If you're bulk billing a patient, you probably know the ropes—Medicare is going to directly pay for the entire invoice. When you process a bulk bill claim in Cliniko, there are a few extra steps that go above and beyond "regular" invoice processing, but don't worry, we'll walk you through all the steps!
Here's what we'll be covering:
- Processing the bulk bill claim.
- Understanding the bulk bill claim form.
- Reviewing the status of that claim.
- Recording a bulk bill payment.
Read on to get started with Medicare bulk billing! (And if you're looking for processing patient claims, rather than bulk bills, head over here.)
Process a bulk bill claim for Medicare
☝️Note: In order to do this, you'll need to have your Cliniko account integrated with Medipass. Learn how to do that here.
To process a bulk bill claim for Medicare, create the patient's invoice as you normally would. After creating it, you'll see that you have the option to bulk bill (below the payment summary):
In order to proceed, you'll need to hit that "Bulk Billing" link next to the Medicare logo. From there, you'll be able to enter claim details (note that if these details already exist in Cliniko, they'll be populated automatically—but you can manually enter/modify anything—more on that below):
When you have all the details included, hit that "Submit claim" button, and that's it—there is no need for you to enter a payment at this point, because the invoice is now awaiting Medicare's approval on this claim.
But, you probably have some questions about all the details you have to fill out when recording that claim. That's covered in the next section! 👇
Understanding the bulk bill claim form
As you'll see, this is a little more intensive than simply processing a "regular" payment in Cliniko. When you start the process for a bulk bill claim, you'll have to ensure that the claim form is being filled out properly!
The practitioner details
This is the person who is going to receive the claim for this service. While the default name is going to be the practitioner who's listed on the invoice, you can hit the "Change" button, and select a different practitioner.
This is where you'll input the patient's details: mobile number (optional), first and last name, date of birth, and Medicare number and reference number.
☝️Note: While you can enter the patient's Medicare details on the claim form itself, you'll need to do this each time—unless you enter the Medicare details into the patient file!
If you edit a patient's details, you'll be able to enter both the Medicare number and the reference number in the General information section:
This will allow these numbers to automatically be pulled into the claim form, meaning you don't need to enter them each time you process a claim for this patient.
When the patient's Medicare details are being pulled in automatically, the claim form would look like this (you'd see the patient details at the top, next to the practitioner details):
This is where you'll include everything about the referral. The referrer type, referring doctor provider number, referral date and referral period are all required fields. You don't need to include the referring doctor's name if you don't want to.
These are the services that are being claimed. This will automatically display what was on the invoice:
But you can edit the services, if need be (including removing and adding items):
This one is pretty self-explanatory, but…you'll need to click the "Submit claim" button to actually submit the claim!
Review a Medicare bulk bill claim's status
When reviewing the invoice after processing the bulk bill, you'll be able to see the details of the claim (including service, amount, and status) right on the invoice page itself page:
As Medicare claims don't happen instantly, you'll see the claim's "pending" status at the bottom of the invoice:
You can also view the claim in Medipass, and easily download/print the Medicare benefit form right from this page! 🖨
You'll also be able to see whether or not a claim has been made if you try to enter a payment again:
That should help to avoid confusion, in case a few different people aren't sure of the invoice's bulk bill status!
Recording a payment from a bulk bill claim
When a claim is approved by Medicare, this will "talk" to Cliniko—meaning that the invoice is basically told, "Hey, this is all good! Claim's approved. 👍"
You'll see that it says "Approved" under the Medicare section of the invoice:
Now, once that claim is approved, the big question is how does the payment get recorded?
If you've set up a Medicare payment allocation in your Medipass settings, the payment will be automatically allocated to the invoice when the claim is approved. 🎉 You won't have to do anything except check the invoice to make sure all looks good!
If you're not sure whether you have a Medicare payment allocation set up, head to Settings → Integrations and take a look at the Medipass section. Your Medicare section should look like this:
☝️Note: It's not required to select a Medicare payment allocation, but if you prefer things to be automated, you might want to consider it! If you don't select a Medicare payment allocation, you'll have to manually record Medicare payments as they come through.
If you want the Medicare payment allocation to say "Medicare", you'll have to add it as a new payment type in your account settings first.
Now, when a claim is approved/paid, you'll be able to view the payment as you would any normal payment—you can view the invoice's related payment, and see the details:
If you don't have a Medicare payment type allocation set up, you'll have to record the payment manually, as you would any other invoice.
What you've just read should help you out when it comes to processing those bulk bill claims—but you may want to know more about other Medicare-related things in Cliniko, or just claiming in general! We recommend checking out the following guides:
- Integrating your Cliniko account with Medipass.
- Processing patient claims for Medicare.
- Processing health fund claims with HICAPS (COMING SOON)
- Troubleshooting problems with Medicare claims (COMING SOON)
Now, while the above walks you through everything from the Cliniko side of things, you may have some questions about your setup in Medipass. You can view their support documentation here!
☝️Note: Medipass offers some different plans; you'll want to ensure that you're signed up for a plan that allows for Medicare claiming. Head here to learn more about the different plans that Medipass offers.
We can certainly help out with any questions you have about Cliniko and Medicare, though. 😊 Send our support team a note via the little "chat" icon in the lower-right, and we'll talk things through!