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Audit4 Billing transition to Medicare Web Services

Services Australia introduced new mechanisms to replace the old Medicare PKI Certificate communication method for billing and claiming.  Audit4 meets all Medicare’s Web Services Integration requirements and received its final Notice of Integration (NOI) from Services Australia on the 9th of March 2022.  All practices that are using Audit4’s Billing module are now using the new Medicare Web Services.

Last Updated: 3/6/2022

Timeline 

February 2021:

S4S commenced Audit4 development work to support Medicare Web Services.

July 2021:

Audit4 v20.1.0 granted Notice of Integration (NOI) by Services Australia for Medicare Online – Online Patient Verification (i.e. Medicare, DVA and Health-fund numbers), Patient Claims, Bulk Bills and DVA Claims.  Inpatient Medical Claims are excluded at this point and still rely on Medicare Adapter and PKI Certificate for secure communication with Eclipse.

August 2021:

Audit4 v20.1.0 deployed to our Alpha site for live real world use communicating with Medicare Online via Web Services.

August 2021:

S4S commenced Audit4 v20.2.0 development work to extend Web Services support to include Inpatient Medical Claims and Eligibility Checking.

Sept/Oct 2021: 

Audit4 v20.1 deployed to a number of Audit beta users for real world use for communicating with Medicare Online via Web Services.

S4S Support provides assistance with PRODA B2B Device registrations and transitioning of Audit4 Billing sites over to Medicare Web Services commences (IMCs excluded).

Jan 2022:

Audit4 submitted new version to Medicare for conformance testing for Inpatient Medical Claiming via Web Services.  S4S Support continues assistance with PRODA B2B Device registrations and transitioning of Audit4 Billing sites over to Medicare Web Services (IMCs excluded).

 Feb 2022:

Due to delays getting Audit4 Testing and Conformance completed, list of Audit4 Sites that require IMC Functionality sent to Medicare to request additional time.  Request granted.

March 9, 2022:

Audit4 receives official Notice of Integration (NOI) for IMC Claiming via Web Services from Services Australia – Audit4 Billing is now able to use Medicare Web Services for all its communications with Medicare for claiming and reporting.  Roll-out of this new Audit4 version for Billing sites that require IMC functionality commences.

Late May, 2022:

Successful completion of Audit4 version roll-out to all sites requiring IMC functionality so that all Audit4 Billing sites are solely using the new Medicare Web Services.

May 30, 2022:

Cessation of additional time allowed for sites requiring IMC functionality.  All Audit4 Billing sites have been transitioned to the new Medicare Web Services.

Preparing for Web Services

You will need to register your organisation in PRODA. The following link is provided by Services Australia to help you prepare for Web Services.
https://www.servicesaustralia.gov.au/organisations/health-professionals/subjects/web-services-digital-health-and-aged-care-channels/how-prepare-web-services

Services Australia can help with the PRODA Organisation registration process.  If you sign up to use Audit4’s Billing module, further step by step instructions will be provided to assist with this process and S4S Support will help to get this working within your Audit4.

Does this change how Audit4 Billing works?

Basically no.  The user Audit4 user billing interface does not really change – it is the communication method underneath that uses the new Medicare Web Services method.  However Online Eligibility Checks (OECs) are now available for In-Patient Medical Claiming.