# Keep Medicare claims connected to clinic billing. Prepare applicable bulk-bill and patient-paid claims from the billing workflow. Keep the patient, provider, invoice and returned response together, so your team can see what needs to happen next. Feature availability depends on your plan, enabled features and access permissions. Canonical HTML: [https://dappleos.com/features/medicare](https://dappleos.com/features/medicare) Feature group: [Clinical care](https://dappleos.com/features/clinical-care) ## At a glance - **Start with the bill.** Keep the claim connected to its patient, provider and invoice. - **See what needs attention.** Bring missing details and their next action into view. - **Keep assignment connected.** Record the required Assignment of Benefit against the bulk-bill claim. - **Follow the response.** Inspect the claim state and its available recovery actions. - **Review the financial result.** Use claim, batch and payment-report views with the right context. ## Begin with the bill you’re already preparing. For applicable services, prepare the Medicare claim alongside the patient’s invoice. Keep the service date, selected provider, location and MBS items in context. Bulk billing and patient-paid claiming follow their own paths. - Patient and invoice context together - Provider and location configuration - General and specialist patient-paid claim types ## Make the missing detail easier to find. The readiness panel brings card, verification, consent and provider details into the billing workflow. When something needs attention, the relevant action sits beside it. A different claimant has their own record and readiness checks. - Masked Medicare details remain visible - Fixable patient and claimant details - Bank details shown separately from blocking checks ## Keep the agreement with the claim. For bulk-bill claims that require an assignment, send the claim-linked form or record an agreement completed outside DappleOS. A sent form remains awaiting acceptance. Recorded evidence stays with the claim. - Send or resend the assignment form - Accepted and externally recorded states stay distinct - Required assignment holds the claim before transmission ## Choose when the patient-paid claim is submitted. Use After Payment to hold a draft until the invoice is settled, or Process Now for the supported unpaid-claim path. Choose Not Required when the patient is paying privately without a Medicare claim. - After Payment - Process Now - Not Required, Patient Paying Privately ## Stay with the claim that needs attention. Open the claim to inspect its status, service details and returned response. Use the correction, resubmission or deletion actions available for that claim’s state, timing and your permissions. A failed attempt remains something your team can follow up. - Persistent submission errors with the claim - Supported correction and resubmission - Eligible deletion actions with explicit confirmation ## Connect the response to the financial record. Review Claims, Bulk Billing Batches and Payment Reports in DappleOS. For bulk billing, a returned benefit can be applied to its linked invoice under the supported conditions. Patient-paid benefit reporting stays distinct from money paid to the clinic. - All, Bulk Bill and Private views - Claim and batch context beside payment reports - Returned amounts and status, without a second billing record ## Keep the clinical and billing context close. Use the same platform for the patient record, clinic billing and supported Medicare workflow. Your clinic chooses the appropriate service, provider and claiming path; DappleOS keeps the related records connected. - Clinical context - Connected invoice - Claim and payment reporting ## The service and provider, in context. MBS items and Medicare details sit alongside the invoice. Service eligibility and the correct item selection remain the clinic’s responsibility. ## A check with an action beside it. Here, card verification is completed and the readiness panel updates. This checks the recorded details; it does not guarantee acceptance of a service. ## Sent and accepted are different states. The form can be sent while the claim awaits assignment. Acceptance is recorded separately before the claim enters the applicable batching workflow. ## Choose the submission timing deliberately. After Payment is the default supported choice. Process Now and Not Required serve different billing decisions. ## The invoice settles. The draft can progress. A settled invoice can trigger submission of its eligible After Payment draft. A submission failure remains a draft for the team to investigate. ## Keep the reason in view. The claim retains a submission error, so the operator can review the context and use the available action. Submitted is a processing state, not a payment promise. ## A bulk-bill benefit against its invoice. This example shows an $80 returned benefit applied to an $80 bulk-bill invoice. The example amounts illustrate the workflow, not a current MBS fee. ## Read the benefit in the correct context. A private claim’s report keeps the assessed amount, service charge and patient gap together. A bank-pended payment can retain its assessed amount with a separate status. ## Configured access. Deliberate claiming. Give the right people the tools to prepare and follow claims, with patient details and clinic responsibilities kept clear. - Provider and location setup: The clinic configures its PRODA connection, participating locations and providers before the relevant claiming workflow can run. - Role-based access: Medicare viewing, creation, deletion and administration use separate permissions. Payment-report access follows the relevant permissions. - Patient details in context: Masked card details and applicable readiness actions stay beside the claim. A different claimant is checked against their own record. - Clear outcomes: Submission, assessment and payment are different states. The clinic remains responsible for eligibility, accurate services and appropriate claiming decisions. ## See the claiming workflow in your clinic’s context. Bring your billing mix and provider setup to a demo. We’ll walk through the supported claim paths, readiness checks and reporting with your team. ## FAQs ### Which Medicare claim types does DappleOS support? DappleOS includes Medicare bulk billing and patient-paid MBS claiming. Patient-paid claims include general and specialist paths. Use the workflow for applicable services and configured providers; offering an aesthetic service does not itself make it eligible for a Medicare benefit. ### What does our clinic need to configure? The clinic needs its PRODA connection, participating Medicare locations and provider configuration. Patient and claimant details, the service information and relevant consent must also be ready. A demo can map the product setup to your clinic’s billing mix. ### What does the readiness panel check? It brings together Medicare card details, verification, private billing consent, applicable patient details and provider context. If someone other than the patient is claiming, their own record is checked too. Bank details are displayed separately and are not, by themselves, a submission blocker. Readiness does not guarantee service eligibility or acceptance. ### How is Assignment of Benefit recorded? For a bulk-bill claim requiring assignment, the clinic can send the claim-linked form or record supported evidence completed outside DappleOS. Sent, accepted and externally recorded states are distinct. The required assignment must be recorded before that claim is transmitted. This is a different workflow from general clinical consent. ### Can patient-paid claims wait until the invoice is paid? Yes. After Payment holds a draft until the invoice is settled, then eligible drafts can be submitted. Process Now is the separate supported unpaid-claim path. Not Required means no Medicare claim is submitted for that invoice. If automatic submission fails, the draft remains available for follow-up. ### What happens when a claim needs attention? The claim detail shows its state and relevant response. Available actions depend on claim status, timing and staff permissions, including supported correction, resubmission and eligible deletion workflows. Sending a claim does not guarantee assessment or payment. ### Which claim and payment reports can staff review? Permitted staff can review Claims, Bulk Billing Batches and Payment Reports, including the relevant All, Bulk Bill and Private views. Reports preserve the returned amount and status. A bulk-bill benefit may be applied to its linked invoice; a patient-paid rebate must not be treated as a second clinic payment. ## Related features - [Clinical workflows](https://dappleos.com/features/clinical-workflows) - [Informed financial consent](https://dappleos.com/features/informed-financial-consent) - [Reporting and analytics](https://dappleos.com/features/intelligent-reporting) - [Clinical notes and markings](https://dappleos.com/features/clinical-notes-markings) ## Next step [Book a demo](https://dappleos.com/sales-call)