Verify Patient
Confirm patient details with Medicare and Health Fund before billing
Verify patient eligibility with Billumbra
Billumbra connects to the Electronic Claim Lodgement and Information Processing Service Environment (ECLIPSE) so you can double-check anaesthetic patients before you submit claims.
Get Started (Video)
Select Patient Record
Click on patient in the calendar view to open the patient's record.
Click the Dropdown Button
Click on the down arrow to view options
Click OPV Check
This will run a patient verification in real time
Types of Verification
There are three types of patient verifications for medicare and health fund claiming. Billumbra will automatically detect the type of verification based on the information enetered.
OPVAn Online Patient Verification confirms patient’s details are correct with the patient’s private health insurer and medicare enrollment.PVMA Patient Verification Medicare (PVM) verifies the patient’s details are correct with medicare only.PVFA Patient Verification Fund (PVF) verifies the patient’s details are correct with their private health insurer only.
Responses
Success
When the OPV check succeeds, Billumbra highlights the Medicare or health fund details in green and the date checked. The OPV Check will be saved with the patient's profile.
Update Required
This occurs when a Patient Verification has been accepted however patient details were not an exact match. Billumbra will present you the option to updated Medicare Details on the patient's profile.
Failed Check
This occurs when the card number and/or patient details submitted did not match Medicare checks.
Other Responses
- 9009 This transaction type is not permitted for this type of client. Health Fund Locations cannot request a PVF (Patient Verifications Health Fund)
- 9662 - Provider must contact Fund.
- 9663 Check Fund and Membership Card details.
- 9664 Check patient details. If correct, check Fund and Membership Card. If correct, the name known to the Fund may differ from that held by Medicare OR Patient Unique Identifier has not been supplied (if applicable to Fund).
- 9665 Cannot uniquely identify the Patient from the information supplied. Please resubmit with additional information and/or confirm the details with your patient.
- 9666 Patient must contact Fund.
- 9667 Health Fund Membership cover suspended or cancelled.
- 9668 Medical claims are not covered for this patient. Patient must contact Fund.
- 9669 Membership details matched however claims for the patient cannot be submitted using this channel at this time. Patient to contact Fund.
- 9671 The Health Fund identified does not currently accept transmissions through this channel
- 9686 Baby not known at Fund.
- 9687 EFT details are not registered