IMC Claim Types

Agreement - AG

The provider has signed an Agreement with the Fund (of which the patient is a member) specified in the claim. Payment goes to the provider or Billing Agent via the Health Fund.

Scheme - SC

The provider is operating under a scheme with the Fund (of which the patient is a member) specified in the claim. Payment goes to the provider or Billing Agent via the Health Fund. Assumes any financial interests are disclosed to the patient.

Patient Claim - PC

The patient is a member of the Fund specified in the claim. If claim has been paid, payment from Medicare goes to the patient or claimant and payment from the Fund goes to the member. If the claim has not been paid, the payment from Medicare and the Fund goes to the patient, via cheque (made out to the provider), who then passes it on to the provider.

The IMC Patient Lodgement Advice and Declaration must be shown (on-screen or printed) to the patient and the patient's verbal consent received prior to lodgement of an IMC PC claim.

Medicare Only - MO

Payment from Medicare goes to the specified Billing Agent. There is no Fund involvement.

Billing Agent - MB

Payment from both Medicare and the specified Fund goes to the specified Billing Agent.