Helpdesk

 From: "Department of Human Services" Date: 12/05/2016 6:37 pm

Subject: Ceasing of Medicare Benefits Cheque Payments to Patients and Claimants

As you may be aware, from 1 July 2016, Medicare benefit cheque payments to patients/claimants are stopping. This communication aims to provide advice regarding how this change will impact your software and the need to have it updated to affect these changes.

Change Overview

From 1 July 2016, Medicare benefit cheques will no longer be issued to patients/claimants. Customers have been informed through various communication channels that they will need to register their bank account details with Medicare and their benefit will be paid directly into their bank account via EFT. This change excludes Pay Doctor via Claimant (PDVC) cheques, which will continue to be issued.

This mandates an update from your software to remain compliant with Medicare and their new claiming rules. It will include a change to the Medicare Online printed statements, which Medilink will complete for their 2016 R2 update.

Scope of Change

The claiming channels this change relates to are:

·  Patient Claims Store and Forward (PCS) 

·  Patient Claims Interactive (PCI)

·  In-Patient Medical Claims – Patient Claims (IMC-PC)

For your information, below is a payment process overview, which details how payments will be directed to patients/claimants currently and post 1 July 2016:

Business Scenario	Current Payment Result	Payment Result Post July 1 2016
Benefit payment is directed to the claimant (e.g. Fully Paid Accounts)	Payment by EFT or Claimant Cheque Payment by EFT to the claimant’s bank account details as stored with Medicare. If there are no bank account details stored with Medicare, a cheque made out to the claimant is issued.	Payment by EFT only Payment by EFT only to the claimant's bank account details stored with Medicare. If the claimant does not have bank account details stored with Medicare, they will need to register these in order to receive payment.
Benefit payment is directed to the provider. (e.g. Partially Paid or Unpaid accounts)	Payment by PDVC Cheque Payment by cheque made out to the provider but sent to the claimant.	Payment by PDVC Cheque No change to current process.
Temporary Bank Account Details (Fully Paid Accounts only) Supplied using data elements: BSB Code Bank Account Number Bank Account Name	Temporary Details for payment by EFT If supplied, for that claim only, payment by EFT to the bank account details supplied in the claim rather than those stored with Medicare.	Temporary Details for payment by EFT No change to current process.
Temporary Address Details Supplied using data elements: ClaimantAddressLine1 ClaimantAddressLine2 Claimant Address Locality Claimant Address Postcode	Temporary Details used to direct correspondence and all cheques If supplied, for that claim only, correspondence and/or a cheque directed to the address details supplied in the claim rather than those stored with Medicare.	Temporary Details used to direct correspondence and PDVC cheques only If supplied, these details will only be used to direct correspondence regarding the claim or a Pay-Doctor-Via-Claimant Cheque if either are required. They will not be used to send claimant cheques as these will no longer be issued.

The updated should be distributed to your users to support this change effective from 1 July 2016, however, we understand this is a short timeframe and it may take a little longer for you to complete this work.

Software vendors should contact the OTS Product Integration team arrange approval of your updated software prior to your production implementation on 1st July 2016.