Claims processing
Claims processing flows
Tyro Health Online will electronically submit this invoice, however Tyro Health Online will not settle funds. Decisions on the invoice and related remittance can be viewed within the WorkCover Queensland Provider Connect portal . Providers can manually mark a claim as approved/paid in Tyro Health Online which will trigger a webhook event.
Claim structure
To issue a successful claim, the following details are required in each invoice:
- Provider, profession and location : Usually set with a single provider number attribute. These details must be registered with Tyro Health in advance of a claim. Only one provider can claim per invoice.
- Patient Details: including first and last name, date of birth and claim number.
- Service items: including date of service, item number and fees are required. Multiple service items from multiple service dates can be claimed per invoice.
WorkCover Queensland does not currently support attachments however Invoice level Comments are supported. If an attachment is required to support a claim those details must be sent directly to WorkCover Queensland by the provider.
Supported Providers and Patients
Professions and geographies
WorkCover Queensland currently support electronic claims from:
- Aboriginal and Torres Strait Islander Health Practice
- Acupuncture
- Ambulance
- Audiology
- Chinese Medicine
- Chiropractic
- Counselling
- Dental
- Diagnostic Imaging
- Dietetics
- Exercise Physiology
- General Health Equipment
- General Practice
- Genetic Counselling
- Home Care service and Aids
- Hospital
- Mental Health
- Myotherapy
- Naturopathy
- Nursing and Midwifery
- Occupational Therapy
- Optometry
- Orthoptics
- Orthotics/Prosthetics
- Osteopathy
- Pathology
- Perfusion (Medical)
- Pharmacy
- Physiotherapy
- Podiatry
- Psychology
- Radiology
- Remedial Massage
- Social Work
- Specialist Physician
- Specialist Treatment centres
- Speech Pathology
Providers must first register with Tyro Health prior to submitting a WorkCover Queensland claim. This registration process is self-service and can be completed within a few minutes. If providers deliver services from multiple locations or businesses, each unique provider number must be registered. Details on provider registration and WorkCover Queensland activation is provided at: (https://help.medipass.com.au/en/articles/4824343-enable-workcover-queensland-digital-claims)
Patients
Injured workers with a valid and active claim number can use the service. Patients can have more than one active claim with WorkCover Queensland at the same time.
Eligibility checks and quotes
The WorkCover Queensland integration does not currently support patient quotes or eligibility checks.
Processing and Settlement periods and Payment of invoices
Providers can lodge WorkCover Queensland claims 24/7. Funds will be settled directly by WorkCover Queensland.
Reporting, statements and receipts
Tyro Health automatically generates patient reports, statements and receipts on behalf of the partner/providers. These reports and receipts can be obtained from the Tyro Health Online provider portal or via API calls.
Remittance reports
Remittance reports can be viewed within the (https://www.worksafe.qld.gov.au/service-providers/working-with-workcover/provider-connect)