Claiming with Medicare Easyclaim

The following topics explain how to process different claims with Medicare Easyclaim:

• Fully-paid Patient Claims
• Part Paid Patient Claim
• Unpaid Patient Claims
• Bulk Bill Claims

The following items are not accepted through Medicare Easyclaim:

• In-hospital items
• ACIR information
• Bulk Bill claims more than 2 years from date of service.
• Patient claims more than 2 years from date of service.
• Time duration dependent items
• Notional charges
• Patient claims pathology items excepting group 9 items
• Bulk Bill pathology items which are self-deemed or rule 3 exemptions
• Patient claims and Bulk Bill claims with non-standard referrals
• Items where the charge exceeds $9,999.99
• Department of Veterans' Affairs (DVA) claims
• Currently item 105 cannot be claimed more than once a day using Medicare Easyclaim. Medicare Australia is considering enhancing the system to allow additional items to be claimed more than once a day using the 'not duplicate' indicator.
• Claims for Allied Health Workers

In the unfortunate event that Medicare Easyclaim is not available at the practice the practice needs to issue the patient/claimant an account/statement and advise the patient/claimant to lodge their claim through an alternate channel, i.e. at the appropriate Medicare office. Bulk Bill claims need be the completed as with the current existing processes. Since Medicare Easyclaim works independent from EFTPOS services, it is possible that Medicare is available while EFTPOS is not and vice versa.