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Submitting a Medicare Claim for In-Hospital Services

Julee Written by Julee
... on a stunning September day.


This article explains how to submit Medicare In-Hospital Services Claims.

Submitting a Medicare Claim for In-Hospital Services at the time of Invoicing.

1. Click on Generate Invoice on the appointment screen.

In Fresh View, it looks like this:

 

2. Tick Add to Medicare Queue.

3. Click on Save Invoice.

4. Ensure the Item Code and Claim amount are correct in the open pop-up box.

5. Select the appropriate Provider Number for the Provider that matches the Location or Claiming Group (Minor ID).

6. Tick the box of the Item(s) to claim.

You can add multiple items to an invoice to claim them simultaneously to reduce online claiming fees.

7. Click Submit Claim.

8. In the pop-up window that opens, select a Claim Type.

  • Medicare Bulk Bill Claim: Medicare is billed directly for a Patients medical or allied health service, and the practice accepts the Medicare benefit as full payment for the service. The patient assigns their right to a Medicare benefit, so the benefit is paid to the practice.
  • Medicare Patient Paid Claims (Client Reimbursement): The Patient or Claimant (e.g. a parent) pays the practice for the total amount of the service, and the practice lodges a Medicare claim on their behalf.  If the Claim is accepted, Medicare will pay the designated amount directly to the Patient or Claimant.

9. At Location, select Hospital.

10. Select a Referral or No Referral Required as appropriate.

11. Add the Number of patients seen.

12. Select the Hospital name and review the Facility ID below it.

If the Hospital doesn’t have a Facility ID saved, navigate to the Contacts menu > locate the Hospital from the list > add the Facility ID to the section highlighted below > Save Changes.

13. If required, select a Principal Payee.

14. Review the details and click Submit.

For successful claims, Patient Medicare benefits are usually available in their bank account within one to two business days.

After clicking Submit, any errors will be outlined in red with helper text identifying the issue.

After the error is resolved, the user can click Submit again to send the invoice for claiming.

For example:

Submitting a Medicare Claim for In-Hospital Services on an Existing Invoice

1. Find and open the Invoice.

2. Click Online Claims.

3. On the open pop-up window, follow steps 4 onwards from the section above.

Reviewing Online Claims

Check the Medicare Report via Reports > Financials > Medicare to quickly review the status of Medicare Claims.

To see a list of submitted claims for a specific period, generate the Report using the chosen period, Locations, Claiming group, Providers, etc.

 

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