How to set up for electronic claiming
The Department of Health (the Department), in partnership with the Department of Human Services/Medicare (DHS) has developed a web-based electronic claiming (e-Claiming) facility that allows contracted service providers (providers) to lodge claims for payment via the internet.
The e-Claiming facility is designed to ensure that all parties – providers, the Department and DHS are able to reliably track and process all claims received electronically.
The Australian Government Hearing Services Program (the program) has an accreditation process for all entities prior to being offered a contract to provide services under the program. It is not possible to set up the e-Claiming facility until you are accredited to provide services, however you may benefit from making contact with a software developer in advance.
The software that your business uses is an individual business decision, and may be different for every business. The Department does not have any preference for software providers. The current software providers are
|
Provider / Company |
Software |
Phone Number |
Email Address |
|
Francois Capmeil / |
Fitting Wizard |
(02) 9592 4603 |
|
|
Lindsay Symons / |
Hear Aid |
(03) 5832 2261 |
|
|
Jeff Crumb / Simply Hearing |
Simply Hearing Software |
Office 888.662.3881 Ext. 223 Fax 519.725.0846 |
|
| Florin Voinescu / Onda Labs | EarWorks | +617 5641 2339 | florin@ear-works.com |
The e-Claim Handbook and File Format Guide is designed to assist providers in setting up an e-Claiming facility. These have been updated and are accessible via the links provided below.
User guides
Two e-Claiming guides have been prepared to assist you
How do you set up e-Claiming?
When the Department advises you in writing of your successful accreditation and subsequent offer of a contract, you are able to set up for e-Claiming. After you have installed your chosen software, you will need to generate a test file and email it to hearing@health.gov.au. For assistance creating your test file, you should contact your software provider.
Upon receipt of your test file the Department will check to make sure that the information is compliant with DHS’s e-Claiming software. If necessary, you will be requested to provide additional information. The testing phase can take up to three working days, per test file submitted.
The Department will then forward the test file to DHS who will perform a more rigorous scan of the test file through their automated verification process. Once complete, DHS will advise the Department of the outcome. Additional information will be requested, if required, otherwise you will be asked to complete a template document that is required by DHS to finalise your e-Claiming access.
After you return the template document to the Department, we will forward to DHS who will allocate a user ID, default password and Minor Customer Identification numbers (minor ID’s). For security reasons this information is sent to you via secure email. If you have not received the email within two weeks, then you should call DHS on 08 8274 9370 as soon as possible.
The minor ID’s are the identifiers used in tracking the claims made for all providers. It takes up to 20 working days for DHS to finalise the creation of the minor ID’s.
Can you have separate minor ID’s for each site?
You can have separate minor ID’s which will allow you to lodge claims completely independently from each site. If you make a business decision that additional minor ID’s are required for each site, you will need to email hearing@health.gov.au to discuss your requirements.
How long does it take to get paid after lodging claims?
E-Claims are paid by DHS within 24 hours of lodgement. Manual claims sent via the Hearing Services Online Portal or to the Department can take up to 15 working days to process.
Who should you contact with any queries?
If you are having trouble with the e-Claiming facility i.e. logon, lodgement etc. please contact the DHS e-Claim helpdesk on 08 8274 9370.
For general information about e-Claims and e-Claiming setup and procedures to start claiming electronically through DHS, please call 1800 500 726 or email hearing@health.gov.au.
How to become a contracted service provider