Ancillary Information

OCV check: Medicare obtains information via a live connection with Centrelink. If Medicare does not receive data from the Centrelink server, Medicare will use the data stored on its system. So, if for example there is no concession card registered with Medicare, the client will receive a message that the patient has been verified, but no Medicare concession entitlement.

OPV check: When performing an OPV check, Pracsoft sends requests to Medicare for:

  • Medicare card number.

    Patient's first name (first 5 characters only).

    Medicare reference number.

    If any of these are different, a check of the patient's DOB is performed. If the patient's details are updated after the OPV check and the patient has another patient as their payer, ensure that the payer's details are updated also, otherwise refunds will fail, usually with a no benefit payable.

    Billing excisions: Excisions are usually billed at 100% for the first item, 75% for the second item and 50% for the third and any subsequent items. When these are billed through the Tyro terminal, they will all be returned as 100%. It appears that Medicare are changing the amounts to 100% for all items received, but when the reports are returned, they show exceptions for the correct amount. Due to this, it is advisable that sites do not send these via Easyclaim, but retain them for later lodgement, transmitting them via online claiming.