A Patient Claim is when the practice sends an electronic claim on behalf of the patient. Essentially this means that the practice does the leg work that the patient would otherwise have to do in taking the account to Medicare and health fund offices to obtain rebates.

 

A patient claim can be submitted for either Medicare only or Medicare + Fund. It will cause cheques to be sent to the patient, made out to the doctor. The practice must still send a standard paper account to the patient and wait for the patient to send the cheques and the balance.

 

The main benefit to using Patient Claims is only that you bypass the time taken for the patient to take the account to Medicare +/- fund. In many cases this will be useful. You should also send some information to the patient (form letter perhaps) advising them that you have already transmitted the account to Medicare +/- fund. Also, you are expected to get the verbal permission of the patient to transmit their details.

 

It benefits the patient in that they don't have to go to Medicare/fund. This can be a substantial benefit to the patient, particularly if they are recovering from an operation. It's up to you to determine whether any extra paperwork/consent is worth the likelihood that the accounts will be paid more quickly.

 

There is also a '90 day pay doctor' scheme. With this, if a Medicare cheque has been made out to the doctor, but is not banked within 90 days, Medicare will automatically cancel the cheque and deposit the money directly into the doctors account by EFT. This is good if the patient holds on to the cheque, but doesn't help with the fund payment or any gap charged.

 

There are 2 PC buttons in Access Anaesthetics; the top one is is for Medicare + fund, the bottom for Medicare only. (I'm not sure why you would do a Medicare only patient claim rather than a BB claim.) You can also use these if the patient has paid in full and wants to claim their Medicare/fund rebates. In this case the cheques are made out to the patient.

 

Note that with patient claims there will be no reports received. Once you send the claim, that's it - you hear nothing until the patient pays you or you have to chase them up. Essentially you treat the account like any account sent to a patient.