Medicare and DVA testing
- To get started with testing, we will need to issue you with some credentials that will allow you to interact with the Tyro Health Online. To get in touch with us, please send us an email at healthpartnerships@tyro.com and we’ll help you get started.
- Only valid test accounts with Tyro Health Online arranged staging business and providers can be used to test the resource.
- A Tyro Health Online STG environment API key is required
Testing
This page includes test data and other information to make sure your integration works as planned. It can be used to trigger different flows in your integration and ensure they are handled accordingly.
Provider test data
The following providers are authorised for claim authorisation. These providers can be used as GP, Specialist, Diagnostic Imaging, MRI, Radiology Oncology servicing, payee or referring providers (not Pathology).
| Provider Number | Last Name | First Name |
|---|---|---|
| 2438521X | JORDAN | BRIDGID |
| 2438531W | HAUSER | ELLY |
- If transmitting claims for Diagnostic Imaging use LSPN Number: 14
- If transmitting claims for Pathology use SCP Number: 00001
- If transmitting claims for Radiation Oncology use Equipment Number: 00901
The following provider is a ‘Generalist Provider’ (to only be used where asked for in the test plan).
| Provider Number | Last Name | First Name |
|---|---|---|
| 2423391B | HOWELL | ION |
Referee providers
The following providers can only be used for Referral and Request purposes.
| Provider Type | Provider Number | Name |
|---|---|---|
| General | 2054781W | Dr Brenda Reed |
| Specialist | 2121331W | Dr Vivian Mortier |
Payee providers
Any valid servicing provider can be used as a payee provider.
Medicare patient test data
Claims submitted to Medicare are validated by Medicare number and patient details.
Valid test patients can be found in the table below
The following Single Medicare cards have been set up for testing. The Individual Reference Number (IRN) is found next to the name of the person on the Medicare Card.
| Medicare Card | IRN | Last Name | First Name | DOB | Sex | Address | Locality | State | Postcode |
|---|---|---|---|---|---|---|---|---|---|
| 4951649791 | 1 | FRANCIS | Jarred | 10-02-1968 | M | 133 Wolverene Est | Jabiru | NT | 886 |
| 6951824181 | 1 | FOSTER | Arline | 2-01-1973 | F | 115 William St | Kamona | TAS | 7260 |
| 4951649881 | 1 | GENTLE | Rolf | 18-06-1953 | M | 19 Zeppelin Gdns | Canaga | QLD | 4413 |
| 2954537491 | 1 | MANWARING | Ricki | 9-08-1960 | F | 72 Jamieson St | Pullaming | NSW | 2381 |
The following Families have been set up for use during testing.
| Medicare Card | IRN | Last Name | First Name | DOB | Sex | Address | Locality | State | Postcode |
|---|---|---|---|---|---|---|---|---|---|
| 2954468081 | 1 | KEYES | Damian | 20-08-1982 | M | 141 Law Tce | Clarenza | NSW | 2460 |
| 2954468081 | 2 | KEYES | Cletus | 11-03-1984 | M | 141 Law Tce | Clarenza | NSW | 2460 |
| 2954468081 | 3 | KEYES | Harrison | 28-08-1914 | M | 141 Law Tce | Clarenza | NSW | 2460 |
| 2954468081 | 4 | KEYES | Ardath | 17-04-1921 | F | 141 Law Tce | Clarenza | NSW | 2460 |
DVA test patient
Valid patient test details include:
The following Veterans cards have been set up for use during testing. These veterans can also be used for Medicare Claims if the Medicare Card Number is used. DVA Card Types: PT
| Veteran File No. | First Name | Last Name | DOB | Sex | Address | Locality | State | Postcode |
|---|---|---|---|---|---|---|---|---|
| NX901687 | PLACIDO | IMELDA | 12-01-1967 | M | 5 FLORENCE PL | GRIFFITH | ACT | 2603 |
| NX901688 | SABINA | RORY | 26-02-1954 | F | 42 GAVIN ST | O'CONNOR | ACT | 2602 |
| NX901689 | CRAIG | EMILE | 26-05-1965 | M | 97 INGO CCT | THE BASIN | NSW | 2108 |
| NX901690 | ELENORE | GLADYS | 11-06-1952 | F | 34 JUDE PL | PARADISE BEACH | NSW | 2107 |
Alternative/exception patient test details include
The following alternate enrolment types have been set up for use during testing:
| Enrolment Type | Medicare Card / DVA File No. | IRN | Last Name | First Name | DOB | Sex | Address | Locality | State | Postcode |
|---|---|---|---|---|---|---|---|---|---|---|
| > 70 years of age | 2951386025 | 1 | Smith | Henry | 17-06-1940 | M | 12 Wattle St | Dubbo | NSW | 2830 |
| > 7 years of age | 2951386025 | 2 | Smith | Lyndall | 20-09-2012 | F | 12 Wattle St | Dubbo | NSW | 2830 |
| < 7 years of age | 2951386025 | 6 | Stevens | Reggie | 26-08-2019 | M | 12 Wattle St | Dubbo | NSW | 2830 |
| DVA Long Name | N 026027K | N/A | Clarksonnnnnnnnnnnnn | Peterrrrrrrr | 07-12-1935 | M | Locked Bag 5115 | Parramatta | NSW | 2124 |
| DVA Only Name | NX000098A | N/A | Brown | Onlyname | 16-10-1916 | F | 48 Charles St | Erskineville | NSW | 2043 |
| Enrolment Type | Medicare Card | IRN | Last Name | First Name | **DOB ** | Sex | Address | Locality | State | Postcode |
|---|---|---|---|---|---|---|---|---|---|---|
| Only Name | 2297460337 | 1 | Devo | Onlyname | 01-01-1980 | M | 45 Lameo St | Sydney | NSW | 2000 |
| Long First Name | 2298039875 | 1 | Jones | Marrianna-Louise | 19-05-1967 | F | 6 Jones Pl | Gowrie | ACT | 2904 |
| Long Name | 3950921522 | 1 | Weatherby-Wilkinson | Harriett-Jane | 12-03-1992 | F | 18 Wadey St | Southbank | VIC | 3006 |
| RHCA | 2297582345 | 1 | Xpatriot | English | 15091975 | M | 34 Continental Ave | Sydney | NSW | 2000 |
| Expired RHCA | 2297402205 | 1 | Forigner | French | 16051980 | F | International St | Deakin | ACT | 2600 |
| Lost card | 5500393925 | 1 | Boyes | Simon | 23-05-1980 | M | Dropball Ave | Nailsworth | SA | 5083 |
| Transferred to different card, old card quoted | 6951393261 | 3 | Harris | Sam | 12-09-2000 | F | 4A Watkins St | Eden Hill | WA | 6054 |
| Deceased (30/06/2024) | 2296510128 | 4 | Jones | Sad | 15-09-1964 | M | 1 Happy Pl | Fadden | ACT | 2904 |
| Unknown on Medicare Australia systems | 2398125261 | 1 | Doe | John | 13091979 | M | 1 Lost Pl | Sydney | NSW | 2000 |
| Old Issue Number | 2298264833 | 1 | Watts | Gregory | 12-05-1970 | M | 25 Main Rd | Wanniassa | ACT | 2903 |
| Safety Net Patient | 2295919746 | 1 | Davis | Eva | 02-05-1979 | F | 502 Lion Pl | Macquarie | ACT | 2614 |
Concession Entitlement Verification
| Enrolment Type | Medicare Card | IRN | Last Name | First Name | DOB | Entitlement # |
|---|---|---|---|---|---|---|
| Concession Entitlement Verification - CLK | 2293653285 | 1 | Leonard | Bobby | 10-02-1958 | 100015482A |
| Concession Entitlement Verification - DVA | 5500053244 | 1 | Thompson | Terri | 01-01-1960 | NX840351 |
Inpatient Medical Claiming, In-Hospital Claiming, Online Eligibility Checking and Overseas Claiming
The following details have been set up for Inpatient Medical Claiming, In-Hospital Claiming, Online Eligibility Checking and Overseas Claiming for testing
| FundBrandId | TST | Generic Fund Brand ID |
| Patient fund memberNumber | 1-19 AN characters | The fund membership details can be made up data, meeting the field format conditions. |
| Patient fund memberRefNumber | 1-2 N characters | |
| Facility ID | 9988770W | Generic facility ID number |
| Billing Agent ID | 3539440H | SIMPBILL |
Medicare Bulk Bill simulated responses
Medicare Bulk Bill submissions are usually processed overnight. To quickly simulate responses (and test configured webhooks), transactions can be stubbed. Stubs can be applied at multiple levels:
- Submission
- Processing
- Processing claim item
- Payment
| Sub Text | Level | Expected Response | Notes |
|---|---|---|---|
| STUB_OK | Submissions (required) | Submission succeeds | |
| STUB_DOWN | Submissions (required) | Submission fails with 3004 (medicare down) | Claim will be successful after the next batch run. Approx every 2 hour |
| STUB_FAIL | Submissions (required) | Submission returns a fail 3999 | Claim will not be resubmitted |
| STUB_FAIL_XXXX | Submissions (required) | Submission returns a fail XXXX | Replace XXXX |
| STUB_PROCESSING_ITEM_FAIL | Processing claim item | Processing report returns with Explanation code 160 | |
| STUB_PROCESSING_ITEM_FAIL_XXX | Processing claim item | Processing report returns with Explanation code XXX | Links to return codes: Medicare, |
| STUB_PAYMENT_FAIL | Payment | Payment report returns with fail 8002 | |
| STUB_PAYMENT_FAIL_XXXX | Payment | Payment report returns with fail XXXX |
Stub text(s) are applied on claim item's Service Text field and should be set on the first claim item of the claim, with the exception of STUB_PROCESSING_ITEM_FAIL, which can differ for each claim item. Stub outcome can also be applied on different levels ie. Submission, Processing claim item, Payment. To initiate a stub, Submission level is mandatory.
Examples:
- STUB_OK;STUB_PROCESSING_ITEM_FAIL_123: Submission submits successfully, but processing report returns an explanation code of 123 and results in no benefits paid for the item.
- STUB_DOWN;STUB_PAYMENT_FAIL_1234 : Submission failed because medicare was down. After a couple of hours, re-submission succeeds with a successful approval of claim. Payment fails with an error code of 1234.
Our STG environment is connected to Medicare/DVA by default. Their adjudication engine will approve some claims and others might stay in a forever "under review" status. This is a condition of the Medicare/DVA non-production environment.
We can manually request processing but for most instances, it's best to stub the response by inserting the text "STUB_OK" into service text for each item claimed. For example:
serviceText: STUB_OK,
You can also simulate other Medicare/DVA decline/response codes by substituting STUB_OK with STUB_<ERROR_CODE>, using any valid return code published here:
https://www.servicesaustralia.gov.au/medicare-digital-claiming-return-codes?context=22796