What can you claim with Medicare Easyclaim?

This article outlines which items cannot be claimed using Medicare Easyclaim. Medicare Easyclaim allows patients to use your practice's EFTPOS terminal to claim their Medicare benefit and have it paid directly into their bank account.

Visit the Services Australia website to learn more about Medicare Easyclaim.

IMPORTANT   Interactive Patient Claims can only be sent within six months of the date of service. If the claim falls outside this period, please direct the patient to claim this service with Medicare directly.

How does Medicare Easyclaim work with Bp Premier?

Integrated EFTPOS

This function allows you to transmit payment amounts from the Bp Premier payment screen directly to the EFTPOS terminal. Front desk staff are not required to re-enter payment amounts into the EFTPOS terminal. Patients can pay via debit or credit card.

Integrated Medicare Easyclaim

For accounts paid in full, administrative staff can send the claim to Medicare Australia for verification. Approval is received in seconds. If the claim is approved by Medicare, the patient will be prompted by the EFTPOS terminal to swipe their EFTPOS card through the terminal. The rebate will then be paid into the patient’s bank account in 11 seconds.

Accounts can be paid in full by patients using any payment method: credit, cash, or EFTPOS. However, only cards that link to a Savings or Cheque account are accepted for Medicare Easyclaim rebates. These rebates cannot be made to a credit card account. Patients may need to a different bank card to claim their rebate to the card used to pay their account.

For accounts where a gap payment or a part payment is made, administrative staff will still have the option to send the claim to Medicare Australia for verification. However, gap and part payments will result in a pay doctor cheque being sent to the patient. The patient must bring the cheque into the practice to cover the outstanding amount.

Which items cannot be sent via Easyclaim?

Some medical services cannot be claimed using Medicare Easyclaim:

• services for veterans, Department of Veterans' Affairs claims
• in-hospital services
• bulk bill claims more than 2 years from date of service
• patient claims more than 2 years from date of service
• multiple attendance items (where number of patients > 1)
• services requiring service text or notes
• services that are time dependent
• services with separate sites (unless you enter a restriction override code)
• services with non-standard referrals
• services for assisted reproductive technology
• derived fee items
• complex pathology.

However, these services can be claimed through other claiming channels, such as Medicare patient claiming.

For more information on EasyClaim and which services cannot be paid, review the Department of Human Services information on Medicare EasyClaim.

Last updated: 12 December 2023.