Note, for the purposes of this guide we are doing an Optical claim. The full list of specialities include:


  • Nursing
  • Optical
  • Dental
  • Speech Pathology
  • Allied Health
  • Psychiatry


These different specialities may have specific item numbers and rules associated with billing. You should refer to the materials provided by DVA and bill accordingly.


Claim


The first thing to do is to make sure you have the Optical Doctor Type. Go to File Menu -> Change Details -> Edit Lists, then click the drop-down and change it to Doctor Types, and if you do not have "Optical" in the list, Add it.


DoctorTypes.png


Then go in to your provider (File Menu -> Change Details -> Provider Details, then highlight the Provider and click Edit Provider), and set them to be "Optical":


ProviderDocType.png


Then when you do a DVA claim you will notice that the Practice Type will say "Optical". It's also worthwhile noting at this point that you may need to add in the DVA Allied Health - Optical Items in to the Medilink Item Fee area, for example item 10911 (you can just click the List button and do it there, set the V rate to the DVA fee).


DVABilling.png


There is potentially a bit of a trick if the Optometrist is also billing GP or Specialist items via DVA (i.e. 23/36/104/105/110 etc). I don't know if you will be doing that, but if you do then you should choose GP or Specialist in the Billing Screen when you bill GP or Specialist items and batch them separately.


DVASpecialistBilling.png


You then batch up the claims via the regular Veteran Affairs batching screen. This will automatically group/split biling types/events them as appropriate. This is also where you can exclude services manually by unselecting them


Batching.png


Then forward the batches. (Note: in the 2022 R1 Medicare Online Web Services version all claims will be automatically forwarded.)


Later (at least overnight) receive & process them as you would any other bulk billing type.






You can attempt to retrieve a specific batch via the Medicare Online screen. (It is largely unnecessary to do this as doing a 4. Receive will attempt to receive all outstanding batches at least a day old).



If you try and attempt to receive a single batch on the same day it was sent:



If a Receive attempt (either bulk or single) retrieves no Processing or Payment reports it will show the following.