Submitting Medicare Bulk Bill Webclaims using HPOS

A guide to help health professionals submit Medicare bulk bill claims electronically for real time assessment through HPOS.

Medicare Bulk Bill Webclaim is an online claiming channel that can be accessed using HPOS. It enables easier processing of Medicare claims which results in less resubmissions and faster payment times.

You must have access to the internet and a printer to be able to complete your claims using HPOS. It does not require specific software.

You must have an individual PKI certificate to be able to manage your Medicare Bulk Bill Webclaims through HPOS. PKI certificates ensure that information you submit through our online services is secure. Read more about PKI certificates, including how to get one.

What you can claim

All Medicare eligible items rendered in-hospital and out-of-hospital can be claimed using Medicare Bulk Bill Webclaim including:

  • General Medical Services
  • Dental Services
  • Optometric Services
  • Specialist Services
  • Allied Health Services
  • Diagnostic Imaging Services
  • Pathology Services

Submitting a Medicare Bulk Bill Webclaim

Once you have lodged your claim, you will get an immediate response. Submitted claims will return a status of either 'Paid' or 'Requires Further Assessment'. A claim ID is automatically generated when a claim is submitted and can be identified by the + symbol.

Medicare Bulk Bill Webclaim will save the last service type you entered to assist you with lodging your claims. You can also begin your claims and finalise them at a later time.

Notional charges cannot be entered in a Medicare Bulk Bill Webclaim. You must enter a benefit assigned amount against each service.

Submitting a claim

  • select Claims
  • select Make a new claim
  • select Medicare Bulk Bill Webclaim
  • select Find a patient, and enter your patient's details, select Find
  • fill in your provider details
  • select the appropriate service type, and enter the claim details. You can select from 7 service types:
    • General Medical Service
    • Dental Service
    • Optometric Service
    • Specialist Service
    • Allied Health Service
    • Diagnostic Imaging Service
    • Pathology Service
  • select Assess Claim to send the claim for initial assessment
  • review claim details
  • print the Assignment of benefit, obtain the patient's signature and provide a copy to the patient as they are both legislative requirements
  • select Submit Claim

Medicare Bulk Bill Webclaim allows you to submit:

  • one patient per claim
  • a maximum of 3 Assignments of benefit per claim. Each Assignment of benefit can be for a different service type
  • each Assignment of benefit can have a maximum of 14 items
  • all items on an Assignment of benefit must have the same date of service except Pathology services

If you have made an error in a submitted claim, you cannot delete the claim in HPOS, but you can call the Medicare provider line to delete the claim.

Once you have entered patient details, you can save a claim at any stage in the process.

Finalising a claim after saving

Saved claims that have not been finalised will be deleted after 30 days. Where edits are saved the 30 days period begins again. The claim ID will remain the same.

  • select Claims
  • select View saved claims
  • select Medicare Bulk Bill Webclaim
  • select relevant saved claim
  • click Open claim
  • enter missing claim details
  • select Assess Claim to send the claim for initial assessment
  • review claim details
  • print the Assignment of benefit, obtain the patient's signature and provide a copy to the patient as they are both legislative requirements
  • select Submit Claim

Specialists Claims

Any procedure contained in MBS Category 3 must be claimed as a Specialist Service.

If there is more than one anaesthetic service performed on the same date of service, separate Assignment of benefit forms must be completed for each anaesthetic service group.

The 'Number of patients seen/field quantity' field can be used to advise the number of units required for nerve block services.

Claims referred to us for further assessment

For services that require more information for assessment, a return message will occur advising which field requires more information and where necessary, additional fields will open. As long as all other details in the claim are correct, Medicare Bulk Bill Webclaim will allow you to submit a claim with additional information for further assessment.

Claims sent for further assessment will generally be processed within 2 business days.

Claiming if you do not have immediate access to the internet or a printer

If you intend to claim from a site without access to the internet you can print a manual Assignment of benefit form prior to the visit. This Assignment of benefit form allows you to record the claim and patient details, obtain the patients signature and give a copy to the patient. When you have access to the internet you can transfer the information into Medicare Bulk Bill Webclaim in HPOS.

Completing a manual Assignment of benefit form

  1. Only one patient is allowed per form.
  2. check date of service is before Medicare card expiry date – indicate with an X in the Expiry Date Checked box.
  3. complete patient details and all other fields that relate to the service provided.
  4. The Practitioner use box must indicate where required name of hospital, emergency, lost referral, time of service, information about anesthetists or service duration.
  5. Patient must sign the Assignment of benefit form after the service has taken place and the form has been completed (legislative requirement).
  6. If the patient is unable to assign their right to benefit to the servicing provider, tick the box beside Patient is unable to sign. An explanation should be given as to why the patient was unable to sign in the relevant box.
  7. A copy of the Assignment of benefit form must be provided to the patient (legislative requirement).
  8. When an internet connection is available, access HPOS and Submit a Medicare Bulk Bill Webclaim.

Accessing Payment Reports

A payment report will be available 1 business day after your claim has been finalised. You do not need to subscribe to receive the reports, they will be sent to you through Messages.

Processing time

When a Medicare Bulk Bill Webclaim is submitted successfully and no manual assessment is required, the claim will be processed and paid within 1 business day.

You must have your bank account details(HW052) registered with us in order to receive payment.

Service availability

Medicare Bulk Bill Webclaim is not available for claim submission between 11:30pm and 12:30am. You can still enter in the service details during this time and save them for submission at a later time.

Page last updated: 27 October 2016

This information was printed Sunday 4 December 2016 from humanservices.gov.au/health-professionals/enablers/submitting-medicare-bulk-bill-webclaims-using-hpos It may not include all of the relevant information on this topic. Please consider any relevant site notices at humanservices.gov.au/siteinformation when using this material.