The following items are not accepted through Medicare Easyclaim:
o In-hospital items
o ACIR information
o Bulk bill claims more than 2 years from date of service
o Patient claims more than 2 years from date of service
o Time duration dependent items
o Notional charges
o Patient claims pathology items excepting group 9 items
o Bulk bill pathology items which are self deemed or rule 3 exemptions
o Patient claims and Bulk Bill claims with non-standard referrals
o Items where the charge exceeds $9,999.99
o Department of Veterans' Affairs (DVA ) claims
o Currently item 105 cannot be claimed more than once a day using Medicare Easyclaim. Medicare Australia is considering enhancing the system to allow additional items to be claimed more than once a day using the 'not duplicate' indicator.
o Claims for Allied Health Workers.
In the unfortunate event that Medicare Easyclaim is not available at the practice the practice needs to issue the patient/claimant an account/statement and advise the patient/claimant to lodge their claim through an alternate channel, i.e. at the appropriate Medicare office. Bulk Bill claims need be the completed as with the current existing processes. Since Medicare Easyclaim works independent from EFTPOS services, it is possible that Medicare is available while EFTPOS is not and vice versa.
A note about pending transactions:
If a transaction/claim does not have a report available from Medicare Australia after 48 hours, Pracsoft presents you with the following message.
At this point you can;
o Contact Medicare Australia to enquire about the status, and/or
o Examine the details of the transaction/claim by selecting View > Pending Transactions Log
Please note that MedicalDirector Customer Service cannot assist you with the status of such transactions/claim; you must contact Medicare Australia for assistance.