amsant-icons-request Medicare

Medicare Online cuts paperwork and speeds up payment times. Key features can be used for patient claims and bulk bill claims, allows Online Patient Verification and Online Eligibility Verification, provides notification of immunisation through the Australian Childhood Immunisation Register,  is integrated with practice management software, makes payments within 2-3 working days via electronic funds transfer and has secure communication using Public Key Infrastructure (PKI)

See below for Indigenous health education resources about health program payments and services to help improve Aboriginal and Torres Strait Islander Australians’ health outcomes.

amsant-icons-requestMedicare Online Resources

Indigenous Health Education MBS program

This program provides an introduction to the range of Medicare services that support Indigenous health. These services are available to assist health professionals better manage and improve the health outcomes of Aboriginal and Torres Strait Islander Australians.  Click here to access the online learning module.

Education Guide- Aboriginal and Torres Strait Islander health assessments and follow-up services

Information on Indigenous specific health assessments and follow-up services for Aboriginal and Torres Strait Islander patients. Includes a case study. Click here to access the education guide.

Education guide - Chronic Disease Management services to support Indigenous health

An overview of services in the MBS for managing Indigenous patients with a chronic or terminal condition. Includes a case study. Click here to access the education guide.

Education guide - Closing the Gap - PBS Co-payment Measure

Information about prescribing, dispensing and claiming pharmaceutical items under the CTG-PBS Co-payment Measure. Click here to access the education guide.

Education guide - Mental health services - supporting Indigenous health

An overview of the Medicare services for managing and treating patients with mental health care needs. Includes an Indigenous patient case study.  Click here to access the education guide.

Education guide - Telehealth - supporting Indigenous health

Outlining Medicare eligibility requirements for telehealth services that can support Indigenous health. Includes a case study.  Click here to access the education guide.

amsant-icons-04 Healthcare Identifiers

The Healthcare Identifiers (HI) Service is a national system for allocating a unique identifier to healthcare professionals, organisations and consumers. Healthcare Identifiers will help ensure consumers and healthcare professionals can have confidence that the right information is associated with the right individual at the point of care. The HI Service allocates three types of healthcare identifiers.

To access healthcare identifiers you must have a Medicare Public Key Infrastructure (PKI) certificate. These can be requested on all HI Service registration forms, or can be requested at a later date.  A Medicare PKI site certificate is required for organisations to access healthcare identifiers and other organisations’ contact details, using appropriate patient administration systems or practice management software. A Medicare PKI Individual certificate is required to access other functions, such as updating contact details.

The functions you have access to depend on the software you have. Contact your software provider for more information about software available to you.  To access HI Service functions through HPOS you must have a Medicare PKI Individual certificate. IHIs are not available through HPOS.

 

amsant-icons-requestHealthcare Identifiers Resources

Individual Healthcare Identifier

For individuals receiving healthcare services. IHIs are automatically assigned to every person enrolled in the Medicare program or registered with the Department of Veterans’ Affairs. Other individuals, such as overseas visitors, can apply directly to the HI Service for an IHI.

Communicare functionality allows the patients IHI to be downloaded from the national Health Identifier Service into the patients Communicare file. This process happens in the background when a patient’s file is opened.

Healthcare Provider Identifier- Individual (HPI-I)

For individual healthcare providers such as GPs, allied health professionals, nurses, dentists and pharmacists who are involved in providing patient care.  Healthcare professionals who are registered with the Australian Health Practitioner Regulation Agency (AHPRA) have been be assigned a HPI-I, which is available through AHPRA.

Healthcare Provider Identifier – Organisation (HPI-O)

For organisations that deliver health care (such as hospitals or general practices),

Health Professionals Online Service (HPOS)

Health Professionals Online Services (HPOS) is a fast and secure way for health professionals and administrators to do business with the Department of Human Services. Click here for more information.

Healthcare Provider Directory (HPD)

An important component of the HI Service is the Healthcare Provider Directory (HPD), which is a listing of healthcare providers (individuals and organisations) who are registered with the HI Service and have opted to list their nominated information in the directory. It includes contact and location details, as well as details of services provided. The HPD is not a public directory and is only available to healthcare providers and authorised users of organisations registered with the HI Service.

Being published in the directory allows you to search it for contact, speciality details and healthcare identifiers of other registered healthcare providers in the directory, and vice versa. This can be useful when sending secure messages, referrals, discharge summaries and forwarding test requests for patients.

You can consent to a directory entry when you apply for your HPI-O, or you can apply for one at a later date.

If you are an individual healthcare provider whose profession is regulated by the Australian Health Practitioner Regulation Agency (AHPRA), when you consent to the inclusion of your professional and business details in the directory, you are also consenting to the directory being updated to reflect any changes to those details held by AHPRA. Access to the directory is through appropriate patient administration systems or practice management software, or online through HPOS.

To add your details to the health provider directory click here to access the form.

Health Care Identifiers User Guide

Read the healthcare-identifiers-user-guide for important information about getting, using and disclosing healthcare identifiers.

 

amsant-icons-04 ePIP Requirements and Policies

From May 2016 the Practice Incentive Program Digital Health Incentive replaces the Practice Incentive Program eHealth Incentive (ePIP), and includes new eligibility requirements.  The Medicare PIP Digital Health incentive aims to encourage health services to adopt the latest developments in Digital Health with the view to helping services improve administration processes and patient care and outcomes.  Eligible health services can receive a maximum payment of $12,500 per quarter, based on $6.50 per Standardised Whole Patient Equivalent [SWPE] per year.

To be eligible for the PIP Digital Health Incentive, health services must meet all 5 requirements below.

amsant-icons-03 ePIP Requirements

Health services must be compliant with all requirements to be eligible to claim ePIP.

Requirement 1- Integrating Healthcare Identifiers into Electronic Practice Records

The practice must:

  1. Apply to Human Services to obtain a Healthcare Provider Identifier–Organisation (HPI–O) for the practice, and store the HPI–O in a compliant clinical software system;
  2. ensure that each general practitioner within the practice has their Healthcare Provider Identifier–Individual (HPI–I) stored in a compliant clinical software system; and
  3. Use a compliant clinical software system to access, retrieve and store verified Individual Healthcare Identifiers (IHI) for presenting patients.
Requirement 2- Secure Messaging Capability

The practice must have a standards-compliant secure messaging capability to electronically transmit and receive clinical messages to and from other healthcare providers, use it where feasible, and have a written policy to encourage its use in place.

Requirement 3- Data Records and Clinical Coding

Practices must ensure that where clinically relevant, they are working towards recording the majority of diagnoses for active patients electronically, using a medical vocabulary that can be mapped against a nationally recognised disease classification or terminology system. Practices must provide a written policy to this effect to all GPs within the practice.

Requirement 4- Electronic Transfer of Prescriptions

The practice must ensure that the majority of their prescriptions are sent electronically to a Prescription Exchange Service (PES).

Requirement 5- My Health Record system *new

The practice must:

  • Use compliant software for accessing the My Health Record system, and creating and posting shared health summaries and event summaries;
  • Apply to participate in the My Health Record system upon obtaining a HPI–O; and
  • Upload a shared health summary for a minimum of 0.5% of the practice’s standardised whole patient equivalent (SWPE) count of patients per PIP payment quarter