Online Claiming: Medicare Easyclaim and Tyro

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 panel.

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 check box 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.

See Finish processing the payment for instructions on finalising the process

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 check box will appear.
5. Enter the partial amount being paid into the selected field.
6. Tick the check box 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.

See Finish processing the payment for instructions on finalising the process

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 check box 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.

See Finish processing the payment for instructions on finalising the process

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.

See Finish processing the payment for instructions on finalising the process

Patient is splitting payment types

If the patient is paying using multiple payment types (for example, part EFT, part cash):

1. Click in the first payment method the patient is using: Cash, EFT, Credit Card, Direct Credit, or Cheque total.
2. Enter the amount to be paid using the method.
3. Repeat steps 1–2 for each payment method being used by the patient.

If you select EFT or Credit Card, the Use Tyro check box will appear and will be ticked automatically.

4. 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.
5. The Payment total field will be updated.



6. Click Allocate if you need to allocate the payment across the services in the invoice. Auto-allocate will automatically distribute payment starting from the first service.

See Finish processing the payment for instructions on finalising the process

Patient is paying with two cards

If the patient is paying using two cards (for example, EFT and Credit Card, or two different EFT cards):

1. Click in the EFT field and enter the amount to be paid using the first card. The Use Tyro check box will appear and will be ticked automatically.
2. Click Process to process the first payment.
3. Click Close to close the Payment details screen.
4. Select Open > Billing History to open the Billing History screen for the patient.
5. Select the account you just processed in steps 1 and 2 and click the Pay single invoice button. The Payment details screen will reappear.
6. Click in the EFT field and enter the amount to be paid using the second card. The Use Tyro check box will appear and will be ticked automatically.

The Payment total field will be updated automatically.

See Finish processing the payment for instructions on finalising the process

Patient is paying multiple invoices

If the patient is paying more than once invoice:

1. Enter the payment details for the first invoice using one of the payment methods described in this section.
2. Click Process to process the first payment.
3. Click Close to close the Payment details screen.
4. Select Open > Billing History to open the Billing History screen for the patient.
5. Click the Pay all button. The Payment details screen will reappear.
6. Enter the payment details for the remaining invoices using one of the payment methods described in this section.

See Finish processing the payment for instructions on finalising the process

Patient is paying after the service day

If a patient is paying an account at a later time:

1. Select Open > Billing History to open the Billing History screen for the patient.
2. Select the account the patient is paying and click the Pay single invoice button. The Payment details screen will appear.
3. Enter the payment details for the invoice using one of the payment methods described in this section.

See Finish processing the payment for instructions on finalising the process

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 Medicare Easyclaim? for more information. These items may be able to be transmitted by Online Private Patient Claiming.

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



2. 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.



3. 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.

4. 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 card will 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 immediately 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 check box 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.

If you exited the Payment details screen after processing the payment but before submitting the claim to Medicare via Easyclaim or Patient Claiming, you can still submit the claim to Medicare if the patient is still present at the practice.

IMPORTANT   This method is only available 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. The Send via Patient Claiming check box will be greyed out. To process the claim, click Send.

This section describes what happens when a claim for unpaid or partially paid accounts is submitted to Medicare.

Claiming Benefits for unpaid and partially paid accounts

Where the patient has not paid the account, the unpaid or partially paid private accounts may be submitted to Medicare. If Medicare benefits are assessed as being payable for the claim, a statement and/or Pay Doctor via Claimant Cheque (PDVC) in the provider's name will be sent to the patient's last known address as recorded by Medicare Australia.

It will be the patient's responsibility to present the cheque to the provider and arrange for payment of the account's balance, if any.

Pay Doctor via Claimant Cheques involving Medicare benefits cannot be sent directly to providers or to patients at a provider’s address (even if requested by the patient to do so).

If the patient does not forward the cheque to the practice, or the cheque has not been banked within 90 days, Medicare will cancel the cheque and pay the practice the rebate amount using Electronic Funds Transfer.

Visit the Services Australia website to learn more about submitting unpaid and partially paid accounts to Medicare and the Pay Doctor Via Claimant (PDVC) cheque scheme.

Patient authority to request PDVC cheque

To submit a gap payment, you will need to ensure the patient understands that they will receive a cheque and will need to forward it to the practice.

You will also need to get written permission from the patient, with the patient's signature and the date of the claim.

Visit the Services Australia website to learn more about obtaining patient authority for a PDVC cheque for an unpaid or partially paid account.

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.

To identify the items that need action, filter the Payment Integration Transaction 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:

Reason	Explanation or example
Maximum number of services for this item already paid	This may occur when claiming for a care plan items or similar, where you can only claim one per patient per year
No benefit payment for services performed by this provider	Can occur if the provider is not entitled to claim the service
Bulk bill additional item claims incorrectly	This can occur due to another related item being rejected
Rejected in association with another item in this claim	This can occur due to another related item being rejected
Service cancelled at providers request	Occurs when the practice has called Medicare to ask that the claim be rejected due to a mistake.

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.

Due to the speed at which Tyro processes payments and Medicare rebates, cancelling or refunding payments processed through Tyro is 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 check box 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? check box unticked for Tyro payments. This check box 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. See Cancel an Easyclaim rebate for more information.

If the patient has had their claim processed via Easyclaim:

Due to the speed at which Easyclaims are rebated to the patient's bank account, Medicare rebates cannot be cancelled directly from Bp Premier. You must 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 in Orchid SP2 or later:

1. Select Management > Payment Integration Transactions from the main Bp Premier screen. The Payment Integration Transactions screen will appear.



2. Select Tyro from the Payment Integration drop down.
3. Select a Transaction Type of ‘Private Easyclaims’.
4. Find the claim that you need to cancel and identify the Transaction ID.
5. Right-click the claim and select Copy Transaction ID to clipboard to copy the transaction ID. Use Ctrl+V to paste the ID elsewhere.

To find the Easyclaim Transaction ID in Orchid SP1 and below:

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.