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ANZ Medicare Easyclaim Operating Manual

Medicare easyclaim merchant
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Merchant Trading Name:
Merchant Identification Number:
Terminal Identification Number:
Medicare Easyclaim
Merchant Operating Guide
ANZ POS TURBO™
MEdicARE EASyclAiM MERchANT SUPPORT: 1300 633 269
179896_Medicare_Merch_op_Guide_74719.indd 1
6/08/10 5:11 PM

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Summary of Contents for ANZ Medicare Easyclaim

  • Page 1 Merchant Trading Name: Merchant Identification Number: Terminal Identification Number: Medicare Easyclaim Merchant Operating Guide ANZ POS TURBO™ MEdicARE EASyclAiM MERchANT SUPPORT: 1300 633 269 179896_Medicare_Merch_op_Guide_74719.indd 1 6/08/10 5:11 PM...

  • Page 2: Table Of Contents

    2.2 Bulk Bill Claims 2.3 Medical Practitioner 3. General information 3.1 Patients and Claimants 3.2 Bank Accounts 3.3 Optional Fields 3.4 Medicare Easyclaim Reference Guide 3.5 Express Claims 3.6 Receipts 3.7 Ineligible Claims 3.8 Terminal-Timeout 3.9 System Unavailability 4. Setting up the Terminal 4.1 Adding Terminal Operator IDs...
  • Page 3 7. Processing Medicare claim Transactions - Specialists 7.1 Paid Patient Claims 7.2 Partially Paid Patient Claims 7.3 Unpaid Patient Claims 7.4 Bulk Bill Claims 8. Processing Medicare claim Transactions – diagnostic Services 8.1 Paid Patient Claims 8.2 Partially Paid Patient Claims 8.3 Unpaid Patient Claims 8.4 Bulk Bill Claims 9.

  • Page 4: Welcome

    Your ANZ Merchant Agreement contains valuable information and important requirements relating to operating procedures. Instructions in this Merchant Operating Guide form part of the ANZ Merchant Agreement and may be varied or replaced by ANZ at any time. 1.2 important contact details for Practitioners ANZ’s Medicare Easyclaim Merchant Support...

  • Page 5: Claim Types

    If a claimant has not received their Medicare rebate processed via Medicare Easyclaim, they should contact the financial institution that issued the EFTPOS card used in the transaction. NOTE: * Call charges apply. 24 hour service. ** Call charges may apply from mobile phones or payphones only.

  • Page 6: Bulk Bill Claims

    2.1.3 Unpaid Patient claim An Unpaid Patient claim exists when a claimant has not paid a medical practitioner’s account. Where Medicare Australia assesses that a rebate is payable, Medicare Australia will issue a statement and a Pay Doctor via Claimant (PDVC) cheque, which is mailed to the claimant’s Medicare address that is recorded with Medicare Australia.

  • Page 7: General Information

    Self Deemed Code, Account Reference Number and Location Specific Practice Number (LSPN). Please refer to your Medicare Easyclaim Reference Guide to view definitions of the above optional fields. The Medicare Easyclaim Reference Guide is included in the Medicare Easyclaim Starter Kit and is available directly from Medicare Australia.

  • Page 8: Receipts

    Medicare Australia approval, the terminal will time-out. When a time-out occurs in this scenario, the terminal will return to the ANZ Idle screen and the claim details will need to be entered again.

  • Page 9: System Unavailability

    Scenario 4 - Bulk Bill If there is no response within approximately 30 seconds to the prompt on the Assign benefits screen, the terminal will time-out. When a time-out occurs in this scenario, the transaction will be cancelled and a ‘Cancelled by Practitioner Receipt’...

  • Page 10: Setting Up The Terminal

    A user ID is required to process Medicare transactions. The user ID is part of the Security mode features of the ANZ EFTPOS terminal. Security mode is used to prevent unauthorised use of the terminal when it is left unattended.

  • Page 11: Modifying Terminal Operator Ids

    ADD NEW OPERATOR Enter Operator Name then press ENTER. OPERATOR NAME ADD NEW OPERATOR Enter Operator ID then press ENTER. USER ID? ADD NEW OPERATOR USER ID? The new Operator is added to the terminal. RECORD ADDED… If another operator is to be added please repeat ADD NEW OPERATOR the previous 3 steps.

  • Page 12: Removing Terminal Operator Ids

    OPERATOR ADMIN 1 ADD OPERATOR Press 4 to select OPERATOR LIST. The terminal 2 MODIFY OPERATOR will print an Operator List. Press CANCEL to 3 REMOVE OPERATOR return to ANZ idle screen. 4 OPERATOR LIST 179896_Medicare_Merch_op_Guide_74719.indd 12 6/08/10 5:11 PM...

  • Page 13: Medicare Admin Functions

    The practitioner is stored in the terminal using their Medicare provider number and their name (maximum of 16 characters). Please note that practitioners will be displayed on the terminal in the order of creation. 01/01/2010 12:08 From the ANZ idle screen, keep pressing SWIPE OR ENTER until the ‘SERVICES’ screen is displayed. INSERT...

  • Page 14: Removing Practitioners

    To delete another practitioner, enter Provider Number then press ENTER. If there are no PROVIDER NUMBER 2 more practitioners to delete, the terminal will print a Service Provider List then return to the ANZ idle screen. 179896_Medicare_Merch_op_Guide_74719.indd 14 6/08/10 5:11 PM...

  • Page 15: Creating Mbs Lists

    After adding or removing a practitioner, the terminal will send the new practitioner details to the Medicare Easyclaim host system and print a Provider Listing. The terminal will automatically contact the host system to retrieve a refreshed list of practitioners. This is required if the new practitioner data is to become available on the terminal, this process may take several minutes.

  • Page 16: Printing Duplicate Medicare Receipts

    To add an additional MBS item, repeat the above 3 steps. If there are no more MBS items MBS ITEM NUMBER 2 to add press ENTER to return to the ANZ idle screen. You can create lists for: • Practitioner Numbers (including servicing, payee, requesting and referring providers) •...
  • Page 17 Select XTRA from the menu by pressing XTRA the CHQ soft-function key. SERVICES 1 MEDICARE EASYCLAIM Press 1 to select MEDICARE EASYCLAIM. 9 ADMIN MEDICARE EASYCLAIM 1 PATIENT CLAIM Select the next screen from the menu 2 BULK BILL CLAIM by pressing the CHQ soft-function key.

  • Page 18: Processing Medicare Claim Transactions - General Practitioners

    NOTE: A Medicare transaction can be initiated by swiping a patient’s Medicare card. In this case, commence at the MEDICARE EASYCLAIM screen. 01/01/2010 12:08 From the ANZ idle screen, keep pressing ENTER SWIPE OR INSERT until the ‘SERVICES’ screen is displayed.
  • Page 19 Enter the number corresponding to the patient PATIENT IRN on the Medicare card then press ENTER. Press 1 if the claimant is the patient, if not press CLAIMANT=PATIENT 1=YES If the claimant is not the patient, the following 2=NO screens will be displayed: If the claimant’s Medicare card number is the same as the patient’s, press ENTER.
  • Page 20 DATE OF SERVICE Press ENTER to accept default date. If a different DDMMYY date is required, press CLEAR to remove default 080208 date then enter correct date in format ddmmyy. CONNECTING TO HOST PLEASE WAIT Enter the MBS Item number then press ENTER. MBS ITEM 1 If you have previously created a list, select the desired MBS Item number from the list.
  • Page 21 APPROVED message outlining the reason. Please refer to the Terminal Error Messages (section 18) in your ANZ Turbo Merchant Operating Guide. If the claim is cancelled, the terminal will print a cancelled claim receipt. Press ENTER to print a claimant copy or CLEAR to return to the start screen.

  • Page 22: Partially Paid Patient Claims

    6.2 Partially Paid Patient claims A Partially Paid Patient Claim exists when a portion of an account of the medical practitioner has been paid. Where Medicare Australia assesses that a rebate is payable, Medicare Australia will issue a statement and a Pay Doctor via Claimant (PDVC) cheque, which is mailed to the claimant’s address that is recorded with Medicare Australia.

  • Page 23: Unpaid Patient Claims

    ITEM OVERRIDE CODE 1 1 N/A Select appropriate item override code from the 2 NOT DUPLICATE list, if no item override code applies press 1. 3 NOT NORMAL A’CARE RESTRICTIVE OVERRIDE CODE 1 N/A If N/A is selected in the previous screen, select 2 SEPARATE SITES the appropriate restrictive override code, if no 3 NOT RELATED...
  • Page 24 Enter the account reference number or just ACCOUNT REF. NO press ENTER. DATE OF SERVICE DDMMYY Press ENTER to accept default date. 080208 CONNECTING TO HOST PLEASE WAIT… Select first MBS ITEM NUMBER. Select PREV or NEXT from the menu by pressing the CHQ or MBS ITEM 1 CR soft-function keys until you locate the MBS ITEM NUMBER.

  • Page 25: Bulk Bill Claims

    It is the medical practitioner’s discretion whether to bulk bill a patient or not. Follow these steps to submit a Bulk Bill claim. 01/01/2010 12:08 From the ANZ idle screen, keep pressing SWIPE OR ENTER until the ‘SERVICES’ screen is displayed.
  • Page 26 CEV REQUEST IND. Press 1 if no concessional entitlement 1 NO verification (CEV) is required. If it is required, 2 YES press 2. Select the provider of the service (e.g. press 1 SERVICE PROVIDER to select [NAME 1]). 1 [NAME 1] Select PREV or NEXT from the menu by 2 [NAME 2] pressing the CHQ or CR soft-function keys...
  • Page 27 Select the Location Specific Practice Number (LSPN) from the list. If there is no LSPN press 1 LSPN 1 to select N/A. If you wish to add a different LSPN, enter 99 and enter the relevant LSPN then press ENTER. If applicable enter or select a second MBS MBS ITEM 2 item number.

  • Page 28: Processing Medicare Claim Transactions - Specialists

    Follow these steps when the claimant has paid their account in full. NOTE: A Medicare transaction can be initiated by swiping a patient’s Medicare card. In this case, commence at the MEDICARE EASYCLAIM screen. 01/01/2010 12:08 From the ANZ idle screen, keep pressing...
  • Page 29 Swipe the patient’s Medicare card or enter the Medicare card number then press ENTER. If PATIENT CARD the patient is not the claimant, swipe the SWIPE CARD OR KEY claimant’s Medicare card or enter the card number then press ENTER. Enter the number corresponding to the PATIENT IRN patient on the Medicare card then press...
  • Page 30 ACCOUNT PAID 1 FULLY PAID Press 1 to select FULLY PAID. 2 PARTIALLY PAID 3 UNPAID Press ENTER to accept default date. If a DATE OF SERVICE different date is required, press CLEAR to DDMMYY remove default date then enter correct date 080208 in format ddmmyy and press ENTER.
  • Page 31 RESTRICTIVE OVERRIDE CODE 1 N/A If N/A is selected in the previous screen, select 2 SEPARATE SITES the appropriate restrictive override code, if no 3 NOT RELATED restrictive override code applies press 1. 4 NOT FOR COMPARISON Select the Location Specific Practice Number (LSPN) from the list.

  • Page 32: Partially Paid Patient Claims

    Please refer to the Terminal Error Messages (section 18) in your ANZ POS Turbo Merchant Operating Guide. If the claim is cancelled, the system will issue a cancelled claim receipt.
  • Page 33 Enter the account reference number or just ACCOUNT REF. NO press ENTER. Press ENTER to accept default date. If a DATE OF SERVICE different date is required, press CLEAR to DDMMYY remove default date then enter correct date in 080208 format ddmmyy and press ENTER.

  • Page 34: Unpaid Patient Claims

    RESTRICTIVE OVERRIDE CODE 1 N/A If N/A is selected in the previous screen, select 2 SEPARATE SITES the appropriate restrictive override code, if no 3 NOT RELATED restrictive override code applies press 1. 4 NOT FOR COMPARISON Select the Location Specific Practice Number (LSPN) from the list.
  • Page 35 Press ENTER to accept default date. If a DATE OF SERVICE different date is required, press CLEAR to DDMMYY remove default date then enter correct date in 080208 format ddmmyy and press ENTER. Enter the referring provider number and press REFERRING PROV.

  • Page 36: Bulk Bill Claims

    It is the medical practitioner’s discretion whether to bulk bill a patient or not. Follow these steps to submit a Bulk Bill claim. 01/01/2010 12:08 From the ANZ idle screen, keep pressing ENTER SWIPE OR INSERT until the ‘SERVICES’ screen is displayed.
  • Page 37 MEDICARE EASYCLAIM Press 2 to select BULK BILL CLAIM. Press 4 to 1 PATIENT CLAIM select BULK BILL EXPRESS (for more 2 BULK BILL CLAIM information on Express Claims, please refer to 3 PATIENT EXPRESS section 3). 4 BULK BILL EXPRESS...
  • Page 38 REF. OVERRIDE TYPE If no referring provider number was entered in 1 NOT REQUIRED the previous screen, select the number that 2 LOST represents the REF. OVERRIDE TYPE. 3 EMERGENCY REF. ISSUE DATE If REFERRING PROV. NO is NOT N/A, Select Ref. DDMMYYYY Issue Date and press ENTER.

  • Page 39: Processing Medicare Claim Transactions – Diagnostic Services

    NOTE: A Medicare transaction can be initiated by swiping a patient’s Medicare card. In this case, commence at the MEDICARE EASYCLAIM screen. 01/01/2010 12:08 From the ANZ idle screen, keep pressing ENTER SWIPE OR INSERT until the ‘SERVICES’ screen is displayed.
  • Page 40 CLAIM TYPE 1 GENERAL PRACTICE 2 SPECIAL/AH/DENTAL Press 3 to select DIAGNOSTIC. 3 DIAGNOSTIC Swipe the patient’s Medicare card or enter the Medicare card number then press ENTER. If the PATIENT CARD patient is not the claimant, swipe the claimant’s SWIPE CARD OR KEY Medicare card or enter the card number then press ENTER.
  • Page 41 PAYEE PROVIDER 1 N/A Press 1 if the payee provider is also the 2 [NAME 2] practitioner who provided the service. If not, 3 [NAME 3] select the payee provider from the list (e.g. 4 [NAME 4] press 2 to select [NAME 2]). PREV NEXT ACCOUNT PAID...
  • Page 42 RESTRICTIVE OVERRIDE CODE 1 N/A If N/A is selected in the previous screen, select 2 SEPARATE SITES the appropriate restrictive override code, if no 3 NOT RELATED restrictive override code applies press 1. 4 NOT FOR COMPARISON Select the Location Specific Practice Number (LSPN) from the list.

  • Page 43: Partially Paid Patient Claims

    APPROVED message outlining the reason. Please refer to the Terminal Error Messages (section 18) in your ANZ POS Turbo and ANZ POS Mobile Merchant Operating Guide. If the claim is cancelled, the system will issue a cancelled claim receipt.
  • Page 44 ACCOUNT PAID 1 FULLY PAID Press 2 to select PARTIALLY PAID. 2 PARTIALLY PAID 3 UNPAID Enter the account reference number or ACCOUNT REF. NO just press ENTER. Press ENTER to accept default date. If a DATE OF SERVICE different date is required, press CLEAR to DDMMYY remove default date then enter correct 080208...

  • Page 45: Unpaid Patient Claims

    RESTRICTIVE OVERRIDE CODE If N/A is selected in the previous screen, 1 N/A select the appropriate restrictive 2 SEPARATE SITES override code, if no restrictive override 3 NOT RELATED code applies press 1. 4 NOT FOR COMPARISON Select the Location Specific Practice Number (LSPN) from the list.
  • Page 46 The claimant is then responsible for forwarding the cheque, with any outstanding amount, to the medical practitioner. Repeat the steps in section 8.1 until you reach the ACCOUNT PAID menu. ACCOUNT PAID 1 FULLY PAID Select 3 for Unpaid. 2 PARTIALLY PAID 3 UNPAID Enter the account reference number or just ACCOUNT REF.

  • Page 47: Bulk Bill Claims

    RESTRICTIVE OVERRIDE CODE 1 N/A If N/A is selected in the previous screen, select 2 SEPARATE SITES the appropriate restrictive override code, if no 3 NOT RELATED restrictive override code applies press 1. 4 NOT FOR COMPARISON Select the Location Specific Practice Number (LSPN) from the list.
  • Page 48 01/01/2010 12:08 From the ANZ idle screen, keep pressing SWIPE OR INSERT ENTER until the ‘SERVICES’ screen is displayed. CARD SERVICES Select XTRA from the menu by pressing the XTRA CHQ soft-function key. SERVICES 1 MEDICARE EASYCLAIM Press 1 to select MEDICARE EASYCLAIM.
  • Page 49 Select the provider of the service (e.g. press 1 SERVICE PROVIDER to select [NAME 1]). 1 [NAME 1] Select PREV or NEXT from the menu by 2 [NAME 2] pressing the CHQ or CR soft-function keys until 3 [NAME 3] you locate the provider of the service.
  • Page 50 RESTRICTIVE OVERRIDE CODE 1 N/A If N/A is selected in the previous screen, select 2 SEPARATE SITES the appropriate restrictive override code, if no 3 NOT RELATED restrictive override code applies press 1. 4 NOT FOR COMPARISON Select the Location Specific Practice Number (LSPN) from the list.

  • Page 51: Processing Medicare Claim Transactions –Pathology Services

    It is the medical practitioner’s discretion whether to bulk bill a patient or not. This section illustrates the steps to process Bulk Bill claims for Pathology Clinics. 01/01/2010 12:08 From the ANZ idle screen, keep pressing ENTER SWIPE OR INSERT until the ‘SERVICES’...
  • Page 52 Enter the number corresponding to the patient PATIENT IRN on the Medicare card then press ENTER. CEV REQUEST IND. Press 1 if a concessional entitlement 1=NO verification (CEV) request is required. If not, 2=YES press 2. Select the provider of the service (e.g. press 1 SERVICE PROVIDER to select [NAME 1]).
  • Page 53 ITEM OVERRIDE CODE 1 1 N/A Select appropriate item override code from the 2 NOT DUPLICATE list, if no item override code applies press 1. 3 NOT NORMAL A’CARE RESTRICTIVE OVERRIDE CODE 1 N/A If N/A is selected in the previous screen, select 2 SEPARATE SITES the appropriate restrictive override code, if no 3 NOT RELATED...

  • Page 54: Medicare Receipts

    10. Medicare Receipts 10.1 Fully Paid Medicare Easyclaim Patient claim This is an example of a fully paid Medicare Easyclaim patient claim receipt. 179896_Medicare_Merch_op_Guide_74719.indd 54 6/08/10 5:11 PM...
  • Page 55 10.2 Unpaid / Partially Paid Medicare Easyclaim Patient claim This is an example of a partially paid Medicare Easyclaim patient claim receipt. The receipt for an unpaid or pended claim will contain the same information. 179896_Medicare_Merch_op_Guide_74719.indd 55 6/08/10 5:11 PM...
  • Page 56 10.3 Pended Medicare Easyclaim Patient claim This is an example of a pended Medicare Easyclaim patient claim receipt. 179896_Medicare_Merch_op_Guide_74719.indd 56 6/08/10 5:11 PM...
  • Page 57 10.4 cancelled Medicare Easyclaim Patient claim 179896_Medicare_Merch_op_Guide_74719.indd 57 6/08/10 5:11 PM...
  • Page 58 10.5 Medicare Easyclaim Bulk Bill claim This is an example of a receipt for Medicare Easyclaim Bulk Bill claim. 179896_Medicare_Merch_op_Guide_74719.indd 58 6/08/10 5:11 PM...
  • Page 59 10.6 cancelled Medicare Easyclaim Bulk Bill claim This is an example of a receipt issued when the patient declines a Medicare Easyclaim Bulk Bill claim. 179896_Medicare_Merch_op_Guide_74719.indd 59 6/08/10 5:11 PM...
  • Page 60 10.7 Error Receipt This is an example of an error receipt for Medicare Easyclaim. The message displayed will vary depending on the Error code. 179896_Medicare_Merch_op_Guide_74719.indd 60 6/08/10 5:11 PM...
  • Page 61 Merchant Operating Guide form part of your Merchant Agreement and may be varied or replaced by ANZ at any time. 179896_Medicare_Merch_op_Guide_74719.indd 61 6/08/10 5:11 PM...
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