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Document last updated on: 18/10/2023

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Medicare Online Patient Billing Guide for SAAS Web

Overview 

See Also
 This guide refers only to SAAS Web Medicare Online Patient Billing procedures

Refer to the Operator Defaults Guide for options related to billing types.

See also the various guides to Medicare Online Reports and also refer to the PRODA Guide and other prerequisites for accessing Medicare Online services in SAAS Web.

The Medicare Online billing and claim procedures are:-

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  •       Medicare Bulk Billing

  •       Department of Veterans Affairs Claims

  •       Medicare Patient Claims


Each of these Medicare Online billing procedures are processed with the same Patient Billing screen.

The different processing requirements for each claim type is determined by the work-flow - and the workflow is determined by the Account Billing Type.

If the Billing Mode is set to Medicare Online Billing - then :-

Account Billing Type = Medicare (Bulk Billing) for Medicare Bulk Billing
Account Billing Type = Private for Medicare Patient Claim
Account Billing Type = Veteran Affairs for Department of Veteran Affairs Claim

Additionally - for each of the three Account Billing Types - the Operating Mode must be set to either GENERAL PRACTICE or SPECIALIST. Each has it's own requirements when making Medicare claims, and each has a different workflow.

For multi-disciplinary practices there are effectively six Medicare claim types - e.g. Medicare Bulk Billing (GP), Medicare Bulk Billing (Specialist) etc.

Account Billing Type determines Patient Claim Type   

As can be seen from the images below - the Patient Claim Type is determined by the Account Billing Type.
This is selected from the Patient Account List.

For Medicare Online claims - it is essential that the correct Patient Account is selected and that the required billing type is displayed before proceeding with the invoicing and claim details.

Medicare Bulk Billing
Medicare Patient Claim
Department of Veteran Affairs Claim

Mode Override 

The Mode Override in Patient Billing allows you to change the default Operating Mode (defined in Set Defaults) - to change the Operating Mode between GENERAL PRACTICE and SPECIALIST.

Medicare Bulk Billing 

 When the Account Billing Type is Medicare (Bulk Billing) :-

  • Click on New Invoice. The Date of Consultation defaults to 'today'. Back-date this if requred.
  • For each Invoice Line Item - use Quick-Pick or look up the MBS Item number. Change fee-level or override the Charge amount if required.
  • Click the Plus icon to create a new line item.
  • When finished - click [Continue]


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If you have customised your Quick-Pick list - each billing item is only 1 click.

A completed Invoice for medicare Bulk Billing.

Click [Continue] to start the Medicare Claim Process ...

Medicare Patient Claim 

When the Account Billing Type is Private - Medicare patient claims are lodged on behalf of a patient or claimant.


After the billing items have been entered - you have these options:-


  • [Print Invoice] (Prints a standard Invoice)
  • [Pay Now] (Allows Full or Part Payment)
  • [Continue] (Unpaid)

Types of patient payment options

There are 3 payment options for patient claims that can be lodged through Medicare Online.

  • Fully paid account - patient or claimant has paid their account in full
  • Part paid account - patient or claimant has paid a contribution toward settlement of the account
  • Unpaid account - account has not been paid

(1) Payment Type (Select from drop-down list)

(2) Enter Amount (If not fully paid - or the the payment is composed of multiple parts)

(3) Add this payment - will be shown on the summary line (4)


You can add multiple payment parts - when completed you can Print the Receipt if required (5)


For full details - refer to the Medicare Online Patient Claim Payments Guide



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Department of Veteran Affairs Claim   

 When the Account Billing Type is Veteran Affairs :-

  • Click on New Invoice. The Date of Consultation defaults to 'today'. Back-date this if required.
  • For each Invoice Line Item - use Quick-Pick or look up the MBS Item number. Change fee-level or override the Charge amount if required.
  • Click the Plus icon to create a new line item.
  • When finished - click [Continue]

The Department of Veteran Affairs claims processed via Medicare in the standard Patient Billing are DVA Medical Claims.


The Patient requires a valid Veteran Affairs number and card type (though not necessarily a Medicare Card). Specific DVA rules are applied, but the general billing process is the same as Medicare Bulk Billing.


Note that DVA Allied Billing currently uses a separate Allied Services Billing screen which is similar but allows item selections from either the MBS Items list or the DVA Item lists covering each of the various Allied Modalities.



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