Configuring Capable 21C to support Tyro Easyclaim functionality for Medicare EPC claims

Abstract

Capable 21C supports the Tyro system for Medicare EPC claims via Easyclaim. This article describes how to configure Capable 21C to correctly support that functionality.

Underlying challenge

A Tyro terminal is an external device that is connected to Australia's Medicare network. Using a Tyro terminal independently of Capable 21C is quite easy, and Tyro provide instruction on how to do that. Using a Tyro terminal with Capable 21C is also easy. A few setup steps need to be performed before that can happen.

Resolution

Before configuring these features, it is important to enable Tyro functionality

To configure Capable 21C to use Tyro for processing Medicare EPC Payments the following steps must be performed:

There are two payment methods required. The first is for Bulk Billed Claims (if they will be used):

• Go to Setup|Setup Payment Methods.
• There must be a payment method specifically for Medicare Bulk Billing Payments. If one does not already exist, click the button to make a new one. If one does exist, double click on it to see its properties.
• Tick the box entitled 'Tyro Payment Method'.
• Make a note of the exact spelling of the name of the payment method. This will be used a little later.
• Click Close.
• Go to Setup|Settings.
• Go to the 'Other' tab.
• Click on the 'Tyro' System Component.
• Click on the 'Tyro Medicare Payment Pending Method' System Setting.
• Change the setting to match the exact spelling of the payment method noted earlier.

The second payment method is for Fully Paid Claims (if they will be used). These are payments made to the clinic from the patient's EFT account. The patient will be reimbursed directly from Medicare. It is acceptable to use the EFT payment method for this, though Capable Software encourages clinics to have a separate payment method for better statistical reporting:

• Go to Setup|Setup Payment Methods.
• There must be a payment method specifically for Fully Paid Medicare Payments. If one does not already exist, click the button to make a new one. If one does exist, double click on it to see its properties.
• Tick the box entitled 'Tyro Payment Method'.
• Make a note of the exact spelling of the name of the payment method. This will be used a little later.
• Click Close.
• Go to Setup|Settings.
• Go to the 'Other' tab.
• Click on the 'Tyro' System Component.
• Click on the 'Tyro Medicare Payment Method' System Setting.
• Change the setting to match the exact spelling of the payment method noted earlier.

In order for Capable 21C to be able to claim EPC Payments, it must have an appropriate invoice line item configured. When an invoice is processed, that line item will be sent to Medicare. Payment will only be made if the configuration is correct. Follow these steps to setup that invoice line item:

• Go to Setup|Setup Appointment Types and Fees.
• Double click on the relevant type of appointment (on the left).
• Go to the Services tab.
• If there is already an invoice line item (eg a Service) for EPC claims, double click on it. If not, click the 'Create New' button to make a new one.
• The name of the service is not relevant to the claim. Medicare only considers the Item Number for an EPC claim.
• Check that the correct item number has been entered. For example, a Chiropractic Spinal Adjustment has item number 10964
• Tick the box entitled 'Medicare claimable'.
• Specify the appropriate 'Medicare type'. For example, a Chiropractic Spinal Adjustment is typically considered a 'Specialist' item.
• Go to the Fees tab and ensure that the 'Normal Fee' is set appropriately.
• Click Close.
• Repeat these steps if there are other invoice line items you wish to claim via EPC.

The last configuration step is to ensure that each practitioner is configured appropriately for Medicare EPC claiming. Follow these steps:

• Go to Setup|Setup Doctor Details.
• Double click on the practitioner who will be providing the treatment.
• Medicare is not concerned with the name of the practitioner. It will approve claims based on the practitioner's provider number.
• Enter the practitioner's provider number (typically 7 digits and one letter).
• Click Close.
• Repeat these steps if there are other practitioners who will provide treatment.

Detailed Information

No further detail.

Copyright 2006 Capable Software Pty Ltd

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