Doctor-Based Pricing
Our Fees
With ECLIPSE (health fund) Billing
- Fee per practitioner per month: $255 + GST
- This includes billing for Medicare, Veterans, ECLIPSE, Patient Claims, Private Invoice, Workers Comp
- $15 + GST for each additional diary (no billing)
- A one-time setup fee of $215 + GST
- This includes Medicare registration (if required) as well as 2 remote one-on-one training sessions.
Without ECLIPSE (health fund) Billing
- Fee per practitioner per month: $55 + GST
- This includes billing for Medicare, Veterans, Patient Claims, Private Invoice, Workers Comp
- $15 + GST for each additional diary (no billing)
- A one-time setup fee of $215 + GST
- This includes Medicare registration (if required) as well as 2 remote one-on-one training sessions.
Merchant fees
- We will absorb all merchant fees, except for a $4.40 fee per failed or rejected transaction. We will set you up on a direct debit, where you can enter your bank account or credit card. The same details will be used for all succeeding fees, and whenever the payment for that month fails, we will charge you this amount.
Frequently Asked Questions
What if I have not billed anyone for a particular month? Will I still get charged that month?
Yes, regardless if you have not been paid for any services that month, you will still incur the monthly fee.
I have a few provider numbers. Does that cost extra?
No, it doesn’t. A practitioner with multiple provider numbers will not incur a fee per provider number as long as the provider stem is the same.
When can I start claiming/billing?
For Medicare (Bulk Billed) and Veterans claims [for either outpatient or inpatient claims]
For Medicare or the Department of Veterans Affairs to process your claims, Medicare needs to have your provider number linked to a Minor ID and your bank account. FYDO will issue you with a minor ID. Think of it like a customer number we issue you with. This is a process required by Medicare not FYDO.
To link a provider number to a Minor ID, you need to complete a Medicare banking form. We will assist you with this once you sign up.
How long does it take for this form to get processed?
It takes Medicare approximately 2-3 weeks from when they receive the paperwork. We request that you:
- Send us the paperwork
- We send it to Medicare on your behalf
- Then we call Medicare after a few business days to confirm that they received the paperwork and have added it to their queue.
That’s right. They have a queue of about 2-3 week of paperwork to get through.
But I already send claims to Medicare and get paid? They already have my bank account. Do I still need to complete the above and wait 2-3 weeks?
Yes, unfortunately you do. The reason is FYDO must issue you with a new Minor ID. Medicare needs to link your provider number/s to this new Minor ID.
I only send ECLIPSE claims, do i need to complete the above?
No, if you will not send any claims to Medicare or Veterans, then you do not need to complete the above, see the section on ECLIPSE claims below.
For ECLIPSE Claims [in-hospital claims sent to the health funds]
To send claims to the health funds electronically you will need first register with the health funds. Yes, each health fund. There is no one form that registers you with all health funds.
The good news is, the Alliance group (AHSA) is a group that consists of approx 30 funds such as HBF, Aust Unity, Teachers Health, etc. When you register with one fund, you are instantly registered with all the health funds in the AHSA group. View all funds within the AHSA group.
We recommend you register with at least the most common funds first, such as:
- Alliance group
- Medibank / AHM (when you register with one, you get registered with both)
- HCF
- NIB
- BUPA
You can then get around to registering with the other funds when you have time, or when the need arises. However, you don’t want to wait too long. Some health funds do not back pay. This means, let’s say you saw a patient 5 months ago, and you haven’t got around to sending your claim and in fact you have not even registered with the health fund. Naturally, you register with the health fund and then submit your claim. The health fund might reject the claim as you were not registered with them when the service was provided! Not all funds do this. We’ve heard BUPA does this, but you should be able to explain and get this amended. I would suggest, if this is your scenario, that when registering, let the health fund know you have some claims to backdate.
When registering with the health funds, we recommend giving the health fund a call after 4-7 business days (of submitting the paperwork), if you have not heard from them. They don’t always email you to let you know they have registered you.
What if I have both Medicare/Veterans claims as well as ECLIPSE claims?
Well, if you have mostly in-hospital health funds claims to process and hardly any Medicare/Veterans claims, and you are already registered with most funds (at least the heath funds you plan to claim from), then we can book you in for your training session to show you how to submit your ECLIPSE claims.
We can then book you in for another training session to show you how to submit your Medicare/Veterans claims once Medicare confirms your banking form or provider agreement has been processed.
How is the training conducted, and how long does it take?
The goal of the training session is to:
- Show you how to create patients
- Show you how to bill a handful of claims
- Get you to bill a handful of claims, so you will get hands on experience
- Approx 5 claims will be sent
This initial training session will take approx 45 mins to 1.5 hrs, depending on how many questions you have along the way. The session is conducted remotely, not onsite. So we will call you and connect into your computer, and we’ll both see the same screen and it’s like we are sitting besides it each other.
At the end of your first training session, we will book you in for a follow up training session where we will cover:
- How to check for reports and payments from Medicare/Veterans or the health funds
- How to deal with any rejections
- How to receipt/reconcile claims
After these initial training sessions, you will be confident to continue billing on your own. But don’t worry! We are only an email or phone call away if you get stuck.
What do I need to be booked in for a training session?
Since the goal is to send actual claims, to book in for your training session, you will need to have some real actual claims to submit.
You will need the following with you for your training session:
- Patient’s first and last name
- Date of Birth
- Gender (only for veterans claims)
- Medicare or Veterans number
- Date of Service
- MBS/DVA code/s
- Referring Dr name, provider number, referral date and period (if a referred service)
- Health fund and membership number (only for ECLIPSE claims)
- Hospital provider number (only for in hospital claims)
How quickly will I see payments in my bank account?
For Medicare and Veterans claims, you will see money drop into your account within 1-3 business days, with the exception of pathology–these take up to 2 weeks.
For ECLIPSE claims, all health funds have various payment turn around times, but the maximum would be 4 weeks.
For example, HCF pay every Friday, so if you sent a claim on Monday or Tuesday and it was approved, you would normally see payment by that Friday. Medibank/AHM take around 1-3 business days, whereas BUPA takes around 9-11 business days.
For ECLIPSE claims, the good news is, within 5 business days, the health fund must send you a report advising if the claim is going to be paid or has been rejected. If it has been rejected, you can make the necessary edits to re-lodge the claim.
How will I pay you each month?
Upon signing up, you will be sent a request to sign up for a direct debit system. At the beginning of each month, we will send you an invoice showing you a summary of your fees in the previous month. Then about 8 days later, we will deduct that amount from your nominated account.
Can I just pay myself and not be on a direct debit plan?
No, to make this service as affordable as possible, we need to be able to streamline operations.
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Email: fydo@alturahealth.com.au
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