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Setting Up a Medicare EPC or CDM Case

Sam Written by Sam
... on a marvellous March day.

This article explains how to set up a Case to easily claim Medicare or to print invoices with the relevant information for Clients to get reimbursed.

Setting up the case appropriately will also enable tracking of the number of sessions used and remaining for the specified care plan.

Create a Contact called Medicare and tick the Payer option to be able to set Medicare as a Payer.

All referring Doctors will also need to be added as Contacts with their First Name, Last Name and Provider Number.

Do not tick the “Payer” box for Doctors.

See Adding Contacts  for further assistance.

We recommend creating a new Case when a new referral is received. Naming the Case by the type and year of the claim if an easy way to avoid confusion (e.g. EPC 2018, EPC 2019…)

This article only contains information specific to Medicare, the general guidelines to add a Payer to a Case or to link Appointments to a Case can be found here.

The details of the Referral the Client has provided are required for these steps.


In the Case, click Add Payer.


Select Medicare then, click on Next.


Add the Referring Doctor in the Referral section. Essential for successful claims.


Add the Referral Date. Essential for successful claims.


Add the Reference Number, Injury Date and Case Manager of the care plan (optional – Contact the relevant authorities if unsure according to your circumstances).


Add the number of Sessions approved. Optional but helpful for reference and session count, this will not affect the ability to claim.


Add the Expiry Date (optional) – there are no notifications when the expiry date is reached although online claiming will not be possible once the expiry date is reached.


Click Save Changes.


If some appointments are already booked, the bookings will need to be linked to Medicare prior to being invoiced to avoid issues. To do so, click on the chain-link icon next to the number of sessions and tick the bookings that need to be linked to Medicare, then click Save Changes.

Linking the Booking to Medicare will not update the Payer on an existing invoice. If the invoice has already been generated for an appointment, the invoice will need to be updated manually.

All future bookings made under the Case will be linked to Medicare and the number of sessions remaining for this referral will be displayed.

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