Medicare Online for health professionals

You can lodge patient, bulk bill and Department of Veterans’ Affairs claims, and transfer Australian Childhood Immunisation Register data, via a secure internet connection.

You can lodge patient, bulk bill and Department of Veterans' Affairs claims, and transfer Australian Childhood Immunisation Register data, via a secure internet connection.

What you need to know

Medicare Online cuts paperwork and speeds up payment times. Payments for bulk billed services are deposited directly into your nominated bank account in 2-3 working days.

It also makes it easier for you to help patients claim their Medicare benefit on the spot. Patients can receive their benefit electronically, usually the next working day, by providing their bank account details to us.

If you already have Medicare Online, it's easy to 'switch on' patient claiming in your software. To find out more, contact us or your software vendor.

If you are using Medicare Online for patient claiming, you don't have to ask patients for bank details. Patients register their bank details with us to claim on the spot at the practice.

Key features

Medicare Online:

  • can be used for patient claims and bulk bill claims
  • allows Online Patient Verification and Online Eligibility Verification
  • provides notification of immunisation through the Australian Childhood Immunisation Register
  • is integrated with practice management software
  • requires an internet connection, PC and practice management software
  • no batching required
  • makes payments within 2-3 working days via electronic funds transfer
  • makes payments for patient claims, usually the next working day
  • has secure communication using Public Key Infrastructure (PKI)

Online functionality offered through Medicare Online specific for Department of Veterans' Affairs claims includes:

  • paperless claiming for:
    • medical and pathology
    • in-hospital services, including accommodation, theatre fees and prostheses
    • allied health services
    • community nursing services
  • online checks to see if a patient is known to the Department of Veterans' Affairs

Assignment of benefit documents

Assignment of benefit forms no longer need to be stored at the practice if you are using Medicare Online.

If we need to confirm that the service was provided to a patient, we will seek alternative evidence from you that the service was provided. Evidence may include electronic billing information, notes in practice software appointment records, and, if the practice chooses to retain them, the copy of the assignment of benefit form.

The legislative requirements for the assignment of benefit are:

  • an agreement must be made between the patient (assignor) and you for the assignment of benefit
  • the agreement is 'evidenced' through the use of the assignment of benefit form
  • the patient is required to sign the form
  • a copy of the agreement must be provided to the patient

Department of Veterans' Affairs online claims paperwork submission requirements

If you are using online claiming software that is not Department of Veterans' Affairs paperless-enabled, such as, Client Adaptor Release 4 and earlier, you need to send the paperwork accompanying Department of Veterans' Affairs claims to us.

You can contact your software vendor or the Department of Veterans' Affairs processing enquiries line to confirm the online claiming type and if paperwork should be submitted with the claim.

Medicare digital claiming return codes

When you lodge a claim for Medicare benefits, we use return codes to tell you why the claim was rejected or how the claim was assessed.

Read more about Medicare digital claiming return codes

Further information

Page last updated: 5 February 2016