Claiming with Medicare Easyclaim

The following sections explain how to process different claims with Medicare Easyclaim.

Fully-Paid Patient Claims

Bulk-Bill Claims

Part-Paid Claims

The following items are not accepted through Medicare Easyclaim:

In-hospital items

ACIR information

Bulk bill claims more than 2 years from date of service

Patient claims more than 2 years from date of service

Time duration dependent items

Notional charges

Patient claims pathology items excepting group 9 items

Bulk bill pathology items which are self-deemed or rule 3 exemptions

Patient claims and bulk bill claims with non-standard referrals

Items where the charge exceeds $9,999.99

Department of Veterans' Affairs (DVA ) claims

Radiation Oncology items

If you attempt to process a claim type not accepted by Medicare Easyclaim you will be prompted accordingly, and given the option to process the claim via Medicare Online as the alternative.

In the unfortunate event that Medicare Easyclaim is not available at the practice the practice needs to issue the patient/claimant an account/statement and advise the patient/claimant to lodge their claim through an alternate channel, i.e. at the appropriate Medicare office. Bulk Bill claims need be the completed as with the current existing processes. Since Medicare Easyclaim works independent from EFTPOS services, it is possible that Medicare is available while EFTPOS is not and vice versa.