This document provides answers to some of the common questions and concerns we hear about the Zedmed v35 upgrade and Medicare Web Services. It also includes a Lunch and Learn video, which introduces the new claims and payment processes.
Lunch & learn recording
Upgrade preparations FAQ
What do I need to do with Medicare private patient claims?
You can continue to process billing as normal because there are no delayed responses required from Medicare.
What do I need to do with Medicare and DVA batching (bulk bill) and Health fund claims?
To process Medicare, DVA and Health fund claims leading up to the Zedmed v35 upgrade:
- Make sure there are no outstanding batches or ECLIPSE claims before upgrading to Zedmed v35
- Create and suppress the invoices as normal and DO NOT batch or transmit them
- Once you have upgraded to Zedmed v35, you can transmit the held invoices.
What do I need to do with Tyro bulk bill claims?
To process Tyro bulk bill claims leading up to the Zedmed v35 upgrade:
- Make sure there are no outstanding Tyro batches.
- Create and suppress the bulk bill invoices and DO NOT transmit them.
- Once you have upgraded to Zedmed v35, you can transmit the held invoices.
Can we still create Medicare and DVA (bulk bill) invoices before the upgrade?
Yes, you can. These will be on hold, and you will be able to bulk transmit them after the upgrade.
What do I do with private patient claims processed via Tyro?
You can continue to process billing as normal because there are no delayed responses required from Medicare.
Can we still create ECLIPSE invoices before the upgrade?
Yes, you can. These will be on hold, and you can ECLIPSE them from the Patient Record’s Account Enquiry screen after the upgrade.
Will I lose the invoices in the Patient Record?
All invoices will still be available in the Patient record under the Account Enquiry Screen.
Will I still see previous Medicare and DVA reports or ECLIPSE remittance advice in Zedmed after the upgrade?
You will no longer be able to view these previous reports in Zedmed due to the Medicare Web Services changes.
However, you can:
- Back up the Medicare and DVA batching reports and the ECLIPSE remittance advice by saving them as a PDF to your local computer for future reference, before the upgrade.
- Request Medicare and DVA reports from Medicare's helpdesk after the upgrade.
- Request ECLIPSE remittance advice from health funds after the upgrade.
Can I still process AIR?
You can send AIR submissions up until the upgrade, but make sure they have been transmitted before starting the upgrade.
What if I find an outstanding transmitted bulk bill batch the day before the upgrade?
You have 2 options:
- Delay the upgrade until the batch has been paid.
- Proceed with the upgrade, but you will need to contact Medicare, DVA or the Health fund directly to get the remittance advice as it will not be available in Zedmed after the upgrade.
Who can I contact to upgrade to Zedmed v35?
If you have your own IT support team, they can complete the upgrade for you. Otherwise, you can call our Support team on 1300 933 000 to book this in for you during our normal business hours. Zedmed will contact you when we have a specific date for the upgrades to begin.
Do I need to make changes to the practice or doctor registration with Medicare?
This current process has not changed,
Billing and claims FAQ
Can we still continue batching if we want to?
Batching is no longer required in Zedmed. Instead, each claim is submitted individually when you complete the invoice. You can suppress bulk bill invoices if you want to review and submit them at the end of the day, using the Claims Status screen's Transmit Claims feature.
Will we have the ability to suppress bulk bill invoices?
Yes, the option to suppress an invoice is still available on the New Invoice screen.
How can you fix an item error in a bulk bill claim once it's been submitted to Medicare?
The current process has not changed. You must contact Medicare directly on 1800 700 199 so they can cancel the claim. This will allow you to recreate the invoice and retransmit it.
How can you fix an item error in a private patient claim once it's been submitted to Medicare?
The current process has not changed. You use the MA same-day delete function under Account Enquiry on the Patient Details screen to cancel the claim. This will allow you to recreate the invoice and retransmit it.
If you void an invoice and Medicare rejects an item number how do you know to resubmit the claim?
There will still be a description in the Claims Status screen's Payment tab.
How do we resubmit claims?
The current process has not changed.
Will there be a report for rejected claims?
A Rejected Claims report is currently in development and coming soon.
Our Development team is investigating this request and we will advise when it will be available.
Has anything changed for WorkCover or ADF claims?
There are no changes to the workflow for WorkCover or ADF claims.
How are private patients processed via Tyro?
The current process has not changed.
How are gap payments processed?
The billing process, including the processing of gap payments, remains the same.
For example:
- If you create a private patient claim, you still use QuickPay to process the Gap Fee, then MA Online to send the claim.
- If you create an ECLIPSE invoice, you still use QuickPay to process the Gap Fee, then ECLIPSE to send the claim.
Can we add notes to bulk-billed claims for multiple item numbers?
The current process has not changed. When you bill the patient, the New Invoice screen's Properties and notes fields are still available.
PKI certificates FAQ
Do I need to update my Medicare PKI certificate before the upgrade?
We recommend that the latest Medicare PKI certificate be installed. Check with the person who performs your Medicare PKI certificate upgrades to confirm that it is the latest certificate.
Should I install the new PKI Certificate just before the Zedmed upgrade or can we install it without waiting?
You can install the new Medicare PKI Site Certificate as soon as you receive it, and must be done before March 13. If you do not have the current Medicare PKI Site Certificate or CD, please contact Medicare on 1800 700 199. To learn more, see the Services Australia article.
Your own IT support can install the certificate using the steps in our Install Medicare PKI Certificate guide. You can also contact Zedmed Support if assistance is required.
Does the migration extension mean I should ask for PKI extension if existing certificate is expiring on March 13?
The extension date only applies to the migration of Zedmed users to Zedmed v35 and Medicare Web services. The PKI expiration date will still be March 13.
Do I renew our Nash PKI Certificate or revoke it and apply for a new one?
Renew the Nash PKI Certificate on its normal renewal period. You do not need to apply for a new one.
Functionality FAQ
Can we still batch process invoices for Western Australian Country Health Services?
If the Nurse has a provider number to claim, then it can be done in Zedmed.
How do I perform patient verification for DVA eligibility?
The Patient Verification button on the Patient Record checks for Medicare, Healthcare card, DVA and Health fund eligibility.
Is there any change in the way you search for a patient?
No. There is no change to the Patient Search screen or how it works.
What happens when the patient pays in full?
The current process has not changed for patients that pay in full.
Will Medicare payments to doctors still be bulk payments or will they get separate deposits?
Medicare will continue to make payments in the same way. Doctors will still be paid for groups of invoices with a single payment.
How are overseas students with private health cover processed?
Zedmed is unable to process payments for overseas students because they do not have Medicare cards, and Zedmed is unable to send claims to health funds.
Will there be new documentation for the changes?
Yes. A Migration Documentation portal with links to new documentation will be provided to practices before they upgrade to Zedmed v35 and Medicare Web Services. This portal will include a detailed migration guide, updated invoicing guides, and guides for the new claims submission and payment reconciliation processes. Once the migration to Zedmed v35 has been completed, the existing Knowledge Base will be updated with these new guides.