Medicare Easyclaim lets a practice submit a Medicare claim from the practice management system (PMS) and have the Tyro terminal send it to Medicare. Before you begin, review the certification criteria, which set out the minimum requirements for certifying integrated Medicare Easyclaim with Tyro: Certification Criteria for iClient Health.
The claim types are the same on both libraries. The sections below describe how each one works. Then pick your library for the methods and sample code.
In the PMS, the staff select the doctor and patient and build up a list of services provided to the patient. Once complete the PMS should determine if the claim can be sent via Easyclaim (services not accepted through Medicare). If it can, invoke the library passing in the bulk bill XML payload. The terminal will then attempt to have the claim validated by Medicare and if validated, the library will ask the practice to accept the amount of the claim and if accepted, the terminal will ask the patient to 'Assign their right to benefit?'. Once the patient presses 'YES' the terminal will return the bulk bill XML response to the PMS. Please note that bulk bill claims are not assessed in real time and as such bulk bill claims will need to be reconciled via Medicare's Bulk Bill Integrated Reconciliation.
In the PMS, the staff select the doctor and patient and build up a list of services provided to the patient. Once complete allow the patient to pay for the services provided in full. Once paid ask the patient if they would like to claim the rebate from Medicare in the practice. Ensure that the patient has an EFTPOS card (Cheque or Savings). Invoke the library passing in the fully paid XML payload. The terminal will then attempt to have the claim approved by Medicare and if approved, the terminal will display the benefit amount on the screen and asks the patient to swipe their EFTPOS card followed by selecting CHQ or SAV followed by their PIN. Once approved, the terminal will return the fully paid XML response to the PMS and the rebate is in the patients account in around 11 seconds.
In the PMS, the staff select the doctor and patient and build up a list of services provided to the patient. Once complete allow the patient to pay for part or all of the gap. Once paid invoke the library passing in the part paid XML payload. The terminal will then attempt to have the claim approved by Medicare and if approved, the terminal will return the part paid XML response to the PMS indicating that the claim is approved PDVC.
Please see the page on BIR workflow.
Please refer to the JS library API for sample EasyClaim code. After downloading the zip folder, unzip it and click on the iclient-api folder, and then index. At the top left corner underneath the APIs, click on Classes, and then click on TYRO.IClientWithUI, scroll down until you see the index and method tabs, then click on index.
The Medicare Easyclaim payload specifications are available in the EasyClaim Logic Pack Users Guide V2.
Below is a JS Fiddle demo for Fully Paid, Part Paid, and Bulk Bill Claim.
Don't click Save if you make changes in the JS Fiddle sample app. Click Run instead. Clicking Save may break the fiddle's functionality.