Billing – Frequently Asked Questions
What is the benefit in using ‘Doctor Claim’ services?
Does money collected go into my account or yours?
What is the turn around time for processing my claims?
Can I charge my patients’ co-payments?
Once I hand information to ‘Doctor Claim’ how do I know what’s going on?
If I need to see some of the information I sent to you what do I do?
How do I get my billing information to you?
What if I miss some information on the Billing Sheet Form?
What if the claim details I am sending is compensation related?
Where can I obtain an In-Patient Billing Service form?
How often should I send through my billing information?
What about confidentiality of the information I provide to ‘Doctor Claim’?
What billing methods can I use?
How do you manage Informed Financial Consent?
If I only see a few private patients each month, can I still us ‘Doctor Claim’?
How do you follow up on accounts issued to the patient?
If I join ‘Doctor Claim’, am I locked in?
What is the benefit in using ‘Doctor Claim’ services?
Outsourcing your billing is an effective way to use our expertise in medical billing to save you time and administration overheads. Our small processing fee is charged only when payment is recovered, which means we only get paid when you do.
Is there a registration fee?
There is NO Fee for registering with ‘Doctor Claim’.
What systems do you use?
All No Gap Claims are processed via our automated service (Eclipse). The benefits paid for your claims will always be transferred directly into your nominated bank account.
Does money collected go into my account or yours?
Benefits paid for your claims will always be transferred directly into your nominated bank account. Unlike some organisations which hold onto your money in their trust accounts, there is absolutely no lag time. You have access to the income you have generated as soon as the health fund transfers it to your nominated bank account.
Plus because we have well-established communication channels with all the funds, including Medicare the process is expedited – it’s quicker than doing it yourself or training your clinic staff to do it and when required we also follow up on rejected, unpaid or underpaid claims on your behalf.
What is the turn around time for processing my claims?
‘Doctor Claim’ will submit your claims to the respective health fund within 2 days of it being received by our staff.
If you’ve done a ward round on Tuesday and sent through the information to us that day, your claims will be submitted to the respective Health Fund on Thursday.
Once sent, payments will start appearing in your bank account within 5-12 days.
There’s only one exception: a very small number of claims are held up or rejected by the funds. They may require more information or amended details to proceed. If there is such a claim in your batch, it will not delay payment of your other claims. We will investigate and ensure that your rejected claim is reassessed by Medicare and the Health Fund. We may also contact you if there is any additional information required to assess the claim.
Can I charge my patients’ co-payments?
We can prepare your accounts as instructed using No Gap or Known Gap arrangements.
No Gap arrangements do not require a patient account to be raised.
For Known Gap arrangements we submit your claim to the Health Fund and issue a separate account to your patient for the agreed gap. As the co-payment is charged directly to your patient the co-payment will be electronically deposited into your nominated bank account depending on the time it takes to recover it from your patient, similar to patient accounts.
How do you manage arrears?
That is our expertise, we understand the health funds policies and procedures, who to contact and the appropriate language used in the industry to expedite payments and avoid delays. We mediate between your needs and their requirements.
Each of the Health Funds has its own specific way of doing business. Take advantage of the specialised knowledge we have and leave us to liaise with the Health Funds on your behalf to get your claims paid promptly.
We are in daily contact with the funds and we are vigilant about pursuing your interests.
If you have any outstanding claims, we will keep you advised about their status through our monthly reporting.
Once I hand information to ‘Doctor Claim, how do I know what’s going on?
As soon as we receive your medical billing service details from you, we will confirm this by email so you are confident that the claims payment process on your behalf is underway.
We are here to help you and we understand you are busy so if you require to access your billing details you can contact us;
- Monday to Friday from 9.00am to 5.30pm
And like any good financial tracking system, details are constantly updated for each action taken. You won’t need to sidetrack staff to pull files or go searching to locate documents. No bits of paper to worry about losing.
You never lose control over your billing we are here to take care of it for you so you can concentrate on the treatment of your patients.
We keep a record on file of all information you send us and you can request a copy of it any time.
If I need to see some of the information I sent to you what do I do?
All you have to do is let us know the name of your patient and we will send a copy of the account to you. Your records are securely filed at ‘Doctor Claim’ so you can access/request a copy of your accounts at any time.
We will send these requests to you by email.
How do I get my billing information to you?
We provide you with an electronic or hard copy template of our In-Patient Medical Billing Service form, all you will need to do is fill in this form with your claim details and fax, email or post it to us. – It’s that easy.
If you wish you can send your claim details to us on a spread sheet. We are Flexible
Because we know that billing is the bane of your practice, we want to make the procedure as easy and convenient as possible – for you.
You can help us speed the process of submitting your claim by filling in all required information on our In-Patient Medical Billing Service Form e.g. Patient’s full name, date of birth, Medicare card and reference as well as patient Health Fund and membership number.
Please ensure that your patient details include: Patient’s full name, date of birth, Medicare card and reference also Health Fund and membership number.
Please note that it is not mandatory that you use our medical billing service sheets but it is certainly preferred.
What if I miss some Information on the Billing service form?
That is what we are here for. So don’t worry we will contact the hospital, Health Fund or your patient to retrieve all required details. However this will delay the processing of your in-patient medical claim.
What if the claim details I am sending is compensation related?
Prior to submitting your in-patient compensation related claim details to ‘Doctor Claim’ we recommend that you obtain a copy of the approval letter issued by the Health Fund to the patient.
This will ensure that in the future you do not receive a request to refund benefits to Medicare or the Health Fund.
Please note that these claims may be delayed due to the policy and procedures held by Health Funds and Medicare.
Where can I obtain an In-Patient Billing Service form?
You can download it from our website at www.doctorclaim.com.au or you can contact us to request it and we can email, fax or post it to you.
How often should I send through my billing information?
This is up to you. Mostly doctors choose to send through their medical billing information every day or every few days. As soon as you pass it on to us, you don’t have to worry about it anymore. We take care of everything. The next step, for you, will be to check the payment into your nominated bank account by the Health Funds/Medicare/patients.
The sooner we receive your claims details, the quicker you get paid.
How much do you charge?
We charge a percentage of the funds paid to you for the in-patient medical claims we submit on your behalf each month. This is based on the amount that is actually banked into your nominated bank account for in-patient medical claims submitted by ‘Doctor Claim’ on a monthly basis.
This means that if there is any extra work to process an account, that’s our problem. Not yours. There are no hidden costs awaiting you at the end of the month.
We don’t charge a flat fee so if you’re not generating much billing, you’re not paying much either. There are also no retaining fees or start up fees. We only charge when we have successfully received payment of a claim for you in the current month.
If nothing is banked into your account in a particular month, ‘Doctor Claim’ does not charge you a fee. No Claims – No Fees.
We can guarantee that by using ‘Doctor Claim’ you will save significantly on your current administration costs by using our services and allowing us to submit your accounts and follow up any outstanding accounts on your behalf.
What about confidentiality of the information I provide to ‘Doctor Claim’?
All information that is communicated to ‘Doctor Claim’ about both clients and patients is treated in the strictest confidence. No one, apart from ‘Doctor Claim’ staff, is permitted access to any information held by the organisation.
Rest assured that ‘Doctor Claim’ adheres to all relevant legislation regarding confidentiality of patient records and patient information.
What billing methods can I use?
Whatever suits you, including:
- no gap claiming;
- known gap claiming;
- billing to third parties such as insurers or solicitors; and
- Veterans’ Affairs claiming
We have experience in all types of medical claiming used throughout Australia.
How do you manage Informed Financial Consent?
Doctors are responsible for obtaining Informed Financial Consent (IFC) from their patients. To assist, ‘Doctor Claim’ clients have free access to our ‘Informed Financial Consent’ template which can be downloaded from our website.This template can be adapted to suit your practice irrespective of which medical billing method you use.
If I only see a few private patients each month, can I still use ‘Doctor Claim’?
Yes you can. No client is too small. In fact, it is often those specialists who see only a few private patients who do not have the established resources to deal with in-patient medical billing. We’re always happy to help.
Can you bill my outpatients?
No. At this stage ‘Doctor Claim’ is only providing medical billing service for in-patient medical service.
How do you follow up on accounts issued to the patient?
We are specialists in NO GAP claims and at this stage we do not process/issue patient billing.
What reports do you provide?
Monthly reports summaries are provided to all clients. Monthly reports include:
- accounting summary;
- medical billing summary;
- payment summary by Health Fund; and
- Details of outstanding claims
Every month you will receive a detailed list of all patients, item numbers and amounts we have billed for you, exactly what we have collected on your behalf and what remains outstanding.
We are happy to provide additional reports or tailor reports to suit your needs.
If I join ‘Doctor Claim’, am I locked in?
You are free to leave anytime. We understand that your circumstances may change and we will assist you to make the transition to your new arrangements as smooth as possible.
Because it costs you nothing to join and nothing to leave, you can try ‘Doctor Claim’ at any time and see how it works for you. We’re convinced you’ll wish you’d done it sooner!