Telephone claiming service for Medicare 011-43150000

Medicare provides a telephone claiming eservice for patient claims that is available 24 hours a day, seven days a week. The service is available to rural and remote customers who do not have access to online services.

To claim by telephone, claimants can call the Medicare Telephone Claims line, pass a security check and provide the Services Australia Service Officer with the required details of the medical service. The Resources page contains a link to Medicare contact information on the Services Australia Website. When processing a telephone claim the date of lodgement is the date of the phone call.

To align with all other Medicare claiming channels within the agency, claimants are required to provide proof or evidence of their claim in order to receive a Medicare benefit. This means all telephone claims are required to be pended, until the claimant sends in their receipts/accounts prior to any payment being made to the claimant.

Service Officers must advise the claimant all Medicare benefits for paid patient claims will be paid by EFT.

For more information see Account and receipt documents for Medicare claims processing.

The Process page contains information about telephone claiming procedures and recalling and processing a telephone claim from pend.

There are currently 60 remote service centres that provide self service facilities for the purpose of Medicare telephone claims. The service centres provide reply-paid envelopes for claimants to submit their claim.

To assist claimants from self service facilities, Service Officers must:

• complete the usual telephone claiming process
• advise claimant to place all relevant paperwork in the pre-paid envelope and submit it to service centre staff

Note: these claims are then placed in the office's outgoing mail to be forwarded to the Assessing and Benefits team.

Telephone claims pended with reason code 385 are copied from the pend file and incorporated into a daily Report Management and Distribution System (RMDS) report called Medicare pended telephone claims (RSN 385).

Service Officers use this report to contact claimants when resolving outstanding claims or where claims documentation has not been received within 4 weeks of the date of lodgement.

For the purposes of quality control, it is considered an error if a Service Officer did not permanently store bank account details provided, unless the claimant advised that the details were temporary for that claim only.