Medicare & Billing
Medicare claim reconciliation
Reconciliation shows that every service has been paid, declined and dealt with, or billed privately. When it's missing, billing teams keep spreadsheets alongside the system and revenue goes missing without anyone noticing.
Common challenges
What teams struggle with
Matching rows to services
Payment and transaction reports have to be matched to the right patient, provider and service date.
Re-imports
Importing an overlapping report twice shouldn't double-count or change anything.
Claims lodged elsewhere
Claims entered directly in a portal come back with no reference to your system.
Completion status
Batches marked 'complete' by hand while claims were still outstanding.
How we help
Practical solutions that ship
Repeatable imports
Transaction IDs are recorded and every import is applied in one database transaction.
Detail cross-checks
Reference matches are confirmed against Medicare number, IRN, provider and service date.
External claim matching
Candidate matches for hand-lodged claims, with weaker matches left for a person to confirm.
Derived status
Batch status is calculated from the claims in it, so it can't say complete while work is outstanding.
Frequently asked
Questions about medicare claim reconciliation software
Does this work with Tyro Health reports?
Yes. We've built reconciliation against Tyro Health transaction exports, and the same approach works with Medicare Web Services processing and payment reports.
Related guides
You might also need
Medicare Claim Rejections
Reduce and resolve Medicare claim rejections. Pre-submission validation, explanation code worklists, safe resubmission, and private billing fallback.
Medicare & BillingTyro Health Integration
Tyro Health (Medipass) integration for Medicare bulk billing. Batch CSV generation, invoice references, transaction report reconciliation, and direct API integration.
Medicare & BillingMedicare Bulk Billing Software
Bulk billing software for Australian providers. Assignment of benefit, bulk bill claim generation, full-benefit reconciliation, and private billing fallback when Medicare declines.
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