Medicare API integration for GPs, Specialists and Allied Health practices around Australia. Bulk billing, patient claiming, DVA processing and practice accounting all run from the clinical record, so nobody rekeys a claim at the front desk.
Perth-based and Australia-wide. Built for healthcare, quoted at a fixed price, and supported by an Australian team after go-live.
Built here. Your data stays here.
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.
What an integration actually is
Every system in the business is good at its own job and blind to the others. The cost is not the software, it is the person moving information between them and the fact that no two systems ever quite agree.
What you already run
Runs on a schedule, maps your codes to theirs, handles the records that exist in both places, and keeps a log of every sync so a mismatch can be traced instead of argued about.
Get a fixed-price scopeWhat you get
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%.
Meet the person
Your Medicare Integration, handled by the founder from start to end.
HELLO PEOPLE designs, builds and looks after AI, software, app and data solutions for Australian businesses, with senior expertise on every project and a scope agreed before work starts. For an integration, that means every record lands where it should and both systems agree.
Since 2007, HELLO PEOPLE has delivered more than 100 projects from Perth for small and medium businesses across Australia: custom software and apps, system integrations, data migrations, reporting and dashboards, and AI that works inside the systems a business already runs.
I lead every engagement myself. I trained in accounting before moving into IT, hold accounting and IT professional qualifications and an MBA, and bring more than 20 years of experience across sales, service delivery, inventory and compliance. I am also a PhD candidate in AI at Curtin University, researching retrieval-augmented generation (RAG), so the technology is always judged by what it does for the business.
Small and boutique. The person who scopes your integration is the person who builds it, and the same person watches the first live syncs.
No ticket queue and no account manager in between. You hear back within one business day, usually sooner.
The integration is the start, not the end. When you need the next system, integration or report, you call the same person, who already knows your business.
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.
We review your practice management system, billing model, payer mix and current claiming workflow. Compliance requirements documented upfront.
Mapping clinical data to MBS item numbers, payer-specific rules and accounting codes. Edge cases identified: telehealth eligibility, referral expiry, item restrictions, concurrent claims.
Integration built with Medicare claiming APIs and your practice management system. Patient data encryption, audit logging and compliance controls built in from the start.
Real billing scenarios: bulk bill, patient claim, DVA, telehealth, mixed billing appointments. Rejection handling tested. Payment reconciliation validated.
Live with monitoring for the first billing cycle. Your admin team trained on exception handling. Rejection workflows confirmed working.
MBS schedule updates released quarterly. Payer rules change. We keep your integration current so claims continue submitting correctly.
How it runs today
After
Scoped and quoted before you commit. You own the code and the credentials at the end of it.
Get a fixed-price scopeCustom 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.
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