Easyclaim and Online Claiming with PracSoft. Last updated: Wednesday, May 04, 2011

Transcription

1 Level 4, 201 Pacific Highway, St Lenards, NSW

2 Cntents Befre Yu Begin... 3 Imprtant Infrmatin... 3 Overview f the Online Claiming Prcess... 4 Installing a Lcatin Certificate... 5 Create a New Stre fr yur Lcatin (site) Certificate Installing yur Lcatin (site) Certificate int the stre... 6 Setup Lcatin Certificate details in PracSft... 7 On the Server:... 7 On the Wrkstatin(s):... 7 Activate Online Claiming in PracSft... 8 Setting up Practitiners t use Online Claiming... 9 Batching Bulk Claims Using HIC Online Facility IDs Recrding a Facility ID in PracSft Specifying the Facility ID when Recrding a Visit in PracSft Sending Claims t Medicare Australia Step 1 Selecting Claims Advance Optins f the Select Claim Tab Step 2 Preparing Claim Data fr Transmissin Crrecting Failed Vuchers Step 3 Print Claim Reprts Step 4 Transmitting Claims Step 5 Requesting Online Claiming Reprts Editing a Vucher Cancelling Claims and Deleting All Visits Deleting Claims (same day delete) Perfrming a Same Day Deletin Reslving Exceptins Displaying the Status f Claims Immunisatin Claims What t d if an immunisatin claim fails preparatin Optins fr reslving failed immunisatin claims Optin 1: Drpping the immunisatin claim Optin 2: Mdifying the immunisatin claim Optin 3: Releasing the immunisatin claim Online Patient Verificatin (OPV) Medicare Easyclaim Hw it wrks Accunts paid in full Unpaid r partially paid accunts (rebates btained by Medicare Online) Fr bulk billing Fr Large Practice Bulk Bill (ptinal) Enabling Medicare Easyclaim Claiming with Medicare Easyclaim Fully paid Patient Claims with Medicare Easyclaim Part Paid Patient Claims Unpaid Patient Claims with Medicare Easyclaim Bulk Bill with Medicare Easyclaim Infrmatin fr Large Practices abut Bulk Billing Resubmitting Medicare Easyclaim Bulk Bill Claims Easyclaim Transactin Status Trubleshting Ancillary Infrmatin Exceptin Reasn Cdes Level 4, 201 Pacific Highway, St Lenards, NSW

3 Befre Yu Begin Ensure yu have an active Internet cnnectin. Ensure yu have recrded yur Practice's Details. Setup > Practice Details. Ensure yu have enabled Online Claiming. This is a glbal setting nce yu have enabled it n ne PracSft cmputer, everyne using the same PracSft database will als have this functinality enabled. Setup > Glbal Settings. Yu may als cnsider enabling EFTPOS/Medicare Easyclaim if yu wish t take advantage f these services at yur practice. This ptin shuld nly be enabled if yu have already installed the Tyr EFTPOS machine. Setup > Glbal Settings. Register with Medicare Australia s ebusiness t use Online Claiming. Yu will need t knw yur Minr ID r HSS number. This can be fund n yur PracSft registratin details letter. Apply and receive frm HeSA the necessary PKI Certificates and assciated Persnal Identificatin cdes (PIC Passphrase). Practices can use either, Lcatin certificates nly, r Lcatin certificates plus individual certificates (IKeys/smartcards) fr each practitiner. If yu use individual certificates, yu must als use a lcatin certificate. Furthermre, using an individual certificate requires that yu enter yur passwrd fr any claims yu prepare. Ensure yu have installed and setup yur Lcatin Certificate and (if desired) individual practitiner PKI Certificate(s). A mandatry requirement fr using Medicare Australia Online is that all patients have their Medicare Card persnal reference number recrded in PracSft. Once Medicare Australia Online has been activated, this requirement will be enfrced whilst recrding any new visits. If yu ffer bulk billing fr services prvided at a hspital, yu must recrd a Facility ID fr each hspital yu visit. Imprtant Infrmatin Server / Wrkstatin envirnment: It is recmmended that the lcatin certificate is installed nly n the server, with the wrkstatins cnfigured t access this shared central stre lcatin, via PracSft s Wrkstatin Settings. Terminal Services: It is recmmended that the lcatin certificate is installed nly n the Server, with the prfiles and wrkstatins/fat clients cnfigured t access this shared central stre lcatin, via PracSft s Wrkstatin Settings. Essentials: Yu must be lgged in as a Windws Administratr t setup Online Claiming. The default PSI stre lcatin is C:\Prgram Files\Cmmn Files\PKI, and is autmatically shared when PracSft 3 is installed. Multiple PracSft Databases: Running multiple PracSft databases, using different PKI Certificates n a single server is nt supprted. Level 4, 201 Pacific Highway, St Lenards, NSW

4 Overview f the Online Claiming Prcess The fllwing infrmatin is an verview f the steps and prcesses required fr sending Bulk Bill claims t Medicare Australia Online r Department f Veterans' Affairs (DVA) claims. 1. A patient is added t the Waiting Rm, and a visit recrded fr them. Alternatively, when cnducting a hme visit (r similar), yu can recrd the visit withut actually adding the patient t the Waiting Rm by selecting Accunt > Add Visit frm either the patient's recrd r the Waiting Rm. Indicate n the Recrd Visit windw whether the visit is t be inviced t Bulk Bill r DVA. On the Recrd Visit windw, click the Claim buttn t create a (claim) vucher fr this visit. Vuchers are nt immediately sent t Medicare upn clicking the Claim buttn. Rather, PracSft hlds the vuchers first, bundling them int individual 'Claims'; a single 'Claim' can cntain multiple 'Claim Vuchers' (ne fr each visit recrded), up t a maximum f 80, specified via the Online Claiming tab f PracSft's Glbal Settings. Setup > Glbal Settings. 2. Befre Claims (bundles f claim vuchers) can be sent t Medicare Australia they must first be 'batched'. Batching a Claim invlves yu analysing (r prcessing) the Claim t determine whether there are any incnsistencies that might prevent Medicare frm accepting the Claim, and assigning a Claim number t each Claim. Claim numbers can be added manually, but it is recmmended that yu have PracSft generate these numbers autmatically fr yu by ticking the 'Aut Claim N. Generatin' checkbx via the Online Claiming tab f PracSft's Glbal Settings. 3. Once a Claim has been batched it can be sent t Medicare with ther batched claims immediately via Online Claiming. Hwever, cmmn practice is t send claims in bulk, nce a day, twards the end f the day. This prcess differs slightly fr sites taking advantage f Medicare Easyclaim. Fr these sites, claims are prcessed immediately via Medicare Easyclaim; it is nt necessary t prcess the claims in PracSft first, nr then batch them and send them manually in bulk lts. 4. A request is sent t Medicare peridically (usually nce per day) t prvide yu with exceptin reprts r payment reprts abut previus claims yu have sent. Reprts cannt be requested n the same day yu transmit the claim. An exceptin reprt cntains infrmatin as t why particular vuchers within a given claim were rejected, r perhaps why the refund Medicare issued differs frm what yu claimed. It is als pssible (althugh rare) fr an entire claim t be rejected. A payment reprt cntains the amunt f benefit paid by Medicare. If yu have a batch that has had all the vuchers rejected, there will nt be a crrespnding payment reprt, and nce yu reslve the exceptins, that batch will n lnger exist. Reprts are requested via the Request Reprts tab f the Online Claiming windw the same windw used t select, prepare and transmit claims t Medicare. 5. Nw, payment reprts can be cmpared with yur actual banking, and exceptin reprts can assist yu with reslving the exceptins. 6. (Optinal) Nrmally, payments are aut receipted. Hwever there may be ccasins where yu must manually receipt a bulk payment. Level 4, 201 Pacific Highway, St Lenards, NSW

5 Installing a Lcatin Certificate The fllwing prcedure need nly be perfrmed n 1 cmputer. The PIC fr the lcatin certificate will have been prvided t yur practice by Medicare Australia in a letter. The PIC is case sensitive. Launch the PKI Certificate Manger via Windws Cntrl Panel. The PKI Certificate Manager is installed with PracSft. Create a New Stre fr yur Lcatin (site) Certificate. Yu can search fr an existing stre if yu knw yu already have ne. If a Certificate Stre has nt previusly been created n yur system, the Stre Setup Wizard will autmatically launch the first time yu run the PKI Certificate Manager. Yu can manually launch the Stre Setup Wizard n subsequent uses f this applicatin by clicking the Setup buttn n the PKI Certificate Manager main windw, as shwn belw. 1. Select the Create a New Stre ptin (as shwn belw) and click the Next buttn t cntinue. 2. Yu will be prmpted t select the stre s lcatin. Either: Click the ellipse buttn, and brwse t the lcatin where yu want t stre the hic.psi, and then type hic.psi in the file name, r Type in C:\Prgram Files\Cmmn Files\PKI\hic.psi 3. Click the Next buttn. Enter yur preferred passwrd. It is recmmended yu use yur HSS number (Minr ID). Failing that, ensure yu make a nte f the stre passwrd. 4. Click the Finish buttn t create the certificate stre. Level 4, 201 Pacific Highway, St Lenards, NSW

6 Installing yur Lcatin (site) Certificate int the stre 1. T install the lcatin certificates, click the Install buttn. 2. Enter the stre passwrd yu created in step 3 abve. Click the Next buttn t cntinue. 3. The Site Certificate Installatin windw will appear. Brwse t yur CD By using the drp dwn arrw and selecting yur drive label e.g. D:\, r By clicking the ellipse buttn and brwsing t yur CD drive. 4. Click the Next buttn. 5. Enter the PIC passphrase supplied by Medicare (this is case sensitive). 6. Click the Next buttn. Certificates that will be imprted int the stre windw will be displayed. 7. Click the Finish buttn. Yu will be returned t the PKI Certificate Manager. The Persnal tab shuld nw display 2 Certificates. The Other Peple tab shuld nw display: 2 x Medicare Certificates 2x CEO Certificates Level 4, 201 Pacific Highway, St Lenards, NSW

7 Setup Lcatin Certificate details in PracSft On the Server: 1. Frm the PracSft main screen select Setup > Wrkstatin Settings. 2. Then either; Click the ellipse buttn and brwse t the lcatin where yu want t stre the hic.psi, r Enter C:\Prgram Files\Cmmn Files\PKI\hic.psi as the Stre Lcatin (prvided that C is yur lcal system directry/drive). On the Wrkstatin(s): 1. Frm the PracSft main screen select Setup > Wrkstatin Settings. 2. Either; Click the ellipse buttn brwse t the lcatin f the hic.psi, r Enter \\ SERVER NAME \PKI\hic.psi. 3. Enter the Stre passwrd. 4. Click the Save buttn. Nte: If the hic.psi is nt installed in the default lcatin; This lcatin can be fund by pening the PKI certificate manager n the server. Check the lcatin at the tp f the windw in the bar, r By searching fr the stre via the PKI Manager, Stre > Seach fr exisisting stre. Level 4, 201 Pacific Highway, St Lenards, NSW

8 Activate Online Claiming in PracSft 1. Frm the PracSft main windw, select Setup > Glbal Settings Tick the Use Online Claiming checkbx Ensure that: Medicare Australia Server = www2.medicareaustralia.gv.au/pext Medicare Australia Recipient = ebus@medicareaustralia.gv.au 1.3. It is recmmended that yu als tick: Single Claim Receipting. Aut Claim Number Generatin: Claim numbers will be autmatically incremented and displayed when batching. Separate BB/DVA Sequencing: Different letters used t distinguish Medicare and DVA claims. 2. Select the Bulk Billing tab. 3. Enter yur Minr Custmer ID (als knwn as the HSS number). 4. Click the Save buttn. Level 4, 201 Pacific Highway, St Lenards, NSW

9 Setting up Practitiners t use Online Claiming 1. Frm the PracSft main windw, select Admin > Practitiners. 2. Select the Practitiner yu wish t edit frm the list and click the Edit buttn. 3. The Practitiner Details windw appears Tick Online Claiming Agreement Signed s the practitiner s claims appear in the nline claiming windw Tick Added T Lcatin Certificate (Optinal) Tick Patient Claims t send private invices and receipts t Medicare Australia (Optinal) Tick Individual Signing (using the ikey/smartcard tken), if their individual certificate is installed Click the Save buttn Repeat these steps fr all practitiners wh wish t use nline claiming. 4. Clse and repen PracSft. If yu receive any errrs at this time, be sure t nte the errr number(s). 5. Perfrm an Online Patient Verificatin (OPV) check t test: 5.1. Lcate and right click a patient frm the Waiting Rm Select OPV Check frm the menu that appears. The patient's Medicare Card and patient details are sent t Medicare Australia One f the fllwing pssible respnses is returned immediately; Details Validated. OPV Check Failed. Medicare Card r Patient Details require updating. Yu can nw start using Medicare Australia Online Claiming. Level 4, 201 Pacific Highway, St Lenards, NSW

10 Batching Bulk Claims Using HIC Online 1. Frm the PracSft main screen, select; 1.1. Prcessing > Batch Bulk Claims > Medicare, r 1.2. Prcessing > Batch Bulk Claims > Veterans Affairs. The example belw shws the Veteran Affairs windw the standard Medicare windw is identical. Batch Bulk Claims windw shws the details f The servicing practitiner. The lcatin cde. The number f vuchers. The ttal amunt claimed. If Aut Claim N. generatin is ticked, the claim number will have been entered autmatically. If this is nt enabled yu must enter a claim number fr every claim, and the frmat must be Letter### e.g. A0101. The Shw buttn shws vuchers in batch, where yu can print a list. 2. Click the Prcess buttn If yu are sure yu wish t cntinue click Yes when prmpted. 3. Arrws under the Claim Details heading. Use the arrws t scrll thrugh the batching prcess fr all practitiners. These arrws are nly visible there are vuchers fr mre than ne claim. 4. Click the Send buttn t pen the Online Claiming windw. If yu d nt wish t transmit the prcessed claims at this stage click Clse. Nte: Any in hspital vuchers are batched int a separate claim prefixed with #, fr example #1234. Level 4, 201 Pacific Highway, St Lenards, NSW

11 Facility IDs If yu ffer bulk billing fr services prvided at a hspital, Medicare requires yu recrd a Facility ID fr each hspital yu visit. The fllwing infrmatin explains hw t setup Facility IDs, and then hw t use them when recrding a visit. The fficial name fr Facility ID is Cmmnwealth Hspital Facility Prvider Number. It is pssible that the facilities yu need t btain this number frm will nt knw what their Facility ID is. In such a case, it will be necessary fr yu t btain the required infrmatin by ther means; Cntact the Department f Health and Ageing: Cntact the Department f Veterans' Affairs: Recrding a Facility ID in PracSft 1. Select Admin > Referring Prac/Address Bk. The Referring Practitiners windw appears. Althugh this windw is used fr managing Referring Practitiners, it is als used fr recrding Hspital Facility IDs Check first that the facility des nt already exist. If it des, ensure that the fllwing requirements are satisfied fr the existing recrd, by selecting it and clicking the Edit buttn. 2. T add a new Facility ID, click the Add buttn. The Referring Prvider Details windw appears. 3. Enter the fllwing infrmatin: Recrd the facility's full name in the Surname field. Recrd the Facility ID in the Prvider N field (un tick the Validate Prv N bx fr Residential Care Facilities / Nursing Hmes). Indicate the type f facility frm the Specialty list. Level 4, 201 Pacific Highway, St Lenards, NSW

12 Specifying the Facility ID when Recrding a Visit in PracSft The Recrd Visit windw allws yu t enter the data that DVA requires fr a successful nline, paperless claim. If yu select 'Vet Affairs' frm the Invice T list, an extra set f tabs becmes available t the upper sectin f the screen, as indicated in the fllwing image. The Lcatin tab (see image abve) allws yu t specify the lcatin at which the service was prvided. The Treated At field includes the fllwing ptins: Rms; Hspital; Visiting; Residential Care Facility; and Cmmunity Health Centre. When Hspital is selected, the Hspital Admissin check bx becmes available. If either 'Hspital', 'Residential Care Facility', r 'Cmmunity Health Centre' is selected, DVA requires that yu then supply the Facility ID fr the treatment lcatin. In rder t enable this, a Prvider N field appears in the Service Details when yu make ne f these selectins. The Prvider N field includes a list f all such facilities, which are recrded in yur address bk. Nte that the first institutin (in alphabetical rder) will be displayed by default. Yu will need t ensure that yu select the crrect hspital / facility frm this list. If the facility des nt already exist in yur address bk, yu will need t add it befre being able t make this selectin in the Recrd Visit windw. Level 4, 201 Pacific Highway, St Lenards, NSW

13 Sending Claims t Medicare Australia There are 5 steps t sending claims t Medicare Australia Online, all f which are explained belw: 1. Selecting Claims. 2. Preparing Claim Data fr Transmissin. 3. Print Claim Reprts. 4. Transmitting Claims. 5. Requesting Online Claiming Reprts. Step 1 Selecting Claims 1. Open the Online Claiming windw: 1.1. Frm the Batch Bulk Claims menu, click the Send buttn t pen the Online Claiming windw, r 1.2. Frm the PracSft Waiting rm, select Prcessing > Online Claiming. Nte: This windw will nly display claims fr practitiners flagged as using Online Claiming r active within PracSft. Left hand side: Claims that have been batched but nt prepared r sent. Right hand side: Claims that have been prepared r transmitted. Claims can be mved t the right r left f this screen by highlighting the claim and clicking the centre arrws r simply duble clicking the claim. 2. Once yu have selected the claims yu wish t prepare, click the Next Step buttn which will take yu t Step 2 Prepare Claim Data tab. Advance Optins f the Select Claim Tab Select the claim, and right click fr the fllwing ptins: Print the Claim Details: a reprt is generated f all vucher details within the selected claim. Reset Bulk Claim Status: If the claim has been transmitted t Medicare, the claim status may need t be reset. This can nly be dne by a Level 9 user, and the passwrd generated by HCN Technical Supprt. The passwrd is generated n the Claim N. and the date the claim was transmitted t Medicare. This infrmatin is included in the reset bulk claim status windw. Level 4, 201 Pacific Highway, St Lenards, NSW

14 Step 2 Preparing Claim Data fr Transmissin Click the Prepare buttn t prepare claims fr sending. Yu will be prmpted t cnfirm the claim preparatin. If yu are preparing claims fr a practitiner wh uses an individual tken, they must insert the Individual Tken r ikey and type in the passphrase fr each practitiner and each claim, when prmpted. Any successfully prepared claim(s) can be sent t Medicare Australia nw, and will appear in Tab 4 Transmit Claims. Crrecting Failed Vuchers 1. Click the Edit buttn. 2. Select the claim t edit and click the OK buttn. 3. The claim and reasn fr failure will appear in the next windw. 4. Read the preparatin detail. This explains which vucher has errrs and why. In the example abve, a vucher fr Julie Andrews is missing a required RSN Cde. This can be crrected by editing the vucher in this windw. Nte: Sme vuchers may fail prcessing because infrmatin relating t the patient r practitiner is missing r invalid. In the case where patient r practitiner details require updating, yu must exit the Online Claiming windw t crrect the details befre preparing the batch again. 5. Select the vucher with the errr. Level 4, 201 Pacific Highway, St Lenards, NSW

15 6. Click the Edit buttn Always chse Yes t the prmpt t ensure all items remain n the same vucher Fix the vucher details (by adding an RSN Cde, in the case abve). 7. Press the Vucher buttn t update the vucher. Repeat fr all vuchers with errrs. 8. Repeat steps 2 5 fr all failed claims until all remaining claims prepare successfully. 9. Once all claims have been crrected, repeat the prcess by attempting t prepare and transmit the claims. 10. Press the Next Step buttn t prceed t Step 3 Print Claim Reprts. Step 3 Print Claim Reprts Here yu can print claim reprts which prvide a summary f each claim, including the ttal number f vuchers, ttal amunt claimed, and details f all vuchers included in the claim. Click the Next Step buttn t g t Step 4 Transmit Claims. Step 4 Transmitting Claims All claims prepared (but nt transmitted) shuld have a tick in the bx next t the claim number. The transmissin f claims des nt need t be perfrmed at the same time as they are prepared. If yu decide at this stage that yu d nt wish t send ne f these claims simply remve the tick frm the bx and transmit at a later time. The Clear All buttn allws the de selectin f all the claims. The Cancel buttn allws yu t clse ut f this screen withut transmitting any claims. Select the claims that yu wuld like t transmit and click the Transmit buttn. The Transmit Claims windw appears. Level 4, 201 Pacific Highway, St Lenards, NSW

16 Step 5 Requesting Online Claiming Reprts Click the Request buttn t request claim reprts frm Medicare. The request claim reprts frm Medicare Australia windw will appear. Claims awaiting payment and prcessing reprts will appear in this screen. Claim Type Optins All (shuld always be set t all). Bulk Bill. Veteran Affairs. Reprt Type Optins Prcessing. Payment. Bth Prcessing/Payment Reprts (shuld always be set t Bth Payment and Prcessing). Date Sent Reprts can be requested fr the previus 2 years, by changing the date sent range. I. Place a tick besides all the claims that yu wuld like t request. II. Click the Request buttn. Payment Reprts Are printed fr claims that have been paid by Medicare. These are autmatically receipted ff in PracSft. Will nt be requested fr claims that have nt had their exceptins reslved. Exceptin Reprts Any claims that have exceptins will have reprts printed. These exceptins must be reslved befre the claim can have payment reprts requested. All reprt utput can be examined via View > Payment/Prcessing. Nte: Reprts are requested n the practitiner s payee prvider number in PracSft. If this has been changed they will nt receive payment reprts. Level 4, 201 Pacific Highway, St Lenards, NSW

17 Editing a Vucher Errrs in a vucher must be fixed befre yu can send a batched claim. 1. Select and pen the patient whse vucher yu wish t edit. 2. In the patient's details, select the Visits tab. 3. Select the visit by clicking the assciated visit rw. Once selected, the Edit buttn will becme available. 4. Click the Edit buttn. The Recrd Visit windw appears. 5. Make crrectins t the infrmatin as necessary. 6. Click the Vucher buttn t initiate the claim. Cancelling Claims and Deleting All Visits T cancel a claim and delete all visits: 1. Select Prcessing > Receipt Bulk Payments > Medicare (r Veteran's Affairs). The Select Medicare Claims fr Receipt windw appears. 2. Select the claim yu wish t cancel. 3. Change the amunt payable t 0.00 fr all items within the claim. 4. Click the Save buttn. Yu will be prmpted t cnfirm this actin. Deleting Claims (same day delete) Real time patient claims sent t Medicare Australia can be deleted n the same day that they have been sent. Any deletin must be authrised by the patient/claimant. Same day deletins can nly be perfrmed during Medicare Australia s supprted hurs. Any claim that has been referred t an peratr may nt be available fr immediate same day deletin. Same day delete can nly be used n the same business day the transmissin was sent t Medicare Australia (it cannt be used t delete stred patient claims). Level 4, 201 Pacific Highway, St Lenards, NSW

18 Perfrming a Same Day Deletin 1. Select Prcessing > Online Patient Claiming > Same Day Delete. The Same Day Delete windw appears. This displays patient claims that have been sent t Medicare Australia tday. 2. Select the claim t be deleted by ticking the assciated checkbx. 3. Indicate a reasn fr the deletin via the Reasn drp dwn list. In cases where a claim has been registered in PracSft as having been sent t Medicare Australia, but is nt registered by Medicare Australia (perhaps due t transmissin prblems), select 999 as a reasn fr deletin. This cde will delete the claim in PracSft, but nt send a message t Medicare Australia. This ptin shuld als be chsen if the claim has already been deleted at Medicare Australia. 4. Click the Delete buttn. A request will be sent t Medicare Australia t delete each selected claim. Reslving Exceptins Exceptins must be reslved fr each claim, fr payment reprts t be requested, and fr receipting t ccur. Fr example: If 3 claims are paid n the ne payment reprt, all claims fr that receipt must be reslved befre receipting will ccur. If single claim receipting is ticked, the remaining tw will receipt ff autmatically. 1. Click the Reslve buttn t reslve claims. The Reslving Claim Exceptins windw is divided int tw sectins: Upper: Claims with exceptins. Lwer: The exceptins relating t the claim selected in the upper sectin. Level 4, 201 Pacific Highway, St Lenards, NSW

19 2. Select the claim t reslve in the upper windw. Clicking n the reasn cde exceptin fr that vucher will shw the belw screen. 3. Prceed with ne f the fllwing tw ptins: Accept Exceptins: click the Accept buttn t accept Medicare's exceptin. Fr exceptins returned by Medicare where a partial payment has been made, yu must accept these exceptins yu cannt edit and resubmit them. Resubmit/Edit Exceptins: Click the Resubmit/Edit buttn t edit and resubmit the claim. i. The vucher can then be edited and batched in a subsequent claim. ii. iii. iv. Yu will be prmpted t enter a cmment fr why yu are editing r resubmitting the vucher. It is nt essential t enter a cmment when editing. This cmment des nt get sent t Medicare nly cmments added t the text field f service details within the vucher are sent. Cnfirm that yu wish t edit and resubmit the vucher by clicking the Yes buttn. The Edit Visit frm Claim windw will appear. Make any changes yu think necessary t reslve the exceptin reprted by Medicare Click the Vucher r Claim buttn t cnfirm yur mdificatins Yu will be returned t the Reslving Claim Exceptins windw Click Clse when all exceptins are reslved. Once all exceptins are reslved when clsing the reslve exceptin windw PracSft will autmatically request the payment reprt and receipt the claim. Level 4, 201 Pacific Highway, St Lenards, NSW

20 Displaying the Status f Claims 1. Click the Status buttn. The Status f Transmitted Claims windw will appear. There are 3 types f claim status accessible frm the drp menu: Claims Waiting Prcessing: Claims that have been transmitted but have nt had prcessing reprts (exceptins) returned. Claims Waiting Payment: Claims that have received prcessing reprts but have nt received payment reprts. Claims with Payment reprts waiting Aut Receipting: These are claims fr which yu have received bth prcessing and payment reprts, and are waiting aut receipting. 2. Click the Clse buttn t return t the Request Medicare Results windw. Immunisatin Claims If PracSft is enabled t read ACIR data, yu may imprt and transmit immunisatin claims t ACIR thrugh the nline claiming mdule. 1. Frm the PracSft main screen, select Prcessing > Online Claiming. 2. Yu will be prmpted t imprt the immunisatin data. 3. Click the Yes buttn. These claims will nw appear in 1 Select Claim T Prepare, in the frmat f e.g. A00020 with a $0.00 value. These can be prepared and transmitted as Bulk Bill claims. Refer t the steps fr preparing and transmitting claims. What t d if an immunisatin claim fails preparatin. There are numerus reasns why an immunisatin claim might be rejected. Fr example; Errr 9202 'Culd nt set the vaccine batch number' can ccur if the claim cntains any hyphens, spaces r ther symbls, r is missing a batch cde entirely. Errr 2025 'The maximum number f vuchers already exists fr the claim' can ccur if the claim cntains mre than 20 patients per claim, r mre than 5 services per persn. Level 4, 201 Pacific Highway, St Lenards, NSW

21 Optins fr reslving failed immunisatin claims. 1: Drpping the Immunisatins Claim 2: Mdifying the Immunisatin Claim 3: Releasing the Immunisatin Claim Optin 1: Drpping the immunisatin claim. Right click n the claim and select Drp the Immunisatin Claim frm the menu that appears. Nte: Prir t drpping a claim it advisable t print a list, as this remves the claim frm the list f thse selected fr preparatin. These will need t be sent manually t ACIR r deleted and recreated in Medical Directr. T pint a cpy fllw the steps belw. 1. Select View > Immunisatin Claims. The Claim Histry windw appears. This enables yu t view all the immunisatin claims that have been imprted int PracSft. 2. Click the Print buttn t print a hard cpy f the immunisatin claim selected. Optin 2: Mdifying the immunisatin claim. Right click the claim and select Mdify Claim frm the menu that appears. Frm this windw yu can: Examine the data assciated with the immunisatin, and Delete a prblem immunisatin (status is displayed in the Status clumn). Select the immunisatin and click the Delete buttn. A deleted item will be ignred when yu next prepare the claim, allwing yu t successfully send the remaining immunisatin items within the immunisatin claim. The practitiner shuld be ntified f the issue. He can re recrd the immunisatin in Medical Directr, t be imprted and sent in a new claim, r printed ut and sent manually t ACIR. T restre the deleted immunisatin, select the deleted immunisatin and click the Restre buttn. Level 4, 201 Pacific Highway, St Lenards, NSW

22 Optin 3: Releasing the immunisatin claim. Right click the claim and select Release Claim frm the menu that appears. This releases the immunisatin data fr batching with ther immunisatins n the next imprt. Online Patient Verificatin (OPV) OPV is a system that allws yu t check that the patient s Medicare infrmatin recrded in PracSft matches that as registered with Medicare Australia. Autmatic OPV checking can be activated t ccur when recrding a visit and the Vucher buttn clicked. T activate autmatic OPV in PracSft: 1. Select Setup > User Settings. 2. Select the Online tab. 3. Place a tick in the Perfrm OPV Check checkbx. An OPV can als be perfrmed via the Waiting Rm by right clicking the patient name and selecting OPV Check frm the menu. A pp up will appear t indicate the status f the OPV check. If any errrs appear at this stage, nte the errr number and message befre cntacting HCN Technical Supprt. Level 4, 201 Pacific Highway, St Lenards, NSW

23 Medicare Easyclaim Medicare Easyclaim is a system that allws patients t claim instant Medicare rebates at the practice, via yur Tyr EFTPOS terminal while at the surgery. Yu can prcess Patient Claiming and Bulk Bill via Medicare Easyclaim using PracSft's Integrated Easyclaim functinality. Detailed infrmatin n Medicare Easyclaim can be fund frm the Medicare Australia Easyclaim web site at: Tyr and HCN have develped the first integrated Medicare Easyclaim slutin, which links practice sftware t the EFTPOS/Easyclaim terminal. Other systems currently ffer standalne Medicare Easyclaim thrugh cnventinal EFTPOS terminals. HCN and Tyr have wrked clsely with Medicare Australia and the medical cmmunity t imprve the EFTPOS based Medicare Easyclaim slutin and further capture the needs f the market. The PracSft and Tyr Easyclaim slutin streamlines the billing prcess and negates the need fr re keying infrmatin, saving practice staff valuable time. Please nte that in rder t take advantage f this facility yu will need t btain an EFTPOS / Easyclaim terminal frm Tyr. The minimum Tyr Prductin sftware versin cmpatible with Integrated EFTPOS is The versin infrmatin fr yur installed Tyr sftware can be accessed frm the terminal via Menu > Settings > Terminal Inf. Please cntact Tyr Payment Slutin Sales, n (02) , t enquire abut btaining a Tyr EFTPOS/Easyclaim terminal. If at any time yu have questins abut the terminal r pairing the terminal with PracSft yu can call Tyr Payments helpdesk at the tll free supprt number Tyr Payments' trained staff will assist yu with any questins yu might have abut the terminal. Hw it wrks Accunts paid in full 1. After the patient/claimant pays their accunt (using cash, credit card r EFTPOS), their Medicare card details are autmatically transmitted frm PracSft. 2. PracSft sends the claim details t Medicare Australia fr verificatin. The claim is checked and an apprval is sent back a few secnds later. 3. The patient/claimant then swipes their EFTPOS card thrugh the EFTPOS / Easyclaim terminal, enters their PIN and their rebate is paid int their nminated cheque r savings accunt n the same day. 4. Practice staff give the patient/claimant an EFTPOS receipt t cnfirm their rebate has been paid. Imprtant: Easyclaim rebates can nly be depsited int cheque r savings accunt. Unpaid r partially paid accunts (rebates btained by Medicare Online) 1. Medicare card details are autmatically transmitted frm PracSft. 2. The claim is checked and claim submissin is accepted r declined instantly. A cheque made ut t the health service prvider is psted t the patient/claimant within 14 days. 3. When the patient/claimant receives the cheque, they will send it t the health service prvider alng with any ther utstanding balance payment. Fr bulk billing 1. If the patient is bulk billed, the patient will press a buttn n the EFTPOS keypad t assign their benefit t the health service prvider. N signature is required. 2. The Claim and patient Medicare card details are autmatically transmitted frm PracSft. 3. Claim is checked and apprval is sent within secnds. Fr Large Practice Bulk Bill (ptinal) 1. Patient presents t Receptin and OPV/OCV check is perfrmed. 2. Administrative staff print a DB4 frm and attach it t the patient file if desired. 3. Patient has cnsultatin with the Practitiner wh cmpletes the DB4 frm and has the patient sign. 4. Administrative staff cllect the DB4 frm(s) and prcess claims thrugh Medicare Easyclaim at a later time. Cnsider als Medicare rulings regarding this. Level 4, 201 Pacific Highway, St Lenards, NSW

24 Enabling Medicare Easyclaim An imprtant nte fr Windws 2000 Users: In rder t cnfigure Medicare Easyclaim fr the first time, yu must be lgged int Windws with Administrative privileges, after which yu can lgin as a nn admin user t change the cnfiguratin settings if required. 1. Select Setup > Glbal Settings. The Glbal Settings windw appears. 2. Select the EFTPOS/Medicare Easyclaim tab. 3. Tick the Activate EFTPOS/Medicare Easyclaim Integratin checkbx. 4. (Optinal) If yu are a large bulk bill practice yu must als enable the Display OPV/OCV Check Buttn in Waiting Rm checkbx. The remaining bulk bill vucher functins are ptinal. 5. Click the Save buttn t cntinue. Yu will be prmpted that as this is a Glbal Settings change, it will affect all users. Click the Yes buttn t cntinue saving yur preferences. 6. Yu will be prmpted that in rder t use Medicare Easyclaim yu will need t cnfigure an EFTPOS / Easyclaim terminal fr each wrkstatin. If yur cmputer netwrk des nt use a prxy server t cnnect t the Internet, click the Yes buttn nw and then prceed t Step 7 t cnfigure an EFTPOS / Easyclaim terminal. If yur cmputer netwrk des use a prxy server t cnnect t the Internet, yu must nw cnfigure this befre yu can prceed with enabling Medicare Easyclaim. T d s, click the N buttn nw, and then select Setup > EFTPOS/Medicare Easyclaim > Prxy Settings. The Cnnectin Settings windw appears. Level 4, 201 Pacific Highway, St Lenards, NSW

25 The fllwing ptins are available t select frm: Direct cnnectin t the Internet is applicable t anyne wh des nt use a prxy server. Aut detect prxy settings fr this netwrk retrieves the prxy details frm Windws' Internet Optins. This is the default setting. Manual prxy cnfiguratin is fr users wh wish t specify a prxy server. Selecting this ptin requires the entry f a prxy address and prt. T simplify prxies requiring passwrd authenticatin, Easyclaim autmatically uses the user's Micrsft Windws lgin and passwrd. After yu have cnfigured yur cnnectin settings, select Setup > EFTPOS > Terminal Cnfiguratin, and then cntinue nw t Step The Easyclaim Terminal Cnnectin windw appears. 8. Click the Add Cnnectin buttn. The Cnnect this PC t an EFTPOS Terminal windw appears. Level 4, 201 Pacific Highway, St Lenards, NSW

26 Enter yur Merchant ID. Yur Merchant ID is supplied by TYRO and is accessible via the EFTPOS / Easyclaim terminal by selecting Menu > Settings > Terminal Inf n the terminal. Enter the Terminal ID fr the EFTPOS / Easyclaim terminal cnnected t yur cmputer netwrk. The Terminal ID is supplied by TYRO and is accessible via the EFTPOS / Easyclaim terminal by selecting Menu > Settings > Terminal Inf n the terminal. Each EFTPOS / Easyclaim terminal cnnected t yur netwrk has a unique ID. Create and enter a Terminal Name fr the EFTPOS / Easyclaim terminal. This is usually smething that identifies this EFTPOS / Easyclaim terminal frm thers, e.g. 'FrntDesk'. It is advisable t create a unique name fr each f yur EFTPOS / Easyclaim terminals. (Optinal) Tick the Default Terminal checkbx t indicate that this particular EFTPOS / Easyclaim terminal will be the default used fr Medicare Easyclaim prcessing n this cmputer. This is handy f yu have multiple EFTPOS / Easyclaim terminals n yur netwrk. Yu can change this setting n the fly if yu need t later. 9. On the terminal select Menu > Settings > Authrise POS. Click the Cnnect buttn in PracSft t initiate the cnnectin. PracSft will attempt t make a cnnectin with the EFTPOS / Easyclaim terminal. Once yu have clicked Cnnect, yu will have thirty secnds t authrise the EFTPOS / Easyclaim terminal fr use with PracSft by entering yur admin passwrd (initially supplied by TYRO, but is later user cnfigurable) n the terminal and then selecting 'Yes' when prmpted t reset the current key (this need nly be dne n the first wrkstatin; fr subsequent wrkstatins the key des nt need t be reset). If the Add Cnnectin windw times ut, repeat Steps 8 and 9. Once the first PracSft wrkstatin is paired with yur Tyr terminal, n pairing the remaining wrkstatins yu will be prmpted t reset the key n the Tyr machine. Yu must select n. The nly time yu might select yes is if yu have t re pair a terminal (if fr example yu have installed a new wrkstatin). 10. Upn a successful cnnectin yu will be returned t the Easyclaim Terminal Cnnectin windw, where yur cnnected EFTPOS / Easyclaim terminal nw appears in the list f terminals. 11. Click the Clse buttn t cntinue. The Setup Bank Accunts windw appears. In rder t use Integrated Medicare Easyclaim a Merchant Id needs t be assciated with each bank accunt recrded in PracSft. Level 4, 201 Pacific Highway, St Lenards, NSW

27 12. Click the Yes buttn t setup the bank accunt details. The Bank Accunt Setup windw appears. 13. Select the accunt fr which yu wish t use Medicare Easyclaim, and then click the Edit buttn. The Bank Accunt Details windw appears. 14. Enter the Merchant ID fr this bank accunt. This infrmatin will be prvided t yu via e mail nce yur applicatin has been Credit Checked and apprved by Tyr, and is als available via the EFTPOS / Easyclaim terminal by selecting Menu > Settings > Terminal Inf. Click the Save buttn t cnfirm. 15. Repeat these steps fr each bank accunt yu wish t use Medicare Easyclaim with. Failing t setup each bank accunt's Merchant ID will result in yu being prmpted fr this infrmatin when yu perfrm a receipt fr the practitiner. 16. When yu have cmpleted mdifying bank accunts, click the Clse buttn n the Bank Accunt Setup windw. Pairing Terminals: Once the first PracSft wrkstatin is paired with yur Tyr terminal, n pairing the remaining wrkstatins yu will be prmpted t reset the key n the Tyr machine. Yu must select n. The nly time yu might select yes is if yu have t re pair a terminal (if fr example yu have installed a new wrkstatin). Tyr terminal: T restart yur Tyr terminal, remve and replace the pwer cable. Level 4, 201 Pacific Highway, St Lenards, NSW

28 Claiming with Medicare Easyclaim The fllwing tpics explain hw t prcess different claims with Medicare Easyclaim. Fully paid Patient Claims. Part Paid Patient Claims. Unpaid Patient Claims. Bulk Bill Claims. The fllwing items are nt accepted thrugh Medicare Easyclaim: In hspital items. ACIR infrmatin. Bulk Bill claims mre than 2 years frm date f service. Patient claims mre than 2 years frm date f service. Time duratin dependent items. Ntinal charges. Patient claims pathlgy items excepting grup 9 items. Bulk Bill pathlgy items which are self deemed r rule 3 exemptins. Patient claims and Bulk Bill claims with nn standard referrals. Items where the charge exceeds $9, Department f Veterans' Affairs (DVA) claims. Currently item 105 cannt be claimed mre than nce a day using Medicare Easyclaim. Medicare Australia is cnsidering enhancing the system t allw additinal items t be claimed mre than nce a day using the 'nt duplicate' indicatr. Claims fr Allied Health Wrkers. In the unfrtunate event that Medicare Easyclaim is nt available at the practice the practice needs t issue the patient/claimant an accunt/statement and advise the patient/claimant t ldge their claim thrugh an alternate channel, i.e. at the apprpriate Medicare ffice. Bulk Bill claims need be the cmpleted as with the current existing prcesses. Since Medicare Easyclaim wrks independent frm EFTPOS services, it is pssible that Medicare is available while EFTPOS is nt and vice versa. A nte abut pending transactins: If a transactin/claim des nt have a reprt available frm Medicare Australia after 48 hurs, PracSft presents yu with the fllwing message. At this pint yu can; Cntact Medicare Australia t enquire abut the status, and/r Examine the details f the transactin/claim by selecting View > Pending Transactins Lg Please nte that HCN Technical Supprt cannt assist yu with the status f such transactins/claim; yu must cntact Medicare Australia fr assistance. Level 4, 201 Pacific Highway, St Lenards, NSW

29 Fully paid Patient Claims with Medicare Easyclaim 1. Ensure yu have cnfigured PracSft t use Medicare Easyclaim. 2. With a patient selected in the Waiting Rm, press F5. The Recrd Visit windw appears. 3. Ensure that yu have a selectin in the Seen by Dr. drp dwn list. If yu selected a Practitiner fr the patient via the Waiting Rm, this field will already be ppulated. 4. Ensure that yu have a selectin in the Lcatin drp dwn list. If yu selected a Practitiner fr the patient via the Waiting Rm, this field will already be ppulated. 5. (Optinal) Mdify the Cnsult Time and Cnsult Date using the assciated cntrls, if necessary. 6. Via the Invice T drp dwn list, select Patient. 7. Enter service items as necessary. If yu are unsure f the fee number fr a given item, yu can search the standard item list by pressing Ctrl+S. T add additinal items, click the Add buttn. T delete a service item, select the item and then click the Delete buttn. 8. Fr each Service Item ensure yu select an assciated Fee Rate. T d this, click in the Fee Rate field fr the service item. A drp dwn list f Fee Rates will appear, frm which yu can make the apprpriate selectin. 9. (Optinal) Yu may mdify the fees fr individual items by clicking in the Fee clumn and typing a new amunt. 10. In the Payment Optins sectin f the windw select the Pay Nw radi buttn ptin. 11. In the Payment Details sectin f the windw, select the Full Payment radi buttn ptin. 12. Select a Payment Type via the assciated drp dwn list. 13. Click the Receipt buttn t prcess the payment. The New Patient Claim windw appears. Nte that if the refund methd selected earlier was EFTPOS Aut, the New Patient Claim windw will appear after the Integrated EFTPOS payment has cmpleted. Level 4, 201 Pacific Highway, St Lenards, NSW

30 The Refund Methd f EFTPOS Card will be selected by default. With this ptin selected, the Medicare Easyclaim payment is made autmatically and directly int the claimant's bank accunt. If yu have chsen this ptin, cntinue nw t Step 14. If the EFTPOS Card ptin is greyed ut, Medicare Easyclaim is nt supprted fr this claim select ne f the ther ptins t transmit the claim via Medicare Online r press Cancel t edit the claim. (Optinal) Chse the cheque ptin if the claimant wishes t have the Medicare payment returned t them as a cheque. Enter the residential address details fr the claimant. Alternatively yu can tick the Use Medicare Address checkbx t use the claimant's residential address details as recrded with Medicare Australia. Medicare Online is used fr this type f refund. (Optinal) Chse the EFT ptin if the claimant wishes t have the Medicare payment depsited int a designated bank accunt. Yu must then enter the claimant's BSB Number, Bank Accunt Number and Bank Accunt Name. Funds will be depsited after Medicare Australia has prcessed the claim. Medicare Online is used fr this type f refund. 14. Click the Transmit buttn. The claim is prcessed. If yu have selected the EFTPOS Card refund methd, the claimant will be prmpted t insert their EFTPOS card and enter their PIN. Part Paid Patient Claims 1. Ensure yu have cnfigured PracSft t use Medicare Easyclaim. 2. With a patient selected in the Waiting Rm, press F5. The Recrd Visit windw appears. 3. Ensure that yu have a selectin in the Seen by Dr. drp dwn list. If yu selected a Practitiner fr the patient via the Waiting Rm, this field will already be ppulated. 4. Ensure that yu have a selectin in the Lcatin drp dwn list. If yu selected a Practitiner fr the patient via the Waiting Rm, this field will already be ppulated. 5. (Optinal) Mdify the Cnsult Time and Cnsult Date using the assciated cntrls, if necessary. 6. Via the Invice T drp dwn list, select Patient. 7. Enter Service Items as necessary. If yu are unsure f the fee number fr a given item, yu can search the standard item list by pressing Ctrl+S. T add additinal items, click the Add buttn. T delete a service item, select the item and then click the Delete buttn. 8. (Optinal) Yu may mdify the fees fr individual items by clicking in the Fee clumn and typing a new amunt. 9. (Optinal) Enter a Gap figure fr given Service Items as necessary. This will change the Fee amunt. Yu may als change the Fee amunt which will in turn affect the Gap amunt. 10. Fr each Service Item ensure yu select an assciated Fee Rate. T d this, click in the Fee Rate field fr the service item. A drp dwn list f Fee Rates will appear, frm which yu can make the apprpriate selectin. The image abve indicates that a fee rate f Schedule Fee has been selected fr service item In the Payment Optins sectin f the windw select the Pay Nw radi buttn ptin. 12. In the Payment Details sectin f the windw select the Gap Payment radi buttn ptin. Nte that fr Medicare Easyclaim, gap payments referred t here can be a part payment fr a service and nt necessarily the gap amunt between the Medicare benefit and the amunt charges by the prvider. 13. Select a Payment Type frm the assciated drp dwn list. 14. Click the Receipt buttn t prcess the payment. Level 4, 201 Pacific Highway, St Lenards, NSW

31 Nte that the Cheque refund methd ptin is selected. This is the nly ptin available fr 'Gap' payments. The Medicare payment will be returned t the claimant as a cheque addressed t the health service prvider. 15. Enter the residential address details fr the claimant if necessary. Alternatively yu can tick the Use Medicare Address checkbx t use the claimant's residential address details as recrded with Medicare. 16. Click the Transmit buttn. The claim is prcessed. Nte that if the claim includes items nt supprted by Medicare Easyclaim, the claim will be sent via Medicare Online. The Stre buttn will save the claim t be sent later. Stre and Frward claims are sent via Medicare Online. Unpaid Patient Claims with Medicare Easyclaim 1. Ensure yu have cnfigured PracSft t use Medicare Easyclaim. 2. With a patient selected in the Waiting Rm, press F5. The Recrd Visit windw appears. 3. Ensure that yu have a selectin in the Seen by Dr. drp dwn list. If yu selected a Practitiner fr the patient via the Waiting Rm, this field will already be ppulated. 4. Ensure that yu have a selectin in the Lcatin drp dwn list. If yu selected a Practitiner fr the patient via the Waiting Rm, this field will already be ppulated. 5. (Optinal) Mdify the Cnsult Time and Cnsult Date using the assciated cntrls, if necessary. 6. Via the Invice T drp dwn list, select Patient. 7. Enter Service Items as necessary. If yu are unsure f the fee number fr a given item, yu can search the standard item list by pressing Ctrl+S. T add additinal items, click the Add buttn. T delete a service item, select the item and then click the Delete buttn. Level 4, 201 Pacific Highway, St Lenards, NSW

32 8. Fr each Service Item ensure yu select an assciated Fee Rate. T d this, click in the Fee Rate field fr the service item. A drp dwn list f Fee Rates will appear, frm which yu can make the apprpriate selectin. The image abve indicates that a fee rate f Schedule Fee has been selected fr service item (Optinal) Yu may mdify the fees fr individual items by clicking in the Fee clumn and typing a new amunt. 10. In the Payment Optins sectin f the windw select the Pay Later radi buttn ptin. 11. Click the Accunt buttn t prcess the payment. Nte that the Cheque refund methd ptin is selected. This is the nly ptin available fr 'pay later' payments. The Medicare payment will be sent t the claimant as a cheque addressed t the health service prvider. Nte that if the claim includes items nt supprted by Medicare Easyclaim, the claim will be sent via Medicare Online. The Stre buttn will save the claim t be sent later. Stre and Frward claims are sent via Medicare Online. 12. Enter the residential address details fr the claimant if necessary. Alternatively yu can tick the Use Medicare Address checkbx t use the claimant's residential address details as recrded with Medicare Australia. 13. Click the Transmit buttn. The claim is prcessed. Level 4, 201 Pacific Highway, St Lenards, NSW