Bulk Bill Invoicing, Claiming and Receipting

Requirements

Provider/Entity is registered with Medicare - Pre-requisites
Provider/Entity has Bulk Bill Rate selected in Location rates for each Active Location in Utilities - Entities - Locations (Active)
Patient/Client has a valid/verified Medicare Card
If the Provider/Entity is an Allied Health Provider or a General Practitioner, a Referral is not required
If the Provider/Entity is a Specialist a current Referral is required unless an override is selected
Date of Service (DOS) is not older than two years
DCM will not process a Bulk Bill Claim if any of the above is not correct
On transmitting the Claim, the Medicare Card is verified again based on the Date of Service (DOS)

On generating the Invoice with the Rate Bulk Bill, a button labelled Bulk Bill appears on the sidebar to select
Note the Fee equals the Benefit
- If the Billing Entity is not a GP, the Fee is 85% of the Medicare Fee Schedule for an In Room Service and 75% of the Medicare Fee Schedule for an In Hospital Service
- If the Billing Entity is a GP, the Fee is 100% of the Medicare Fee Schedule be it an In Room or In Hospital Service
Right-click on the Item Description to select any Qualifiers that Medicare requires

One invoice equals one claim
No need to batch as should the invoice have any issue; you only have to resolve this one. If batching and one invoice has an issue, you cannot complete the batch until the issue is resolved.

Bulk Bill Claims are paid overnight
This process can be automated
Otherwise, go to Regular Tasks - Online Claiming and select the Get All BB/DVA button on the sidebar

On getting the BB/DVA Payment details, and the Invoice is paid in full, the Invoice will be receipted and the status of the Claim Status will change to Completed without staff involvement
Should there be a difference in what was paid to what was claimed, the Claim Status will be Reports Available.
Right-click on the Claim and select Get Report for detail. Options are:
- Accept what has been paid resulting in what was invoiced updating to what was paid
- Right-click and go to Invoice and Resolve the Issues. There would be a missing Qualifier, eg: Not Normal Aftercare
- Resubmit Later resulting in the Claim being moved to the Claims to Resubmit section
- Resubmit Now resulting in the Claim being Resubmitted with a new Claim ID