Integration

Medicare Integration for Australian Healthcare Providers

Automate bulk billing claims, patient claiming, DVA processing and practice accounting. Clinical data flows to claims without manual re-entry.

Perth-based. Australia-wide. Built for healthcare.

  • AU-wide Perth-based · servicing Australia
  • 18+ yrs Building custom software
  • Australian Healthcare compliance
  • Fixed Price scopes, no surprises
Medicare Integration

Medicare Claiming Integration That Actually Works

Your practice management system knows who the patient is, what consultation happened, and which provider saw them. But that data does not flow cleanly into Medicare claiming, DVA submissions or your accounting software. Someone re-enters it. Mistakes happen. Claims get rejected. Revenue gets delayed.

We build custom integrations so clinical data drives claiming automatically. Bulk billing, patient claims, DVA, telehealth items. Generated from the consultation record with the right item numbers, provider details and patient information.

HELLO PEOPLE is a Perth-based software consultancy. We help Australian GP practices, specialist clinics, allied health providers and medical centres automate their Medicare billing workflows.

Medicare integration hub diagram connecting patient records, claims, billing, HICAPS, reporting and compliance
Sound Familiar?

What we hear from practice managers

If your admin team spends more time on billing than patient care, these will resonate.

Bulk billing claims entered twice

The consultation happens in your clinical software. Then someone re-enters the billing details into Medicare Online or your claiming tool separately. Double handling slows things down.

Rejected claims with no visibility

A claim gets rejected and nobody notices for days. The rejection reason is buried in a portal. By the time it is actioned, the patient has moved on and follow-up is difficult.

DVA and WorkCover claims managed separately

Medicare claims, DVA claims and WorkCover claims each go through different processes. Your admin team juggles three different workflows for three different payers.

Patient billing disconnected from practice management

Gap payments, private invoices and patient statements live in your practice management system. Medicare rebate information lives elsewhere. Reconciling the two is manual.

Reporting for compliance is painful

Generating reports for Medicare audit compliance, claim volumes and revenue breakdown requires pulling data from multiple places and stitching it together.

Telehealth billing not streamlined

COVID made telehealth permanent. But billing for MBS telehealth items alongside in-person items adds complexity to an already manual claiming process.

15-Minute Integration Audit — No Cost, No Commitment

Tell us what systems you are running and what is not connecting properly. We map the gap, find what needs to be built, and give you a fixed-price quote before you commit to anything.

  • 15-minute scoping call
  • Fixed price included
  • Australian team
  • Ongoing support after launch
Book Your Free Audit
Get Started

Tell us about your practice billing

Which practice management system? Bulk billing, mixed or private? DVA caseload? Tell us your setup and we will scope the integration.

What We Build

Medicare Integration Workflows

The most common Medicare-related integrations we build for Australian healthcare providers.

Automated bulk billing claims

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 GP practices, medical centres and allied health providers who bulk bill some or all patients.

Patient claiming and gap billing

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.

Common for specialists, private GPs, psychologists and allied health practitioners with mixed billing models.

DVA and compensable claims processing

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.

For practices with significant DVA caseloads or multi-payer billing environments.

Practice accounting integration

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.

For practice owners and bookkeepers who need clean financial data without manual journal entries.

Telehealth and remote consultation billing

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.

For GP clinics, specialists and allied health providers offering telehealth alongside in-person appointments.

Billing analytics and compliance reporting

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.

For practice managers and owners who need operational and compliance visibility across their billing.

Medical practice with automated billing systems
Patient billing interface showing gap payment calculation
Healthcare professional managing DVA patient documentation
Practice accounting dashboard with automated revenue posting
Healthcare professional conducting telehealth consultation
Healthcare billing analytics and compliance dashboard
Why Integrate

Claims submitted from your clinical workflow

Consultations documented in your practice management or clinical software automatically generate Medicare claims. Item numbers, patient details and provider numbers pulled from the appointment record.

Bulk billing and patient claims submitted without re-entering data. Reduced claim rejection rates because the data comes from the source.

Healthcare professional reviewing patient billing on a tablet

Rejected claims flagged instantly

Claim rejections trigger notifications to your admin team with the rejection reason, patient details and suggested fix. No more checking portals manually.

Rework rate drops because common errors (wrong item numbers, expired referrals, invalid provider combinations) are caught before submission where possible.

Alert notification system for Medicare claim status management

Medicare, DVA and WorkCover in one workflow

Claims to Medicare, DVA and WorkCover generated from the same clinical record. Payer-specific rules applied automatically: item restrictions, referral requirements, pre-approval checks.

Your admin team runs one process. The integration routes claims to the right payer with the right format and rules.

Healthcare administration managing multiple payer workflows

Rebates and payments matched in your accounts

Medicare rebates received in your bank reconcile against invoices in MYOB, Xero or your practice accounting system. Patient gap payments, bulk bill incentives and DVA payments all tracked.

End of day, your revenue is reconciled. Not estimated.

Financial reconciliation dashboard for healthcare practice

Audit-ready reports without manual compilation

Claim volumes, rejection rates, revenue by item number, provider billing patterns. Generated automatically from your integrated data. Ready for Medicare audit reviews or internal governance.

Your compliance obligations met without a quarterly scramble.

Healthcare compliance reporting dashboard
Pricing

How we price Medicare integrations

Depends on your billing model, payer mix and practice management system.

Free 15-minute call

Tell us your practice management system, billing model and which payers you claim from. We will give you a straight answer on what is involved.

Fixed-price quote

Once scoped, you get a fixed price. Bulk billing automation, DVA integration, accounting sync. Each priced clearly.

Support & compliance

MBS schedule updates, payer rule changes and software updates. We keep your billing integration current and compliant.

Healthcare practice and Medicare claims integration across multiple clinic locations
Case Study

Practice + Medicare integration for an allied health network

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 study
8 Clinics unified onto one system
95% Reduction in claim rejection chasing
10hrs Saved per clinic per week
APRA Aligned data handling
How It Connects

Your Medicare integration at a glance

Clinical data drives claims. Payments flow to your accounts. Reporting keeps you compliant.

How It Works

From discovery to live billing integration

A structured approach that respects the compliance and privacy requirements of healthcare billing.

Discovery & Compliance Review

We review your practice management system, billing model, payer mix and current claiming workflow. Compliance requirements documented upfront.

Data Mapping & Rules

Mapping clinical data to MBS item numbers, payer-specific rules and accounting codes. Edge cases identified: telehealth eligibility, referral expiry, item restrictions, concurrent claims.

Build

Integration built with Medicare claiming APIs and your practice management system. Patient data encryption, audit logging and compliance controls built in from the start.

Testing

Real billing scenarios: bulk bill, patient claim, DVA, telehealth, mixed billing appointments. Rejection handling tested. Payment reconciliation validated.

Go-Live

Live with monitoring for the first billing cycle. Your admin team trained on exception handling. Rejection workflows confirmed working.

Ongoing Compliance

MBS schedule updates released quarterly. Payer rules change. We keep your integration current so claims continue submitting correctly.

Why us

Why HELLO PEOPLE for integrations

  • We build, not just connect

    We write proper integration code: API connections, data mapping, error handling, logging. Not Zapier chains that break quietly.

  • Fixed-price quoting

    You get a clear price before we start. No hourly billing that spirals. No surprise invoices at the end of the month.

  • Built for Australian business

    We understand BAS, GST, super, award rates, Australian privacy law, and the platforms local businesses actually use.

  • Senior team, direct access

    You talk to the people building your integration. No account managers, no offshore handoffs, no ticket queues.

  • Ongoing support included

    APIs change. Platforms update. We monitor, maintain, and evolve your integration so it keeps working as your business grows.

Our admin team used to spend two hours a day processing Medicare claims. Now bulk billing happens automatically from the appointment. Rejections are caught immediately. Our claim rejection rate dropped from 8% to under 1%.

Practice Manager Multi-GP medical centre, Perth
Healthcare Sectors

Medicare integrations by provider type

Every practice has different billing needs. The integration matches your specific model.

General practice consultation room

GP Practices

Bulk billing, mixed billing and private billing for general practice. Appointment data flows to claim submission. Gap payments calculated. Rebates reconciled.

Medical specialist conducting a consultation

Specialist Clinics

Referral validation, specialist item numbers and higher gap management. Claims submitted with correct referring provider and referral period tracking.

Allied health professional providing patient care

Allied Health

Medicare-eligible allied health claims: psychology, physiotherapy, dietetics, occupational therapy. Mental Health Care Plan sessions tracked. Referral validity verified before claiming.

Medical centre with reception and multiple consultation rooms

Medical Centres

Multi-provider billing across GPs, nurses and allied health under one roof. Provider-specific item numbers, bulk billing incentives and practice-level reporting.

Dental practice with modern treatment equipment

Dental Practices

Child Dental Benefits Schedule (CDBS) claims and general dental claiming. Treatment plans, item codes and patient eligibility verified before submission.

Healthcare professional conducting a telehealth consultation

Telehealth Providers

Pure telehealth or hybrid clinics billing MBS telehealth items. Patient eligibility, consultation duration and geographic requirements verified before claiming.

FAQs

Common questions about Medicare integration

Can you connect our practice management system to Medicare claiming?

Yes. We integrate with Best Practice, Medical Director, Cliniko, Halaxy, Nookal and other Australian practice management systems. Clinical data flows to Medicare claiming without manual re-entry.

Do you handle bulk billing and patient claims?

Yes. Both billing models supported. Bulk billing claims submitted automatically. Patient claims generate invoices with gap amounts calculated from the MBS schedule fee. Mixed billing practices handled seamlessly.

How much does a Medicare integration cost?

Pricing depends on the systems involved, the volume of data and the exception cases. We provide a fixed-price quote after a 15-minute scoping call — no hourly billing, no surprises.

Can you handle DVA claims as well?

Yes. DVA claims generated from the same clinical record as Medicare claims. DVA-specific item numbers, treatment cycles and pre-approval requirements managed automatically.

What about MBS schedule updates?

The MBS schedule updates quarterly with item number changes, fee adjustments and rule modifications. Under our support plan, we keep your integration current with each update.

Is patient data secure?

Absolutely. All integrations comply with the Australian Privacy Act and My Health Records Act. Patient data encrypted in transit and at rest. Audit logging for all claims activity. We follow healthcare data handling best practices.

How long does the integration take to build?

A single-payer integration for one practice takes 6 to 10 weeks. Multi-payer setups with DVA, accounting and reporting typically run 10 to 16 weeks.

Can you generate compliance reports for a Medicare audit?

Yes. Claim volumes by item number, provider billing patterns, rejection rates and rebate reconciliation. All available in automated reports. Most audit queries can be answered directly from the integrated data.

Get Started

Tell us about your practice billing

Your practice management system, billing model and payer mix. Share your setup and we will come back with a clear scope and cost.

Tell Us About Your Practice Billing

Share your practice management system, billing model and current pain points. We will come back with a clear scope and fixed-price quote.

Prefer a quick chat? Call 0425 531 127. We answer the phone in Perth.