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Creating a New Medicare Claiming Group

Nookal Written by Nookal
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Creating a New Claiming Group


If new Provider Numbers are used for claiming, it is essential to update the Medicare Online integration and provide the new details to Medicare prior to submitting claims.

A Provider can have different Provider Numbers linked to the same Claiming Group (Minor ID). See Adding a Provider for Medicare Online Claiming to find out how to add a Provider Number to an existing Claiming Group.

 

Each Provider Number can only be linked to a single Claiming Group (Minor ID).

Creating a New Claiming Group

A new location doesn’t necessarily require a new Claiming Group unless it needs to be linked to a different bank account.

 

Before creating a new Claiming Group and adding providers to this group, make sure this is what is needed.

1

Head to Setup > Connections > Integrations.

2

Click Configure Medicare.

3

Click Create Group in the bottom right-hand corner.

4

Add a Name in the pop-up window and click Create Group. The Group will be set as Active by default.

Label the Group with the same name as the Location to avoid any confusion.

5

Click Add to select Providers and Provider Numbers to be added to the Group.

If the Provider Number is not displayed or there is an error message, the Provider Number might already be linked to a different Minor ID. See Can I Link a Provider Number to a Different Medicare Claiming Group? for more assistance.

6

Add the Provider Number in the Principal Payee field if required.

7

Call Medicare/DVA eBusiness on 1800 700 199 for the online claiming/banking form(s) relevant to your business.

Are you setting up a new online claiming integration? Ask your Medicare representative:

“I would like to set up online claiming for my business. We use software that submits claims via a centralised site certificate – I do not require a PKI Certificate. I need to set up banking details and also add my provider number(s) to a new Location ID. What forms do I need to complete?”

Generally, they will provide you with two forms:

  • Online Claiming Banking Details – to connect your bank account details to the Location ID (Minor ID).
  • Online Claiming Provider Agreement – to connect your provider number(s) to the Location ID (Minor ID).

These forms may not suit your situation, so it’s best to confirm with the Medicare representative.

8

Fill in the Medicare online claiming paperwork, make sure to include the Minor ID/Location ID to the Medicare forms before submitting to be processed by Medicare.

The Location ID (Minor ID) can be found in the Medicare setup (Setup > Connections > Integrations > Medicare/DVA Online Claiming), next to the name of the Group for the appropriate Location.

 

9

If the new Claiming Group was for a new Location created in Nookal, click on the Active Claiming Locations tab.

10

Click on the Location.

11

Tick the Active box.

12

Click Save Location.

Once processed by Medicare, online claiming is ready for the Claiming Group.

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