A guide to help health professionals use HPOS to check patient eligibility and cap balances and generate bulk bill reports for Child Dental Benefits Schedule (CDBS).
You can use HPOS for CDBS services to:
- check your patients eligibility and CDBS balance
- confirm claimable MBS item numbers through the MBS Item Online Checker
- request provider reports
To reduce the risk of a claim being rejected you can do these things before starting the consultation.
You must have an individual PKI certificate to access CDBS services 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.
Checking your patient's eligibility and balance for CDBS
Checking a patient's eligibility and balance for the CDBS in HPOS is a 2 step process. Firstly check your patient's eligibility in HPOS, or via Interactive Voice Recognition, by selecting CDBS from the main menu. If your patient is eligible and has an available balance, you then select MBS Items Online Checker to confirm that the CDBS item number can be claimed.
Step 1 search for your patient's details
To check a patient's eligibility and cap balance:
- select Child Dental Benefits Schedule from the Main Menu in HPOS
- enter your patient's details. You can enter:
- Medicare card number
- Individual reference number (IRN)
- first name
- date of birth
- if the patient is eligible, HPOS will return a 'Yes the patient is eligible' message, the Medicare card number, IRN, first name, available cap balance and the date of inquiry
Step 2 search a patients MBS history in the HPOS MBS Items Online Checker
To check a patient's MBS history, you need to check if the appropriate MBS item can be claimed. You can do this by checking their history:
- select MBS Items Online Checker from the Main Menu in HPOS
- search for your patients details again
- search Provider details by entering your Provider number
- search MBS Items by selecting the appropriate MBS item number being claimed for your patient
The HPOS MBS Items Online Checker is available to check the patient's claiming history for potential claiming eligibility prior to submitting a claim to us. These results are also available in real time, however some dental items are time dependent. For example, some items can only be billed once every 6 months. If a time dependent item number is billed and the patient visits another dentist within a 6 month period, then the item would be ineligible. CDBS is not restricted to the dentist who provided the initial service.
Results provided within the HPOS MBS Item Online Checker are based on a patient's claiming history and are indicative only of the benefits that may be payable at the date of enquiry. Restrictions that apply to a particular tooth cannot be checked through this service and when claiming services for the individual tooth there is a possibility of a rejection of payment. If the HPOS MBS Item Online Checker returns as claimable, this does not guarantee that your patient is eligible for CDBS.
Request provider reports
Dental providers can obtain their own provider reports through the HPOS Easyclaim service by:
- select Medicare Services from the main menu in HPOS
- select easyclaim processing reports or easyclaim payment reports
- add required details, select search
- results will launch in a new window