Custom medicare integration and medicare api integration for Australian healthcare providers. Bulk billing, patient claiming, DVA processing and practice accounting all flow from clinical data without manual re-entry.
Perth-based. Australia-wide. Built for healthcare.
The systems Australian medical, allied health and specialist practices most often ask us to connect to Medicare claiming. Click any platform to see its dedicated integration page.
Three stages. No surprises. Every custom medicare integration services build is delivered personally by the founder, from the first scoping call through to production cutover. Your live claiming data stays untouched until go-live.
Week 0
15-minute scoping call. We map your practice management setup, the claiming workflows (bulk-bill, mixed, DVA), and the specific bottlenecks slowing your billing team down. Fixed-price quote inside 48 hours.
Weeks 1–N
Integration built in a sandbox and parallel-run against your live claiming data for two weeks. Every item code mapping, field translation and event trigger validated before production. No risk to live billing.
Cutover
Production cutover on a planned window — typically a weekend. Team training, monitoring active, 30 days post-launch support. Documentation and source code handed over in full.
The most common medicare api integration and medicare claim automation workflows we build for Australian healthcare providers. Bulk billing, patient claiming, DVA, telehealth and reporting all sit on one integrated pipeline. Pick a tab to see how yours would take shape.
Bulk billing claims generated automatically from appointment and clinical data. Patient eligibility verified, item numbers applied based on consultation type, and claims submitted to Medicare electronically.
Batch submission for end-of-day processing or real-time submission per consultation. Bulk bill incentive payments tracked and reconciled.
For private billing practices where the patient claims. Consultation generates an invoice, patient is charged, and the claim details submitted so the patient receives their Medicare rebate directly.
Gap amount calculated automatically based on the MBS schedule fee, your practice fee and the rebate percentage. Statements issued to patients with clear breakdowns.
Department of Veterans' Affairs claims generated alongside Medicare claims from the same clinical record. DVA-specific item numbers, referral validation and pre-approval requirements applied automatically.
WorkCover, TAC and other compensable scheme claims also supported with payer-specific rules and submission formats.
Medicare rebates, patient payments, DVA receipts and sundry charges flow into MYOB, Xero or your practice accounting software. Revenue by provider, by service type, by payer — all categorised correctly.
Bank reconciliation simplified because payment sources are identified and matched to invoices automatically.
MBS telehealth item numbers applied correctly based on consultation type, duration and patient eligibility. Bulk billing, patient claiming and DVA billing all supported for remote consultations.
Integration checks telehealth-specific rules — geographic eligibility, established patient requirements, item restrictions — before claim submission.
Claim volumes, revenue by MBS item, rejection rates, average rebate amounts, provider billing patterns — in dashboards that update automatically.
Compliance monitoring for Medicare audit preparedness. Unusual billing patterns flagged proactively. Provider comparison reporting for multi-practitioner practices.
No hourly billing, no vague estimates. Here is how a custom medicare integration services build is scoped and priced. From a free 15-minute call to a fixed-price proposal that includes DVA, medicare billing integration and healthcare medicare integration reporting.
Tell us your practice management system, billing model and which payers you claim from. We give you a straight answer on what is involved and how a custom Medicare integration should be scoped.
Once scoped, you get a fixed price. Bulk billing automation, DVA integration, medicare billing integration, accounting sync. Each priced clearly.
MBS schedule updates, payer rule changes and software updates. We keep your medicare api integration current and compliant so claims keep flowing.
Why HELLO PEOPLE
Zapier, n8n and enterprise iPaaS all connect systems, in their own way. Here's how we compare for a real Medicare, DVA and practice billing build.
| Concern | HELLO PEOPLE | Zapier / Make | n8n / Self-hosted | MuleSoft / Boomi |
|---|---|---|---|---|
| Setup for the Medicare API | We handle PKI + provider auth | No Medicare app available | You build the Medicare nodes | Weeks of enterprise onboarding |
| Medicare claim submission and payment flow | Claims, ERAs, remittances handled | Cannot reach Medicare at all | Powerful, you build each step | Powerful, priced accordingly |
| AU privacy + Medicare compliance fit | AU-native, Privacy Act + MBS rules | Generic, misses AU quirks | Generic, you code the rules | Generic, needs configuration |
| Ongoing cost | One-off + optional support plan | Per-operation, forever | Self-hosted infra + upkeep | Enterprise licence |
| When Medicare updates the API | We patch, no extra charge | Broken sync until you fix it | You update the flow yourself | Support-ticket queue |
| Direct access to the builder | Email Kasun, get Kasun | Chat support tier | Community forum | Enterprise support tier |
| Patient, claim and provider data ownership | You own it, nothing sits with us | Vendor holds middleware | You own it (self-hosted) | Vendor holds middleware |
An allied health network with eight clinics was managing patient records in one system, billing in another, and claiming Medicare manually through the portal. We connected the three so claims submit automatically with the right item codes, and rejections come back into the practice management system for follow-up.
Read the full case studyOur admin team used to spend two hours a day pushing bulk-bill claims to Medicare and reconciling rebates in Xero. HELLO PEOPLE wired the practice management system straight through — claims lodge automatically from the appointment and our rejection rate dropped from 8% to under 1%.
Every medicare claim automation project we ship follows the same six-step structure. Discovery and compliance review, data mapping, build, testing, go-live and ongoing compliance updates. Every step respects healthcare privacy and audit requirements.
Custom medicare integration services usually cover the full claiming pipeline. Clinical data captured in the practice management system, mapped to MBS item numbers, submitted to Medicare via the official APIs, then reconciled back into Xero or MYOB. DVA, WorkCover and patient claiming sit on the same pipeline.
Yes. We integrate with Best Practice, Medical Director, ZedMed, Cliniko, Halaxy, Genie, Power Diary and Nookal. Clinical data flows to Medicare without manual re-entry, and results (paid, rejected, pending) flow back for triage.
Pricing depends on your PMS, payer mix and the volume of claims. You get a fixed-price quote after a 15-minute scoping call. No hourly billing, no surprises. Single-payer integrations are lower cost than multi-payer setups with DVA and WorkCover included.
Yes. Bulk-bill claims are generated automatically from appointment and clinical data, with item numbers applied based on consultation type and eligibility. Bulk-bill incentive tracking, batch or per-consultation submission, and rejection re-work all sit inside the workflow.
Yes. DVA, WorkCover (QLD, NSW, VIC), TAC and Comcare claims are all generated from the same clinical record. Payer-specific item numbers, referral validation and pre-approval requirements are handled automatically.
The MBS schedule updates quarterly with item number changes, fee adjustments and rule modifications. Under our support plan, we keep your medicare integration current with each release so claiming does not break.
All integrations comply with the Australian Privacy Act and My Health Records Act. Patient data is encrypted in transit and at rest. Audit logging covers every claim event. We follow the RACGP and ADHA security guidance for practice systems.
A single-payer integration for one practice takes 6 to 10 weeks. Multi-payer setups with DVA, accounting sync and reporting typically run 10 to 16 weeks. Larger medical groups run in phases so live claiming is never at risk.
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Share your practice management system (Best Practice, Cliniko, Halaxy, Genie), billing model (bulk-bill, mixed, private) and current pain points. We come back with a clear scope and fixed-price quote for the medicare integration you need.
Prefer a quick chat? Call 0425 531 127. We answer the phone in Perth.
