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Quick Reference Guide

This stepthrough article is for practices that process direct bill and private practice claims by EasyClaim through a Tyro terminal, and describes how to:

1. Activate EasyClaim for direct bill and private practice accounts.
2. Process an invoice through EasyClaim.
3. Review sent EasyClaims and resend unsent claims.
4. Correct and resubmit an EasyClaim.
5. Troubleshoot some common errors that may occur during online patient claiming.

The steps in this article assume that you have set up all of your minor IDs, installed your Medicare certificates, and tested that online patient claiming and Tyro work for your Bp Premier installation. If you have not set this up already, see the following articles for more information:

• Set up Online Claiming for single Minor ID
• Set up Online Claiming for multiple Minor IDs
• Configuring Medicare Certificates
• Configure Tyro
• Configure Tyro for Direct Billing

Enable Medicare Easyclaim through the Bp Premier configuration screen.

1. Log in to the Bp Premier server as a user with administrator permissions.
2. Select Setup > Configuration from the main screen. Select the Online claiming tab.



3. From the list of check boxes at the top of the screen, select:

Activate Tyro Integrated EFTPOS	Always tick this option to use your Tyro terminal to process EasyClaims.
Activate Easyclaim Private Patient Claiming	Tick this option if your practice will be sending private practice claims by EasyClaim.
Always send private patient claims by best available method	Tick this option to default the Payments screen to: Send via Patient Claiming if Easyclaim is not configured. Send via Easyclaim if Activate Easyclaim Private Patient Claiming is also selected here.
Activate EasyClaim Bulk Bill claiming	Tick this option if your practice will be sending Direct Bill (bulk bill) claims by EasyClaim.

Bulk Bill Easyclaims make it possible to bulk bill a patient and send their claim to Medicare via Tyro without having to batch the invoice. You also do not have to print the DB4 forms when using Tyro Bulk Bill Easyclaims. A patient assigns the right to the practice to claim on their behalf by answering a question on the Tyro terminal.

If the Easyclaim button does not appear, the account may have services or service details that cannot be processed through Easyclaim, or Tyro may not be configured correctly. See Which items cannot be sent via Easyclaim? for more information.

DVA Direct Bill accounts cannot be processed via Easyclaim.

Process a Direct Bill Easyclaim

Tyro bulk bill Easyclaims can be processed and claimed directly from the Account Details screen. You do not need to pay the account from the Payment Details screen first, or batch for sending.

1. After the doctor has finalised the visit, open the account from the appointment book.
2. Select Medicare Direct Bill from the Bill to: drop-down.

The Pay Now button will become the Easyclaim button.



3. Click Easyclaim. The Tyro Medicare EasyClaim screen will appear while the claim is being processed, and will report the outcome of the claim:

What do I do next?

Regardless of Approved, Cancelled, or Rejected, Bp Premier will return to the Account Details screen. If the claim was approved, you can exit from this screen.

Just like Online Batches, the practice is paid for the service via Medicare overnight. Bp Premier is not updated until you run the Check for Payments process. For Tyro Bulk Bill Easyclaim, run the Check for Payments from the Tyro Transactions screen. You can also use this screen to review any rejections.

Depending on the reason for rejection, you may be able to send the claim again via Easyclaim, Batched Direct Bill, or Patient claiming. Try a different payment method, or wait a short while and click Easyclaim again to reprocess the payment.

The Tyro Transactions screen can be used to review any rejections and resubmit via an Online Batch or have the patient pay privately.

NOTE  Medicare Easyclaim has a 5 minute delay before you can resend the claim to Medicare. You can wait 5 minutes or send the claim via Batched Direct Bill or Private Patient Claiming.

Easyclaims patient claiming is used when a patient fully or partly pays a private invoice and the claim is submitted to Medicare via the Tyro terminal. When a patient pays through the Integrated Tyro solution, payment and claim are submitted one after the other in real time. Tyro payments are processed from the Payment Details screen like any other payment.

The following steps assume that the patient is paying the full amount. If the patient is only paying part of the full amount, see the next panels.

1. After the doctor has finalised the visit, open the account from the appointment book.
2. Select Patient from the Bill to: menu.
3. Click Pay now. The Payment details screen will appear.
4. Click in the payment method the patient is using: Cash, EFT, Credit Card, Direct Credit, or Cheque total. If you select EFT or Credit Card, the Use Tyro checkbox will appear and will be ticked automatically.
5. You only need to change the MID from the default if you are depositing the payment into another provider's account. For almost all transactions you do not need to change this field.
6. Tick Pay full amount at the top of the screen. Bp Premier will enter the amount owing into the selected payment method and the Payment total fields, and select all items in the invoice.

TIP   If the Send via Easyclaim check box is invisible or greyed out, the invoice being processed contains items that cannot be claimed via Easyclaim. See What can you claim with Tyro? for more information. These items may be able to be transmitted by Online Private Patient Claiming.

7. Select the rebate claim method the patient wants to use at the bottom of the Payment details screen.



8. Click Process. The Tyro Terminal will activate, and Bp Premier will display prompts to guide you through the rest of the payment process:
• Swipe / Insert Card
• Enter PIN or Approved signature?
• Select Account type to use

The below screens will appear on the Tyro terminal for the customer and in Bp Premier.



9. If the payment is ‘Approved’, Tyro will print a docket. The docket is the ‘Merchant’ copy for the practice to keep for reconciliation purposes. A prompt will appear on the screen if you wish to print a copy for the patient.

   

If the payment is ‘Declined’, the Tyro docket will contain an error message. Bp Premier will return to the Create Account screen so that the payment can be processed again.

10. If the claim was not successful, the patient must try another claim method or different card.

The final step is to transmit the claim to Medicare.

1. If the Send via Easyclaim option was ticked, the Tyro terminal will automatically start transmitting the claim to Medicare.



Approved

The claim is immediately assessed by Medicare and, if approved, the message Claim approved. Swipe / Insert EFTPOS cardwill appear. Ask the patient to insert or swipe their EFTPOS card they want to rebate paid into, and enter their PIN if required by the card type. The rebate will be deposited immedidately to that account.

Tyro will print a Medicare claim receipt for the patient indicating the benefit rebated to their bank account. Bp Premier will return to the Payment details screen so you can print additional receipts if you need to.

Cancelled

If the transaction is cancelled on the Bp Premier screen or the Tyro terminal, Tyro will print a docket to indicate ' Claim Cancelled' . Bp Premier will return to the Payment details screen so the payment can be processed again.

Rejected

Depending upon the reason for rejection, you may be able to send the claim again via Easyclaim or Patient claiming. Bp Premier will return to the Payment details screen so the payment can be processed again. Tick a different checkbox to try a different method and click Process to reprocess the payment.

NOTE  Integrated Medicare Easyclaim has a 5 minute delay before you can resend the claim to Medicare. You have the option to wait 5 minutes or send the claim via Private Patient Claiming.

2. If the patient paid by Cash, Cheque, or Direct Credit, a receipt will not have been generated during the payment process. After the claim has been processed, click Print Receipt to print a receipt for the patient.

Payment and claim through Tyro is now complete.

The steps are slightly different if the patient is not paying the full amount.

Patient is making a part payment

If the patient is paying only part of the amount owing:

1. After the doctor has finalised the visit, open the account from the appointment book.
2. Select Patient from the Bill to: menu.
3. Click Pay now. The Payment details screen will appear.
4. Click in the payment method the patient is using: Cash, EFT, Credit Card, Direct Credit, or Cheque total. If you select EFT or Credit Card, the Use Tyro checkbox will appear.
5. Enter the partial amount being paid into the selected field.
6. Tick the checkbox next to the item you wish to allocate the payment to. Otherwise, click Allocate if you need to allocate the partial payment across the services in the invoice. Auto-allocate will automatically distribute payment starting from the first service.
7. The Payment total field will be updated.
8. You only need to change the MID from the default if you are depositing the payment into another provider's account. For almost all transactions you do not need to change this field.

Patient is paying the gap

If the patient is only paying the gap between the practice fee and the rebate:

1. After the doctor has finalised the visit, open the account from the appointment book.
2. Select Patient from the Bill to: menu.
3. Click Pay now. The Payment details screen will appear.
4. Click in the payment method the patient is using: Cash, EFT, Credit Card, Direct Credit, or Cheque total. If you select EFT or Credit Card, the Use Tyro checkbox will appear and will be ticked automatically.
5. You only need to change the MID from the default if you are depositing the payment into another provider's account. For almost all transactions you do not need to change this field.
6. Tick Pay gap at the top of the screen. Bp Premier will enter the amount owing into the selected payment method and the Payment total fields, and auto-allocate payment to the services in the invoice.

Patient is making a zero gap payment

If you are processing an Easyclaim transaction where the patient is not paying any money:

1. After the doctor has finalised the visit, open the account from the appointment book.
2. Select Patient from the Bill to: menu.
3. Click Pay now. The Payment details screen will appear.
4. Leave all the payment fields empty.
5. Leave Use Tyro unticked.
6. Tick the invoice lines to be processed in this transaction.



7. Tick Send via Easyclaim and click Process to process the account.

If you cancelled out of the Payment details screen after processing the payment, but before sending the claim via Easyclaim or Patient Claiming, you can still send the claim to Medicare if the patient is still present at the practice.

IMPORTANT   You can only perform this procedure on the original payment date.

1. Open Management > Patient Billing History from the main Bp Premier screen. The Billing History screen will appear.
2. Click the folder icon from the toolbar or select File > Open Billing History. The Select Patient screen will appear.
3. Enter the patient's name, highlight the patient in the list of results, and click Select.
4. Tick Show payments/deposits at the top of the screen.
5. Highlight the payment in the list you want to claim for. Right-click and select Send online patient claim. The Payment details screen will appear.
6. Select Send via Patient Claiming or Send via Easyclaim check box and process the claim.

Direct Bill Private Patient Easyclaims are managed through the Tyro Transactions screen. Select Management > Tyro Transactions from the main Bp Premier screen.

The top half of the screen shows each service that has been transmitted via EasyClaim to Medicare, including any amounts paid by Medicare, the transaction result, and status of the submission and any errors that may have occurred.

The bottom half of the screen shows the transactions associated with the selected service with information including Transaction Date, Transaction ID, Transaction Status, ClaimID that Medicare processed the transaction in, and the user who sent the service to Medicare. If an error has occurred, the row will also show the error message. If an adjustment has been made to the service, the Adjustment column will show the action taken.

The Transaction Result column in the top half indicates whether the service was successfully sent to Medicare or not (success or error).

The Transaction Status column can show the following values:

TIP  When a service contains an error from the Bulk Bill Integrated Report, details about the error are shown in the Transaction Notes column in the transaction list.

From this screen, you can:

• Check for payments, which will update the status of services to indicate if they have been paid
• View the Patient Billing history and the Payment and Processing reports
• Adjust billing for a service (for claims with a status of ‘received’)
• Copy the EasyClaim Transaction ID (required for contacting Medicare to cancel processed claims).

When you first open the Tyro Transactions screen, by default the screen will show transactions of type Bulk Bill Easyclaims and will list all services that have been successfully transmitted to Medicare for the for the past month.

1. From the Tyro Transactions screen, select a Transaction Type of ‘Bulk Bill Easyclaims’.
2. Click Check Payments in the top right. Bp Premier will contact Medicare and attempt to download the Bulk Bill Payment and Processing reports for claims sent since the last payment check, and report on the success or failure of the payments check. Any services that have been paid will be updated and services which were rejected will be marked with their exception message.
3. The Payment and Processing Reports can be printed from this screen or from the View menu.

EasyClaim Payment report

The EasyClaim Payment report is similar to the Online Claiming Payment report.

A Payment report will exist for each deposit into the practice’s bank account. The top section of the screen will show each Payment run (deposit) that has been processed and paid within the date range specified, together with the payment amount and bank account details.

The bottom section shows the transactions that were paid as part of that payment run. Transactions are grouped by provider to make it easier to identify when payments for multiple providers are paid into the one bank account by Medicare. This report can be printed if you require a hard copy.

EasyClaim Processing report

Processing reports show the exception list of all services where the amount paid was not the same as the amount claimed.

The top section shows a report for each provider that had services processed for them on a given date. The bottom section shows the related Claim ID, total benefit paid and total claimed amount, transaction ID, invoice ID, and patient details. Below this information, each item number claim and any errors relating to that item is listed.

Once the check for payments has been run, you will need to action any services with the Txn Status 'received' as these have not been paid. Services with this status will have an error which needs to be addressed.

With Easyclaim services, you can:

• Adjust a direct bill service
• Cancel and refund a whole payment
• Cancel an EasyClaim rebate

Once the check for payments has been run, you will need to action any services with the Txn Status 'received'. Services with this status have been processed by Medicare, but there is an error to be addressed.

To identify the items that need action, filter the Tyro Transactions screen to show:

• Transaction Type of ‘Bulk Bill Easyclaims’
• Transaction Result of ‘Success’
• Transaction Status of ‘Received’.

Some common reasons an Easyclaim direct bill may need adjusting include:

1. Double-click the service you want to adjust, or right-click and select Adjust Service. The Adjust billing window will appear.



2. Select the radio button that corresponds to the adjustment you want to make:

Field	Description
Accept fee of	This will only be active if the service has been part paid. Select this option if you wish to mark the item as reconciled and accept this payment.
Resend via Medicare batch	Select if Medicare has had an issue on their end and they have requested that you resend the item. The item will be resent in an online claiming batch. You cannot resend a direct billed service through Tyro.
Change billing	Select if this service will not be paid by Medicare Direct Bill and you wish to change the billing type to another method. The service will be removed from the list, but will be present when the Transaction Status changes to ‘Received’. When you view the account in the Patient Billing History, the Billed to field will reflect the change. Adjust the invoice from this screen and send to the new payer.
Write off service	Select where Medicare will not pay the service and you have no opportunity to recover the cost via another method. Writing off removes the service from the invoice, or, if only one service exists, writes off the entire invoice. When you view the account in the Patient Billing History, the Status field will show Written off or Part Written off.

3. Click OK to apply the billing adjustment to the service and return to the Tyro Transactions screen.

Right-click a service and select Patient Billing History to open the Patient Billing History screen, if you need to view or adjust invoices.

Because of the speed with which Tyro processes payments and Medicare rebates, cancelling or refunding payments processed through Tyro are not straightforward. These instructions describe how to cancel a rebate and refund a payment made through Tyro.

Reverse the payment in Tyro

Refer to your Tyro terminal documentation for more information. Your terminal must be enabled to process refunds. As a security measure, you will need the Refund password set by your practice when first activating the Tyro terminal.

Reverse the payment in Bp Premier

IMPORTANT  Tyro Medicare Easyclaim rebates to the patient are immediate. Adjustments to the Account or Payment cannot be made after the claim is approved. If you reverse a payment, you must take into account how any related claim has been transmitted, and you must contact Medicare to arrange cancellation.

1. Select Management > Patient Billing History from the Bp Premier main screen.
2. Search for and select the patient from the Billing History screen.
3. Tick the Show Payments/Deposits checkbox at the top of the screen.
4. Highlight the payment and click the Reverse button. Click Yes when Bp Premier prompts 'Are you sure you want to reverse this payment?'.
5. Enter a Reason for reversal, or select a reason from the drop-down menu.



6. You would normally leave the Credit payment to payer's account? checkbox unticked for Tyro payments. This checkbox creates a deposit in the patient's account, to be deducted from future payments, rather than refunding the amount.
7. Any related invoices will change status to ‘Unpaid’, so that the invoice can be adjusted and payment re-entered.

IMPORTANT  Tyro Integrated Medicare Easyclaim rebates to the patient are immediate. Adjustments to the Account or Payment cannot be made after the claim is approved. If you reverse a payment, you must take into account how any related claim has been transmitted, and you must contact Medicare to arrange cancellation.

If the patient has had their claim processed via Easyclaim:

Because Easyclaim claims are immediately rebated to the patient’s bank account, you cannot cancel the Medicare rebate directly from Bp Premier. You will need to contact Medicare to arrange for Medicare to cancel the rebate to the patient’s account. You must supply Medicare with the Easyclaim Transaction ID.

To find the Easyclaim Transaction ID:

1. Select Management > Tyro Transactions from the main Bp Premier screen. The Tyro Transactions screen will appear.
2. Select a Transaction Type of ‘Private Easyclaims’.
3. Find the claim that you need to cancel and identify the Transaction ID.
4. Right-click the claim and select Copy Transaction ID to clipboard to copy the transaction ID. Use Ctrl+V to paste the ID elsewhere.

This article provides a list of return or error codes returned by Medicare after your practice has submitted online claims, and the cause and resolution actions for each code. If a submission has been declined, consult this list before calling Best Practice Software Support to see if you can resolve the problem.

Some resolutions will require your IT Support or a Windows administrator with knowledge of updating environment variables and setting access permissions on folders.

NOTE  In Saffron SP3 and later, Medicare certificates no longer need to be configured. The functionality provided by Medicare certificates has been replaced by Medicare Web Services.

See Troubleshoot Medicare Web Services and PRODA for troubleshooting advice for Medicare Web Services and PRODA-related error messages.

Common Medicare return codes

General troubleshooting steps

NOTE  In Saffron SP3 and later, Medicare certificates no longer need to be configured. The functionality provided by Medicare certificates has been replaced by Medicare Web Services.

If you receive a generic error message, a code not included in the list above, or the following message, follow the resolution steps below to see if the problem is resolved before you call Best Practice Software Support.

Last updated 23 July 2020

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