Two Way Claims

Two Way Claims

From time to time you may be advised by health funds to submit a claim as a "two way claim". Cutting Edge is not able to submit two-way claims on behalf of patients or providers. Strictly speaking a two way claim can only be submitted by a patient.

The electronic equivalent in CE is a fully paid patient claim. We recommend trying this first. To submit a patient claim:
  1. Take payment in full and record it on the invoice in CE.
  2. Select the appropriate claim type, Medicare Claim for uninsured patients, or Inpatient Claim for insured patients.
  3. Submit the claim as usual, the medicare +/- fund rebate will go to the patient.
  4. Note that there will be no processing or payment reports available in CE for this type of claim. 
For an actual two-way claim, the patient must submit it themselves, either via their MyGov portal or at a Medicare office. The process is:
  1. The patient completes a Two-way form available online at https://www.servicesaustralia.gov.au/ms001
  2. The patient signs into their myGov account or myGov app.
  3. They select "Make a Medicare claim," and attach images of the original accounts/receipts along with a completed Two-way form.
  4. Alternatively they can submit it to a Medicare office.
  5. The patient may also need to contact their Health Fund to get the fund component of the rebate.

    • Related Articles

    • DVA Claims

      In Cutting Edge you can submit DVA claims electronically, much like any other claim. Simply create a new invoice, enter the patient name and DOB then select DVA as the fund. In most cases CE will look up the Veteran's File Number for you, but if not ...

    • Dealing with Rejected Claims

      From time to time electronic claims will be rejected. In this case they will appear on the Rejected Claims tab on the ECLIPSE page.  The Invoice Status will also get changed to Follow Up, so you can easily locate rejected claims on the Follow Up tab ...

    • Handling two or more identical services on the same day with Not Duplicate Service flags

      Medicare checks that electronic claims are not duplicates of other claims that have already been paid. This can cause issues where a patient requires more than one consultation on the same day, or is taken back to the operating theatre. To improve ...

    • NIB Claims - Overseas & Manual Claims

      As of June 2023 - NIB will no longer accept manual claims. All claims need to be submited via Eclipse. If you have any issue with a verification - contact NIB 1300 853 530 For deceased patients, Cutting Edge will do a verification based on the date ...

    • Types of Online Claims

      The Health Fund you've selected on an invoice will dictate which claim type (Medicare, DVA or Private Health) is used. This also sets the Fee Calculation to the correct value. Bulk Bill Claims Electronic Bulk Bill claims allow you to claim the MBS ...