Medicare & Billing
Aged care Medicare billing
Mobile allied health providers can see dozens of residents across several facilities in a day. Each visit has to become either a Medicare claim or a line on a facility invoice, and resident details come from facility records and scanned forms rather than a front desk.
Common challenges
What teams struggle with
Second-hand resident data
Medicare numbers, IRNs and dates of birth come from facility profiles and referral paperwork, so they're often incomplete or inconsistent.
Two ways to bill
Each visit is bulk billed to Medicare or invoiced to the facility, depending on the referral, the cap and the outcome of the claim.
Daily volume
End-of-day reports across many sites mean hundreds of claims a week, so manual entry can't keep up.
Changing residents
New admissions, deceased residents and transfers between facilities all affect what can be claimed.
How we help
Practical solutions that ship
Claims from visit reports
Finalised end-of-day reports become claim batches, with residents split into Medicare, private, excluded and needs-input.
Stored claim details
Validated Medicare and referral details are saved on the resident profile and reused, so each claim isn't rebuilt from scratch.
Invoice and claim checks
A visit that's already on a facility invoice isn't claimed from Medicare, and a claimed visit doesn't appear on the next invoice.
Bulk exports
One export across many reports, each claim using the correct practitioner's provider number.
Frequently asked
Questions about aged care medicare billing
Can claiming work from our existing operations app?
Yes. We built this for a mobile allied health provider on their existing operations platform. Claims are generated from the visit reports their clinicians already complete.
Deep dive
Read the technical guide
Allied Health Medicare Claiming: The Rules Software Must Enforce
The rules behind chronic condition (EPC) allied health claims, why first batches fail, how to track caps that Medicare counts across providers, and where AI form reading helps.
Integration guideMedicare Batch Claiming Through Tyro Health
Moving from manual Medicare entry to batch claiming through Tyro Health: the CSV format, stable invoice references, pre-export validation, reconciliation, and when to move to the API.
Related guides
You might also need
Aged Care Software Development
Aged care software for Australian providers. Medication administration, care planning, resident management, and clinical documentation for RACFs and home care.
Medicare & BillingEPC and Chronic Condition Claiming Software
Medicare allied health claiming software for chronic condition management (EPC) referrals. Referral capture, five-service annual caps, entitlement tracking, and rejection handling.
Medicare & BillingMedicare Bulk Billing Software
Bulk billing software for Australian providers. Assignment of benefit, bulk bill claim generation, full-benefit reconciliation, and private billing fallback when Medicare declines.
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