Our team has been working hard to support the new Medicare Integration, and along with a lot of unseen work behind the scenes, we have also made the following changes: New Improvements
Patient Verification
- DVA: It is now possible to source a client's DVA number and check eligibility if; Date of Birth, Family Name, Given Name, and Sex details exist in the client's file by clicking on the DVA Verification button.
- MEDICARE: When hovering the mouse over the Medicare Verification icon, the last date of validation will be shown.
- MEDICARE: In line with updated and improved Medicare Error Messages, more information is now returned where issues with a client's details exist e.g incorrect DOB.
- ENTITLEMENT/CONCESSION: Will now return if the client has a Concession Card as well as return their Medicare number for cross-reference.
Reconciliation Screen
- The Red Highlight colour for Overdue Claims sitting on the rec screen has been toned down to improve the user's experience.
Claims Screen
- New Views have been added to the claim screen to help end-users identify/investigate transactions if unsure of the claim numbers:
- Submitted - Shows all claims that have been successfully submitted to Medicare or DVA. All Medicare Reports are available from this view.
- Paid/Processed - Shows all items Paid and Processed by Medicare or DVA (This includes items rejected). All Medicare Reports are available from this view.
- Patient Claims - Shows Patient Claims that have been made in GPM. The Claim statement is available for this view.
- Archived - This allows a user to see what claims have been archived in the Medicare Reconciliation Screen if something has been archived in error.
- All Claims - Will show all claims processed in Gensolve. All Medicare Reports are available from this view.
- Stored - Shows Bulk Bill and DVA Claims that have been stored but not submitted to Medicare or DVA. To submit items, click on the relevant Stored Claims and click Submit Claims. The Claim statement is available for this view.
- The Claims screen now has an appointment link (pencil icon) located to the right of the Charges column to provide an easier investigation of claims. This is available in all the above views.
- To search for a specific Claim Number, use the Claim No. field. Regardless of the current View, it will return information about the claim you have entered if it exists.
New Functionality & Medicare Requirements
- Same Day Delete functionality has been added for Patient Claims. From the Claims >> Patient Claims screen, there is now an added icon to delete a patient claim on the same day it was sent.
- Pendable Claims - It is now possible to resubmit a Pendable Claim. The claim can be reviewed from the claim screen, once resubmitted within the hour the claim will be sent to Medicare with a status of Pended. This will then be reviewed by a Medicare Operator prior to payment or rejection. (Only the client will be notified).
- DVA White Card holders will now be required to provide an Accepted Disability when claiming. This can be entered via the Injury Description on the Condition. This must now appear in Capital Letters, e.g KNEE. It can also be entered from the claim screen if required. Note the use of '/' is no longer allowed to be used.
Patient Claim Statements
- You can now generate the Statement of Claim and Benefit after processing the Patient Claim
- You can now generate a Lodgement Advice for any Patient Claims that are marked as Pendable by Medicare after processing the claim.
- When adding a claimant to a Patient Claim, it is now possible to add a 2nd Address line and a contact number for the claimant.
- Medicare Safety Net applicable claims now show Medicare Claim Reason Codes and Reason Code Text on the Statement of Claim and Benefit.
Medicare Bulk Bill and DVA Statements
- You can now View/Print a Medicare (Bulk Bill / Patient Claim) or DVA Claim Receipt immediately after a claim has been successfully submitted for all items included in the submission.
- For DVA Claims involving non-exempt GST services such as Exercise Physiology etc or Report related service codes, the DVA Processing Report will now indicate that GST is Applicable.
- Notifications or flags appearing on Processing Reports are now highlighted in Red.
Other Minor Fixes
- An issue with, In-Hospital claims for certain DVA Paperless Claims, (Not related to Allied Health), has been fixed.