Submit a claim with Medicare and DVA Webclaims in HPOS

To submit a claim:

1. Select Claims.
2. Select Make a new claim.
3. Select Medicare Patient Claim Webclaim.
4. Select Find a patient and enter your patient’s details.
5. Select Find.
6. Select the Patient then select Next.
7. Enter Claimant details then select Find.
8. Select the Claimant then select Next.
9. Enter Claim details then select Next.
10. Select Assess claim to send the claim for initial assessment.
11. Review Claim summary.
12. Acknowledge the provider declaration and read the privacy note.
13. Select Submit claim.
14. Print Statement of claim and provide a copy to the claimant.

If a claimant hasn’t registered their valid bank account details with us, you’ll get a message asking if the claimant would like to provide their banking details for processing of the claim through Medicare Patient Claim Webclaim.

For privacy and security reasons banking information supplied as part of a Medicare Patient Claim Webclaim can’t be used to update a Medicare record. You should tell claimants to contact Medicare to update their personal details.

For unpaid claims, a Pay Doctor Via Claimant cheque is issued in the next available payment run after the claim is finalised.

To submit a claim:

1. Select Claims.
2. Select Make a new claim.
3. Select Medicare Bulk Bill Webclaim.
4. Select Find a patient and enter your patient’s details then select Find.
5. Fill in your Provider details.
6. 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.
7. Select Assess claim to send the claim for initial assessment.
8. Review Claim details.
9. Print the Assignment of benefit, obtain the patient’s signature and provide a copy to the patient as they are both legislative requirements.
10. 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 and 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 intend to claim from a site without access to the internet you can either complete:

• a manual Assignment of benefit Medicare bulk bill Webclaim form (DB020) prior to the visit
• Bulk bill voucher - electronically transmitted claims form (DB4E).

You’ll need to download and complete the Assignment of benefit Medicare Webclaim form (DB020) and Bulk bill voucher - electronically transmitted claim form (DB4E).

These forms are interactive. Each form has 2 copies, one for the health professional and one for the patient.

If you have a disability or impairment and use assistive technology, you may not be able to access our forms. If you can’t, please contact us. We can help you access, complete and submit them.

When you have access to the internet, you can submit the information on these forms into Medicare Bulk Bill Webclaim in HPOS.

You can use DVA Webclaim to submit Medical and Allied Health services for the treatment of eligible DVA clients.

You can’t use DVA Webclaim if claiming on behalf of a hospital, community nursing facilities and nursing homes.

To submit a claim you need to:

1. Select Claims.
2. Select Make a new claim.
3. Select DVA Webclaim.
4. Select Find a patient and enter your patient’s details.
5. Key in Veteran file number, first name and surname.
6. Tick the Patient consent field.
7. Select Find.
8. Select the Patient then select Next.
9. Select the correct servicing provider Stem and location numbers.
10. Select Yes or No to confirm if payee provider number is the same as servicing provider number. If No, key in the payee provider number.
11. Key in Account reference number and white card clinical text (not mandatory).
12. Select Correct service type and complete all mandatory field identified by asterisks. You can select from 8 service types:
    • General Medical Service
    • Dental Service
    • Optometric Service
    • Specialist Service
    • Allied Health Service
    • Diagnostic Imaging Service
    • Pathology Service
    • Speech Pathology Service.
13. Add another service on same date of service and same patient if required.
14. Add another voucher if same patient, same service provider and a different date of service. You can only add up to 3 vouchers in a claim and 6 services per voucher.
15. Select Assess claim to send the claim for an initial assessment.
16. Review Claim summary and complete additional information if required.
17. Tick the My obligations confirmation box.
18. If the claim states it is ready for submission at the top of the form, select Submit claim.
19. If claim shows status of Pending, we’ll get back to you electronically within 2 days once the assessment is complete.

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.

To access and submit the claim:

1. Select Claims.
2. Select View saved claims.
3. Select the option Medicare Patient Claim Webclaim, Medicare Bulk Bill Webclaim or DVA Webclaim.
4. Select Relevant saved claim.
5. Click Open claim.
6. Enter Missing claim details.
7. Select Assess claim to send the claim for initial assessment.
8. Review Claim details.
9. Acknowledge the provider declaration and read the privacy note.
10. For Medicare Bulk Bill Webclaims, print the Assignment of benefit, obtain the patient’s signature and provide a copy to the patient as they are both legislative requirements.
11. Select Submit claim.
12. Print Statement of claim and provide a copy to the claimant.