part payments of account & PCI claims

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  • Updated 5 years ago
If patients pay only part of their account (ie. over and above the medicare rebate amount), we don't seem to be able to lodge the claim with medicare.  This only seems to appear when a receipt for the full amount is raised, and the bill/payment screens don't give a PCI Claim option at all. This means the patient can't receive their rebate until they've paid us in full.  Surely the outstanding balance is our problem, not Medicare's?  Is there a reason for this and can it be changed so that as long as they have paid more than the rebate amount we can lodge their claim?  Or is this a Medicare ruling?
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Posted 5 years ago

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Andrew, Community Manager

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Hi Andrea

Welcome to the Community.

Medicare PCI claiming should always be available, whether the item is added with a full payment, part payment, or no payment. The only times the Medicare PCI option should be unavailable would be if Medicare Online Claiming isn't installed or enabled on that PC, or if the item(s) being added aren't setup as 'Medicare/DVA items'.

As for how Medicare offers rebates for Medicare PCI claims, that is solely decided by Medicare. If a patient pays the full amount for a PCI claim, the rebate is given to the patient. If the patient pays none or only part of the full amount, the rebate is to be given to the practice (via a cheque delivered to the patient).

If you feel something is amiss with your Medicare claiming workflow, or you are still finding you don’t have the Medicare PCI claiming option and believe you should, please open a support case using the options available on our website: