You can use Health Professionals Online Services (HPOS) for Child Dental Benefits Schedule (CDBS) services to:
- check your patient’s eligibility and CDBS balance
- confirm claimable Medicare Benefits Schedule (MBS) item numbers through the MBS Item Online Checker
- request provider reports.
You can access this service in HPOS with a Provider Digital Access (PRODA) account. If you don’t have one, register for a PRODA account. Then follow the steps to set up your HPOS access.
To reduce the risk of a claim being rejected you can do these things before starting the consultation.
Checking a patient’s eligibility and balance for the CDBS in HPOS is a 2 step process. First check your patient’s eligibility in HPOS, or using Interactive Voice Recognition, by selecting CDBS from the main menu. If your patient is eligible and has an available balance, select MBS Items Online Checker to confirm that the CDBS item number can be claimed.
You’ll need your patient’s details to before you check, including their:
- Medicare card number
- Individual Reference Number (IRN)
- first name
- date of birth.
Follow these steps to check a patient’s eligibility and cap balance:
- Log in to PRODA to use HPOS.
- From the main menu in HPOS select Child Dental Benefits Schedule.
- Enter your patient’s details.
- If your 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.
Follow these steps to check a patient’s MBS history, to confirm if the appropriate MBS item can be claimed:
- Log in to PRODA to use HPOS.
- from the main menu in HPOS select MBS Items online checker.
- Search for your patients details again.
- Search Provider details by entering your Provider number.
- Search MBS Items by selecting the MBS item number being claimed for your patient.
The HPOS MBS Items Online Checker is available to check the patient’s claiming history. Check their eligibility before 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 is ineligible. CDBS isn’t 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
- benefits that may be payable at the date of enquiry.
Restrictions that apply to a particular tooth can’t be checked through this service. When you claim services for an individual tooth there is a possibility of a payment rejection. If the HPOS MBS Item Online Checker returns as claimable, this doesn’t guarantee your patient is eligible for CDBS.
Dental providers can get their own reports through the HPOS Easyclaim service by following these steps:
- Log in to PRODA to use HPOS.
- 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.