Oliver Frank wrote:
Apology for cross-posting to those who have received this via the
nat-div list.
This week's Friday Fax from the RACGP points to:
http://www.medicareaustralia.gov.au/providers/programs_services/medicare
/electronic-claiming.shtml
"How it works
Bulk bill claims:
1. The patient's Medicare card is swiped through your EFTPOS terminal
2. some basic information is entered on the keypad. For most GP bulk
bill claims this will be no more than five keystrokes, more for
specialists"
How many more? What is the minimum number and what is the maximum
number of keystrokes that specialists' staff will have to enter? This
vague (deliberately so, I suspect) statement reminds of the
advertisement for one brand of electric kettle of 2L capacity, which
said that it could boil 1 cup (250mL) of water in 30 seconds, and that
boiling 2L would take "a little longer". I presume that 2L of water
would have taken 8 x 30 seconds = 4 minutes to boil. Is this only a
"little longer" than 30 seconds or is it in fact eight times as long?
How many more keystrokes than five will specialists' staff have to enter?
" * the claim is automatically encrypted and sent to Medicare,
entitlements are verified and an approval message is sent back to the
terminal
3. the patient then presses "OK/Yes" to assign their Medicare benefit
to the doctor and the terminal prints a patient receipt.
No more batching or storing claims and payment is received usually on
the next working day."
Why only on the next working day and not within the next minute? What
prevents payment within the next minute?
"Paid patient claims:
1. The patient pays as usual (cash, cheque, credit card or EFTPOS)
and their Medicare card is swiped through your EFTPOS terminal
2. some basic information is entered on the keypad. For most claims
this will be around ten keystrokes, more for specialists"
How many more? What is the minimum number and what is the maximum
number of keystrokes that specialists' staff will have to enter?
" * the claim is automatically encrypted and sent to Medicare,
entitlements are verified and an approval message is sent back to the
terminal
3. the patient swipes their bank debit card through the EFTPOS
terminal and enters their PIN. The Medicare rebate is paid directly into
their bank account almost instantly.
So the patient pays in full, in our practice usually using a credit or
debit card - that's one swipe. Then their Medicare card is swiped.
Then at step 3 their "bank debit card" (won't credit cards work for
this?) is swiped. Perhaps we should adapt and adopt the American
baseball motto: "Three swipes and you're out".
"Unpaid accounts
1. The patient's Medicare card is swiped through your EFTPOS terminal
2. some basic information is entered on the keypad. For most claims
this will be around ten keystrokes, more for specialists"
How many more? What is the minimum number and what is the maximum
number of keystrokes that specialists' staff will have to enter?
" * the claim is automatically encrypted and sent to Medicare,
entitlements are verified and an approval message is sent back to the
terminal
3. a cheque is sent from Medicare Australia to the patient who then
brings it back to the practice.
A CHEQUE IS SENT in this all singing all dancing electric system "to the
patient who then brings it back to the practice", which will have to
physically take it to the bank to deposit said piece of paper. IS THIS
PROGRESS ?
"Frequently asked questions
Do I need any special equipment?
If you already have an EFTPOS terminal in your practice you don't need
any other equipment. Participating financial institutions will make sure
terminals can provide electronic Medicare claiming and will also provide
practices with training materials."
What if the bank that supplies our EFTPOS terminal decides not to
participate?
"Will I need to change my computer software?
No. The new system is stand-alone using the existing tried and proven
EFTPOS network. It is not integrated with practice software."
Heaven forbid that we would an integrated system. So the practice has
to record the transaction first in our computer system, then do it all
again via the EFTPOS terminal. IS THIS PROGRESS?
I watched the video demonstration on the Website. I note that the good
news in the video narration that the patient "still pays by whichever
way the doctor requests". Not by the whichever way the patient wants to
pay, but by "whichever way the doctor requests". Does this mean that I
can request (that is, demand) payment by new-release DVDs, while the
plastic surgeon can request (demand) payment in pink Argyle diamonds of
suitable size and quality?
Oliver,
Having finally caught up with this I also wonder how bulk-billing
doctors get any surety or feedback about claims being accepted or not.
Your analysis has raised many good points, especially the cheque issue
if the practice doesn't get paid up front.
Also one of the set of keystrokes is obviously the item number, so there
is lots of potential for data entry errors, and there is no information
about how they'd be handled. Do you need the patient to swipe their card
again, as its obviously the confirmation that the patient is involved in
the process?
More importantly, there is no information about how any data gets into
the practice management system for things like accounting, chasing up
patients re unpaid accounts, dividing up the rebates by whatever formula
or arrangements the practice has in place, etc. All re-keyed into the PM
system or done by hand, without the benefit of those DB4 copies a manual
billing practice keeps?
The whole process seems blind to those implications for practices, which
would presumably require re-keying. Patients seem to get receipts but
not the practice, and who pays for all of that lovely paper coming out
of the eftpos printer?
I also wonder where the consultation with practices has come into this
whole process. Missing as usual?
As I've said before, the government wants a technology to smooth the
path away from bulk-billing for many Australians. Smooth for practices
is another matter.
Greg
--
Greg Twyford
Information Management & Technology Program Officer
Canterbury Division of General Practice
E-mail: [EMAIL PROTECTED]
Ph.: 02 9787 9033
Fax: 02 9787 9200
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