ANZ HealthPay Medicare Claiming Merchant Operating Guide
ANZ HealthPay Medicare Claiming Merchant Operating Guide
21
If Providers have not been setup:
•
Select this option. Key in the different Payee
Provider’s Provider number or leave the field
blank (for N/A) and press ENTER.
Account Reference
The Account Reference option is presented for
Partially Paid and Unpaid claims. This is only used
if to relate this claim back to the patient’s account
in a practice management system.
The default is for no Account Reference data,
indicated by an ‘N’ in the right column of this line.
If an Account Reference value has been entered, a
‘Y’ is displayed instead.
•
Select this option. Key in the Account Reference
number or leave the field blank (for N/A) and
press ENTER.
Referring Provider
The Referring Provider option is presented if the
Service Type of the Service Provider is Specialist/
Allied Health/Dental Service. The Referring
Provider number cannot be the same as the
Servicing Provider number.
The default is for ‘no Referring Provider’. This is
indicated by an ‘N’ in the right column of this line.
A ‘P’ indicates that Referring Provider details have
been entered.
•
Select this option to enter the Referring Provider
Details menu.
If no Referring Provider details are being
indicated:
•
Press 2, select the Referral Override Type and
then press ENTER.
Note.
The default Referral Override Type is “Not
Required” (indicated by N). Other options are “Lost”
(indicated by L) and “Emergency” (indicated by E).
If Referring Providers have been set up (see
Section Referring and Requesting Provider Setup)
and a Referring Provider is being indicated:
•
Press 1 SELECT PROVIDER
•
Select the Referring Provider or N/A from the
list OR:
•
If the required Referring Provider has not
been added previously, select SEARCH
option, key in the Referring Provider
number and press ENTER
•
Key in the Referral issue date and press ENTER
•
Confirm that the details are correct then
press ENTER.
If Referring Providers have not been set up and a
Referring Provider is being indicated:
•
Press 1 SELECT PROVIDER
•
Key in the Referring Provider number and
press ENTER
•
Key in the Referral issue date and press ENTER
•
Confirm that the details are correct then
press ENTER.
Requesting Provider
The Requesting Provider option is presented if the
service offered by the provider is Diagnostic or
Pathology.
The default is for no Requesting Provider, with an
override code depending on the Service type. The
character in the right column indicates the
override code: ‘S’ for Self Deemed, ‘N’ for Not
Required, ‘L’ for Lost and ‘E’ for Emergency. A ‘Y’
indicates that Requesting Provider details have
been indicated.
•
Select this option to enter the Requesting
Provider Details menu.
If no Requesting Provider details are being
indicated:
•
Press 2, select the Request Override Type and
then press ENTER.
Note:
The default Referral Override Type is “Self
Deemed” (indicated by ‘S’) for Pathology and “Not
Required” (indicated by N) for Diagnostic. Other options
are “Lost” (indicated by L) and “Emergency” (indicated
by E).
If Requesting Providers have been set up (see
Section 7.6 Referring and Requesting Provider
Setup) and a Requesting Provider is being
indicated:
•
Press 1 SELECT PROVIDER
•
Select the Requesting Provider or N/A from the
list OR:
•
If the required Requesting Provider has
not been added previously, select
SEARCH option, key in the Requesting
Provider number and press ENTER
•
Key in the Request issue date and press ENTER
•
Confirm that the details are correct then press
ENTER.
If Requesting Providers have not been set up and
a Requesting Provider is being indicated:
•
Press 1 SELECT PROVIDER
•
Key in the Requesting Provider number and
press ENTER
•
Key in the Request issue date and press ENTER
•
Confirm that the details are correct then
press ENTER.