimable items Additional item attributes such as admitted patient indicator, service text, Number Of Patients Seen and Duplicate Service Overrides can be set in the Tyro Health Online UI. A maximum of 16 items are permitted for patient claims and 80 items per bulk bill claim.