Data mapping for Medicare and DVA
This page applies to both Medicare and DVA claims as they both use the Medicare Claiming service.
Data mapping
The information at Setting up describes the most important requirements for processing a Medicare/DVA claim when you are using the Medicare Claiming service.
In some situations, e.g. when the Service Type is S (Specialist), certain extra information must be communicated. If your claim is missing required fields they will be identified when you submit the claim. You can edit the details and re-submit the claim.
The table describes the requirements for different claims and the source of each field. Note that in some situations, Medicare and DVA require more details about the service. This is achieved by adding Cost Flags.
| Field | Source in Case Manager |
| Claim Type |
You select this at the top of the Medicare Claim form. Possible values are: |
| Patient First Name | First Name of the client case contact |
| Patient Last Name | Last Name of the client case contact |
| Patient Date Of Birth | Date Of Birth of the client case contact |
| Patient Gender | Gender of the client case contact |
| Patient Card Number |
Medicare Number of the client case contact Note that for DVA cases the client's DVA card number is stored in their Medicare Number field. |
| Patient Post Code | Post Code of the client case contact |
| Patient Suburb | Suburb of the client case contact |
| Service Type | First letter of the costs' charge code, see Setting up for Medicare/DVA |
| Servicing Provider Id |
Provider number of the employee linked to the costs, see Setting up for Medicare/DVA |
| Payee Provider Id |
Provider number of the office linked to the invoice costs, i.e. the recipient of claim payment. Set for an office at the category level, see Payee provider numbers. Only required for Medicare bulk bill and DVA claims |
| Location Type |
You can specify this when submitting the claim. Alternatively you can store it in advance in the shortcut for the costs' office. Not required for service type P (Pathology) |
| Location Name |
Name of the costs' office You can override the stored value when submitting the claim. Only required when the location type is Hospital; not required for service type P (Pathology) |
| Referral Date |
Referral Date of the case Only required when Service Type is S (Specialist) |
| Referral Provider Id |
Referrer Case Contact Provider, see Referrer provider numbers. Only required when Service Type is S (Specialist) |
| Referral Provider Type |
Can be either General Practitioner or Specialist If the Referrer Case Contact's Service field is General Practitioner this is used, otherwise Specialist is used. Only required when Service Type is S (Specialist) |
| Referral Period Type |
You can set this when submitting the claim using a dropdown list. Case Manager provides this option when it is required. Only required when Service Type is S (Specialist) |
| Referral Period Months |
You can set this when submitting the claim using a dropdown list. Case Manager provides this option when it is required. Only required when Service Type is S (Specialist) and Referral Period Type is N |
| Referral Override Code |
You can set this when submitting the claim using a dropdown list. Case Manager provides this option when it is required. Only required when Service Type is S (Specialist) and a referrer case contact is not linked to the case. |
| Accepted Disability |
You can set this when submitting the claim using a dropdown list. Case Manager provides this option when it is required. Only required for DVA |
| Accepted Disability Text |
You can set this when submitting the claim using a dropdown list. Case Manager provides this option when it is required. Only required for DVA |
| Claim Items | Billable costs linked to the invoice |
| Claim Item Flags |
For some services Medicare and DVA require more details. This is achieved by adding Cost Flags to the cost. |