Home
Finance
Make electronic claims with Services Australia, including Bulk Bill claims, or if your health service operates fully or partially as a private business, bill a patient privately; and balance your banking records.
Patient Claims
For private billing, transmit patient claims to Medicare so that patients can receive a rebate from Medicare as part of the billing process.
Unsuccessful Patient Claims
Fix unsuccessful claims and resubmit them to Services Australia.

Finance
Make electronic claims with Services Australia, including Bulk Bill claims, or if your health service operates fully or partially as a private business, bill a patient privately; and balance your banking records.
- Record a Visit
  Create a visit for a patient, add the patient to the patient queue, and initiate the billing process for all types of visits. Alternatively for previous consults, create a visit and bill the patient.
- Patient Claims
  For private billing, transmit patient claims to Medicare so that patients can receive a rebate from Medicare as part of the billing process.
  - Pay Through Tyro
    After processing the billing, you can make a payment through Tyro automatically.
  - EasyClaim with Tyro
    After a patient has paid for their consult in full, a Medicare claim can be processed through Easyclaim or submitted to Services Australia.
  - Claim Summary
    After a claim has been successfully submitted to Medicare, a claim summary is generated.
  - Unsuccessful Patient Claims
    Fix unsuccessful claims and resubmit them to Services Australia.
    - Correcting Patient Claims
      You can view the list of pending claims and error messages for failed claims that have already been transmitted to Services Australia. You can also delete claims that have already been transmitted.
    - OPV Check for Payer (Claimant)
      Claims can only be transmitted if both the patient and payer OPV checks are successful.
- Medicare Bulk Bill
  For eligible patients, bulk bill the cost of the consult directly to Medicare, using Medicare Australia's online claiming.
- Workers Compensation
  Process Workers' Compensation claims using Helix
- Invoices
  If required, adjust any visit details for a patient's private invoice after it has been issued.
- Receipts
  When payment has been received from an account holder or Services Australia, receipting can be performed for all invoices.
- Transaction History
  View the transaction history for individual patients or account holders, refunds and write-off summaries.
- Banking
  Use the Bank panel to view deposited items and balance your banking records.
- Financial Reports
  Helix provides these reports on the Financial Reports tab.
- Configure Centre Billing
  Add your centre's account details, default billing type, default billing items for different scenarios and your Modified Monach Category for Medicarebilling incentive items.
- Fee Schedules
  Maintain the default fee schedule for patient services that are not bulk billed or DVA-related, import updated MBS and DVA fee schedules into your instance of Helix, and create customised fee schedules.

Unsuccessful Patient Claims

Fix unsuccessful claims and resubmit them to Services Australia.

About this task

Claims that were not processed because the patient is ineligible for a rebate are listed in the

Pending list. Users with the View Medicare exceptions and retransmit permission can open a claim, resolve any problems and retransmit the claim to Medicare.

Procedure

To update and resubmit a claim:

Select Claiming, Banking, and Payments > Patient Claims from the menu.
In the Patient claims tab, select Pending. All pending patient claims are displayed chronologically.
Filter the list of results by:
- Visit Id - view particular visit ID and its associated claim ID.
- Centre - if you have more than one centre, select the required centre from the list.
- HCP - view the required HCP.
To view the error details, for a patient claim, select it in the list.
The claim details are displayed in the Visit panel.

Alternatively, locate the patient claim and hover the mouse over the Errors column or click the error message.
View and resolve the errors for the claim. For more information about error codes, see Medicare digital claiming return codes:
- If the Re-transmit Claim field is disabled, hover the mouse over the Re-transmit Claim and view the eligibility conditions for the claim.
- To view the patient claim summary, click Patient Claim Results. For more information, see Claim Summary.
- If required, add additional codes and click Save.
After you have resolved the errors, click Re-transmit Claim.
You are redirected to the claim method selection panel.
In the Refund/Claim method field, set the previous claim method Easyclaim (EFTPOS) or Medicare Online Claim.
For the Medicare Online Claim method, if required, to send the contact details and bank details to Medicare, set Send contact details to Medicare and Send bank details to Medicare.
Click Retransmit.

Results

Retransmitted claims are submitted to Services Australia again.

After the claim is successfully processed, it moves to the Transmitted claims Transmitted list.

What to do next

If required, print the successfully transmitted claims from the

Transmitted claims

Transmitted tab. For more information, see Print or Download Transmitted Claims.