Claim Screen - Patient Details

Family Name

As per the Medicare Card. Maximum of 40 characters long.

First Name

Where a patient has only one name, that name should appear in the Family Name field and the word "Onlyname" be entered in the First Name field. Maximum of 40 characters long.

Gender

The options are:

• Male
• Female
• Indeterminate
• Unknown or inadequately described

Medicare Number

This is the patients Medicare Card Number. Maximum of 10 characters maximum.

Medicare Ref No.

This is the patients Medicare Reference Number. This number appears to the left of the patients name on their Medicare card. It is one (1) character and can not be a zero (0).

Alias First Name

Is the patient's First Name as known to the Provider for DVA if different to that known by Medicare (or DVA). Maximum of 40 characters long.

Alias Family Name

Is the patient's Family Name as known to the Provider for DVA if different to that known by Medicare (or DVA). Maximum of 40 characters long.

Lodge Claim

To enable the Lodge Claim button to be enabled the user must type CONFIRM.

This is a requirement to have the claim be lodged akin to having to sign it. It is a way of acknowledging that this claim has been purposely put through. This can be done on any of the claim screens.