Find a patient using HPOS

A guide to using HPOS to verify patient Medicare details.

Multiple patient verification requests - from 8 September, the maximum number of multiple patient verification checks allowed will be 50 patient checks per request upload. The existing limit of one upload request per day will remain.

Who can use the service

The find a patient service allows providers and practice staff to search and immediately confirm:

  • patient Medicare numbers
  • concessional eligibility, and
  • patient details

It saves time because you don’t need to call us to confirm these details.

You need a Provider Digital Access (PRODA) account or site certificate to access and verify patient details using HPOS. If you can’t use PRODA, please contact the eBusiness Service Centre for assistance.

Confirming patient details

To confirm patient details, type in the patient’s Medicare card number, Individual Reference Number (IRN) and first name. HPOS confirms these details and the Medicare card number, IRN and patient’s first name is displayed on the screen.

HPOS will tell you if the first 9 digits of the Medicare number and the patient's first name match. This feature helps you find the patient even if you make:

  • issue number errors, for example if the 10th digit of the Medicare number is incorrect
  • IRN errors
  • minor spelling errors in the patient's first name

If there’s a mismatch between the patient’s first name and the IRN fields, HPOS shows the IRN linked to the name.

The date of birth field helps you identify the correct patient. If two patients on the card have the same name - for example, the father and son are both called John - use the date of birth to confirm the patient's details.

How to confirm patient details

  • Select the find a patient tile
  • Select Medicare card details from the use dropdown menu
  • Enter patient details using Medicare data
  • Note that by accessing this service you’re confirming that you have obtained the patient’s consent to search for or confirm their Medicare card details for claiming purposes only. You also agree to maintain the confidentiality of the information you obtain as outlined in HPOS’s terms of use
  • Select the declaration check box to declare the search is for claiming purposes only
  • Select find
  • The results table will display the patient’s Medicare details. The system will prompt you if you need to update your records
  • From the results table select next to view the patient’s profile page
  • From the patient’s profile page, select either:
    • claims to create a new Medicare bulk bill webclaim or Medicare patient claim webclaim for the patient, or
    • confirm to verify a patient’s concessional entitlement status

Searching a patient’s details

When a Medicare card number is unavailable, you can enter personal information to search for a patient. Use the optional fields to refine your search if the system can’t find a unique match on a patient.

The mandatory fields used for searching are:

  • surname/family name
  • first name
  • date of birth

The optional fields are:

  • if the patient is legally known only by one name
  • postcode
  • locality or suburb

When HPOS finds a unique match, it will only display the patient’s Medicare card number, IRN and first name.

It’s important to note:

  • if HPOS finds a unique match but the first name on the Medicare card is different, HPOS will advise that it identified differences and will ask you to check the information and update your records
  • if your patient is on more than one Medicare card HPOS will be unable to confirm a match

If HPOS indicates that it can’t find a record it means a unique record couldn’t be identified. It doesn’t mean the person is not enrolled or not eligible for Medicare.

Contact our Medicare provider enquiries line if you can’t find a match. We have access to more fields that may help identify your patient in the system.

How to search patient details

  • Select the find a patient tile
  • Select patient name and date of birth from the use dropdown
  • Note that by accessing this service you’re confirming that you have obtained the patient’s consent to search for or confirm their Medicare card details for claiming purposes only. You also agree to maintain the confidentiality of the information you obtain as outlined in HPOS’s terms of use
  • Enter patient details using patient's name and date of birth
  • Select the declaration check box to declare the search is for claiming purposes only
  • Select find
  • The results table will display the patient’s Medicare details. The system will prompt you if you need to update your records
  • From the results table select next to view the patient’s profile page
  • From the patient’s profile page select either:
    • claims to create a new Medicare bulk bill webclaim or Medicare patient claim webclaim for the patient, or
    • confirm to verify a patient’s concessional entitlement status

Multiple patient verification requests

Using multiple patient verification requests, you can:

  • search and confirm multiple patient details in a single request
  • search and confirm up to a maximum of 50 patients in a request upload

You’ll get the results in your HPOS inbox within 24 hours. You can only submit one request per day.

In certain circumstances an exemption to the maximum daily limit may be granted.

How to submit a multiple patient verification request

  • Select menu
  • Select multiple details request
  • Note that by accessing this service you are confirming that you have obtained the patient’s consent to search for or confirm their Medicare card details for claiming purposes only. You also agree to maintain the confidentiality of the information you obtain as outlined in HPOS’s terms of use
  • Download and complete the multiple details request template file. We recommend you save this file to your computer
  • Select browse and find your saved the file
  • Select the declaration check box to declare the search is for claiming purposes only
  • Select upload to upload the file

Concessional verification service

You can use HPOS to confirm that a patient is eligible for concessional Medicare services.

Concessional patients must hold or be listed on a Commonwealth concessional card at the date of service. We base patient’s concessional entitlement eligibility on the information we hold at the time the check is completed.

How to confirm a patient’s concessional status

  • Search the patient’s details in the find a patient service
  • Note that by accessing this service you are confirming that you have obtained the patient’s consent to search for, or confirm their Medicare card details for claiming purposes only. You also agree to maintain the confidentiality of the information you obtain as outlined in the HPOS terms of use.
  • From the results table select next to view the patient’s profile page
  • Select the concessional entitlement tab on the left hand menu
  • Enter date of service
  • Tick the declaration box to declare the search is for verification and claiming purposes only
  • Select verify

The check will return:

  • the date of service
  • a concessional entitled result of Yes or No, and
  • the verification receipt number

You can use the verification receipt number to contact us about the verification results.

You can print the concessional entitlement verification results.

Page last updated: 29 August 2018