Using Tyro Easyclaim functionality for Medicare EPC claims
Abstract
Capable 21C supports the Tyro system for EPC claims from Medicare. This article describes how to make a claim using Capable 21C.
Before using these features, it is important to enable Tyro functionality,
configure Capable 21C for Easyclaim claims
AND configure the patient file for Easyclaim claims.
Underlying challenge
Claiming from Medicare is easy using a Tyro terminal. This article describes how to do so.
Resolution
To submit a 'fully paid claim', follow these steps:
- Start the invoice normally by double-clicking on the appointment displayed on the appointment book.
- The desired invoice line item may not appear automatically. If it does not, click on the invoice line item that is displayed and change it.
- Click the 'Request EFT From Tyro' button.
- Follow the Tyro prompts on screen to obtain the full payment from the patient.
- Payment from the patient should appear on the receipting window.
- Now, click the Claim From Medicare button
- A Tyro popup will appear in front of Capable. Follow the prompts to have Medicare credit the patient's account directly.
- Complete the invoice normally.
Detailed Information
Note that Capable 21C supports three kinds of Medicare claims:
- Fully paid claims (this is the default). For these claims, Capable 21C charges the full amount to the patient's EFT card.
It then asks Medicare to pay the patient for the amount they are entitled.
This type of claim is generally preferred by practitioners as it ensures that they get paid regardles of Medicare's decision.
- Part paid claims. For these claims, Capable 21C requests that Medicare issues a cheque to the patient that will be in the name of the practitioner.
This type of claim is not popular, as the clinic will not be paid until they recover the cheque from the patient and bank it.
- Bulk billed claims. For these claims, Capable 21C requests payment directly from Medicare.
The bulk billing system from Medicare assumes that the clinic will NOT charge the patient any gap fee.
This type of claim is not popular as it prohibits clinics from charging a gap.
When invoicing a patient, a 'fully paid claim' can be submitted by clicking the 'Claim From Medicare' button.
The other types of claims can be made by clicking the little drop-down button beside the 'Claim From Medicare' button.
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