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Our fees


Setup fee

  • A one-time setup fee of $200 + GST
  • This includes Medicare registration (if required) as well as 2 remote one-on-one training sessions.

Monthly fee

  • 0.5% on all paid claims or $30, whichever is higher that month + GST
  • This covers email and phone support during business hours.

Merchant fees

Our merchant Ezidebit has a small fee per transaction.

  • For bank accounts: $1.18c per transaction
  • For credit card: VISA 2.4% (minimum $1.18)/Amex 4.4% (minimum $1.18)

FAQ

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 minimum monthly fee.

Is the monthly fee based on invoices i raise or payments i receive?

It is definitely on your receipts and not your invoices. So let’s say you invoiced a patient on the 15th of May and you didn’t get paid till June, we will not charge you for this invoice in May. Only once it is paid, will we charge you a percentage of that, in this example, that would be in June.

I have a few provider numbers, does that cost extra?

No it doesn’t, There is no extra setup fee and the minimum monthly fee or percentage will be charged each month (whichever is higher), regardless on the number of provider numbers.

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. ACSS Health 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 ACSS.

To link a provider number to a Minor ID:

  • If you are already sending claims electronically to medicare (perhaps you are using existing software)
    • Completing a banking form
  • If you are not currently sending claims electronically to medicare (you have not starting billing yet or you send claims by paper or via the proda website)
    • Completing a provider agreement

How long does it take for this form to get processed? (either the banking form or the provider agreement)

It takes medicare approx 2-3 weeks from when they receive the paperwork. We request you:

  • send us the paperwork
  • we send it to Medicare on your behalf
  • then we call Medicare after 4 business days to confirm 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, ACSS Health must issue you with a new Minor ID. So we need 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 below 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, 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. (hyperlink)

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, 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 to), 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, depends 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 2 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 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 upto 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 we will put you on a direct debit system. Your setup fee will be deducted this way. Then at the beginning of each month we will send you an invoice showing you a summary of the receipts you collected 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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