GuidesClaiming

Claiming

Lodge Medicare and DVA claims electronically with Services Australia
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The Claiming services allow health professionals and healthcare locations to submit Medicare and DVA (Department of Veterans’ Affairs) medical claims electronically to Services Australia. DVA covers eligible Australian veterans and their dependants — rather than using a Medicare card, patients are identified by a DVA file number, and the benefit is paid by the Department of Veterans’ Affairs instead of Medicare.

RebateRight supports two Medicare claim flows (below) and DVA medical claiming for eligible veterans — see the DVA claiming card.

Bulk Bill Claim

The patient assigns their right to Medicare benefits to the health professional. The claim is lodged on their behalf, with payment going directly to the provider.

Interactive patient claims

The patient retains their right to Medicare benefits. The claim is lodged on their behalf, with Medicare benefit paid directly to the patient.

DVA claiming

For eligible veterans and dependants covered by the Department of Veterans’ Affairs. Includes veteran verification, general / specialist / pathology medical claims, processing and payment reports, and the treatment service voucher (PDF).

Common Concepts

The two Medicare claim flows share the same building blocks:

ConceptDescription
Voucher (Medical Event)One visit — all the services a patient received on a single date. A claim can contain multiple vouchers (up to 80 for Bulk Bill, 16 for Interactive Patient Claims).
ServiceAn individual MBS (Medicare Benefits Schedule) item within a voucher — e.g. item 23 for a standard GP consult. Each voucher holds up to 14 services.
ReferralA referral from one practitioner to another (typically GP → specialist). Captures the referring provider number, date, and validity period. Required for specialist and some diagnostic services.
RequestAn order form issued by a requesting practitioner for lab tests or scans. Required for pathology and diagnostic imaging services.
Correlation ID (also Transaction ID)Your unique identifier for each claim — echoed on every response and used to trace, resubmit, or pend a claim. See below.

About the Correlation ID

Services Australia refers to this value as dhs-correlationId in requests, and as “Transaction Id” in its reason-code messages — you may see either term.

  • Format — urn:uuid:... (e.g. urn:uuid:MDE00000b896820b03e348a5). The first eight characters after the prefix are the clinic’s Minor ID.
  • Auto-generated — RebateRight generates one for you if your request omits the field. You can still supply your own — for example, to correlate the claim with an identifier in your own system for end-to-end tracing.
  • Same ID = resubmission — reuse the same correlationId to resubmit a corrected version of the same claim, or to pend a pendable claim.
  • New ID = new claim — use a fresh correlationId for every genuinely new claim. Reusing one from a previous claim is rejected by Medicare as a duplicate transaction.

DVA claiming follows a similar voucher-and-services model, but patients are identified with a DVA file number and related veteran fields.

Before You Begin

Claiming requires a Minor ID to be registered with Services Australia before you can submit claims. See the Minor ID Setup guide for instructions.

Ensure you have completed:

  1. Minor ID registration via the HW027 or HW052 form with Services Australia
  2. Practitioners linked to the Minor ID (call Medicare eBusiness on 1800 700 199)
  3. EFT bank details registered with Services Australia for Bulk Bill payment

Implementation Note

It is a requirement by Services Australia that error messages are displayed to the end user exactly as supplied in the response — not truncated, transformed, or changed in any way. These messages may be updated at any time.