Easy Claims

Easyclaims #

Medicare Easyclaim is a system that uses banking infrastructure and EFTPOS terminals to create and lodge Bulk Bill claims. This is know as the Easyclaim Web Service (BBeW). Easyclaim can also be incorporated into Practice Management Systems (PMS).

The Claiming.com.au API has an easyclaims endpoint, which is an alternative channel to retrieve BBeW Processing and Payment Reports for EasyClaims submitted through the banking infrastructure. These reports are available for six months after the claim’s date of lodgement.

Reports can only be requested by the same transmitting location (Minor ID) that submitted the original claim. Requests must include the original EasyClaim transaction ID(s) and payee provider number.

NOTE: the format of EasyClaim transaction IDs are different to other transaction IDs. Here’s an example “01021071412164565742722M”

POST - Fetch one Easyclaim report #

You can request processing and payment reports for a single EasyClaim transaction. In this case the body contains the original EasyClaim transaction ID and the Payee’s provider number.

{{base_url}}/{{version}}/easyclaims?location={{location_id}}

Headers

HeadersValue
Acceptapplication/json
Content-Typeapplication/json
AuthorizationBearer {{oauth_token}}

Params

Paramvalue
location{{location_id}}

Body

{
    "provider": {
        "payee": "2441081A"
    },
    "transactionId": [
        "01021071412164565742722M"
    ]
}

Example Request:

curl --location 'https://sandbox.claiming.com.au/v2/easyclaims?location=25' \
--header 'Accept: application/json' \
--header 'Content-Type: application/json' \
--header 'Authorization: Bearer ' \
--data '{
    "provider": {
        "payee": "2441081A"
    },
    "transactionId": [
        "01021071412164565742722M"
    ]
}'

Example Response:

Body:

{
  "status": "OK",
  "total": 1,
  "records": 1,
  "offset": 0,
  "results": [
    {
      "status": "COMPLETE",
      "transactionId": "01021071412164565742722M",
      "medicareClaimId": "L8621$",
      "timeReceived": 1626184800,
      "benefitPaid": 39.1,
      "chargeAmount": 38.75,
      "provider": {
        "payee": "2441081A",
        "servicing": "2441081A"
      },
      "patient": {
        "medicare": {
          "number": "2951386024",
          "ref": "1"
        },
        "name": {
          "family": "SMITH",
          "first": "HENRY"
        }
      },
      "payment": {
        "runNumber": "1951",
        "date": "2021-07-14",
        "amount": 39.1,
        "bank": {
          "bsb": "062914",
          "accountNumber": "*****3690",
          "accountName": "DR FARRELL"
        }
      },
      "items": [
        {
          "MedicareServiceId": "0001",
          "chargeAmount": 38.75,
          "itemNumber": "00023",
          "date": "2021-07-14",
          "benefit": [
            {
              "assessor": "Medicare",
              "benefitPaid": 39.1
            }
          ]
        }
      ],
      "type": "BulkBill"
    }
  ],
  "transactionId": "SAP00000o3iwh7PGvE0H5ky8"
}

Headers:

HeaderValue
Servernginx/1.19.3
DateTue, 08 Jun 2021 04:49:28 GMT
Content-Typeapplication/json
Content-Length508
Connectionclose
Access-Control-Allow-Origin*
Access-Control-Allow-MethodsGET, POST, OPTIONS
Strict-Transport-Securitymax-age=3153600; includeSubDomains; preload
X-XSS-Protection1; mode=block
X-Content-Type-Optionsnosniff
X-Frame-OptionsSAMEORIGIN

POST - Fetch multiple Easyclaim reports #

The request body can contain up to 1000 EasyClaim transaction IDs for the same Payee Provider. The processing and payment reports be in an array, one for each original claim.

{{base_url}}/{{version}}/easyclaims?location={{location_id}}

Headers

HeaderValue
Acceptapplication/json
Content-Typeapplication/json
AuthorizationBearer {{oauth_token}}

Params

Paramvalue
location{{location_id}}

Body

{
    "provider": {
        "payee": "2441081A"
    },
    "transactionId": [
        "01021071412164565742722M",
        "01021071412061261677122M"
    ]
}

Example Request:

curl --location 'https://sandbox.claiming.com.au/v2/easyclaims?location=25' \
--header 'Accept: application/json' \
--header 'Content-Type: application/json' \
--header 'Authorization: Bearer ' \
--data '{
    "provider": {
        "payee": "2441081A"
    },
    "transactionId": [
        "01021071412164565742722M",
        "01021071412061261677122M"
    ]
}'

Example Response:

Body:

{
  "status": "OK",
  "total": 2,
  "records": 2,
  "offset": 0,
  "results": [
    {
      "status": "COMPLETE",
      "transactionId": "01021071412164565742722M",
      "medicareClaimId": "L8621$",
      "timeReceived": 1626184800,
      "benefitPaid": 39.1,
      "chargeAmount": 38.75,
      "provider": {
        "payee": "2441081A",
        "servicing": "2441081A"
      },
      "patient": {
        "medicare": {
          "number": "2951386024",
          "ref": "1"
        },
        "name": {
          "family": "SMITH",
          "first": "HENRY"
        }
      },
      "payment": {
        "runNumber": "1951",
        "date": "2021-07-14",
        "amount": 39.1,
        "bank": {
          "bsb": "062914",
          "accountNumber": "*****3690",
          "accountName": "DR FARRELL"
        }
      },
      "items": [
        {
          "MedicareServiceId": "0001",
          "chargeAmount": 38.75,
          "itemNumber": "00023",
          "date": "2021-07-14",
          "benefit": [
            {
              "assessor": "Medicare",
              "benefitPaid": 39.1
            }
          ]
        }
      ],
      "type": "BulkBill"
    },
    {
      "status": "MEDICARE_REJECTED",
      "transactionId": "01021071412061261677122M",
      "medicareClaimId": "L8617$",
      "timeReceived": 1626184800,
      "benefitPaid": 0,
      "chargeAmount": 76.15,
      "provider": {
        "payee": "2441081A",
        "servicing": "2441081A"
      },
      "patient": {
        "medicare": {
          "number": "2951133955",
          "ref": "1"
        },
        "name": {
          "family": "WATTS",
          "first": "TESTER"
        }
      },
      "items": [
        {
          "MedicareServiceId": "0001",
          "chargeAmount": 76.15,
          "itemNumber": "00104",
          "date": "2021-07-14",
          "assessmentNotes": [
            {
              "assessor": "Medicare",
              "code": "611",
              "note": "Referral/request details not supplied - no benefit payable"
            }
          ],
          "benefit": [
            {
              "assessor": "Medicare",
              "benefitPaid": 0
            }
          ]
        }
      ],
      "type": "BulkBill"
    }
  ],
  "transactionId": "SAP00000Qpj8H0ikpZgULxZc"
}

Headers:

HeaderValue
Servernginx/1.19.3
DateTue, 08 Jun 2021 04:49:28 GMT
Content-Typeapplication/json
Content-Length1472
Connectionclose
Access-Control-Allow-Origin*
Access-Control-Allow-MethodsGET, POST, OPTIONS
Strict-Transport-Securitymax-age=3153600; includeSubDomains; preload
X-XSS-Protection1; mode=block
X-Content-Type-Optionsnosniff
X-Frame-OptionsSAMEORIGIN

POST Easyclaim report not ready #

If the EasyClaim is still being processed it will have a status of REPORT_NOT_READY

{{base_url}}/{{version}}/easyclaims?location={{location_id}}

Headers

HeaderValue
Acceptapplication/json
Content-Typeapplication/json
AuthorizationBearer {{oauth_token}}

Params

Paramvalue
location{{location_id}}

Body

{
    "provider": {
        "payee": "2441081A"
    },
    "transactionId": [
        "01021071412593092486022M"
    ]
}

Example Request:

curl --location 'https://sandbox.claiming.com.au/v2/easyclaims?location=25' \
--header 'Accept: application/json' \
--header 'Content-Type: application/json' \
--header 'Authorization: Bearer ' \
--data '{
    "provider": {
        "payee": "2441081A"
    },
    "transactionId": [
        "01021071412593092486022M"
    ]
}'

Example Response:

Body:

{
  "status": "OK",
  "total": 1,
  "records": 1,
  "offset": 0,
  "results": [
    {
      "status": "REPORT_NOT_READY",
      "transactionId": "01021071412593092486022M",
      "type": "BulkBill"
    }
  ],
  "transactionId": "SAP00000ezjSbv2kSQ64I6U6"
}

Headers:

HeaderValue
Servernginx/1.19.3
DateTue, 08 Jun 2021 04:49:28 GMT
Content-Typeapplication/json
Content-Length211
Connectionclose
Access-Control-Allow-Origin*
Access-Control-Allow-MethodsGET, POST, OPTIONS
Strict-Transport-Securitymax-age=3153600; includeSubDomains; preload
X-XSS-Protection1; mode=block
X-Content-Type-Optionsnosniff
X-Frame-OptionsSAMEORIGIN

POST - Easyclaim rejected #

Rejected EasyClaims will have a processing section but no payment section.

{{base_url}}/{{version}}/easyclaims?location={{location_id}}

Headers

HeaderValue
Acceptapplication/json
Content-Typeapplication/json
AuthorizationBearer {{oauth_token}}

Params

Paramvalue
location{{location_id}}

Body

{
    "provider": {
        "payee": "2441081A"
    },
    "transactionId": [
        "01021071412061261677122M"
    ]
}

Example Request:

curl --location 'https://sandbox.claiming.com.au/v2/easyclaims?location=25' \
--header 'Accept: application/json' \
--header 'Content-Type: application/json' \
--header 'Authorization: Bearer ' \
--data '{
    "provider": {
        "payee": "2441081A"
    },
    "transactionId": [
        "01021071412061261677122M"
    ]
}'

Example Response:

Body:

{
  "status": "OK",
  "total": 1,
  "records": 1,
  "offset": 0,
  "results": [
    {
      "status": "MEDICARE_REJECTED",
      "transactionId": "01021071412061261677122M",
      "medicareClaimId": "L8617$",
      "timeReceived": 1626184800,
      "provider": {
        "payee": "2441081A",
        "servicing": "2441081A"
      },
      "patient": {
        "medicare": {
          "number": "2951133955",
          "ref": "1"
        },
        "name": {
          "family": "WATTS",
          "first": "TESTER"
        }
      },
      "items": [
        {
          "MedicareServiceId": "0001",
          "chargeAmount": 76.15,
          "itemNumber": "00104",
          "date": "2021-07-14",
          "assessmentNotes": [
            {
              "assessor": "Medicare",
              "code": "611",
              "note": "Referral/request details not supplied - no benefit payable"
            }
          ],
          "benefit": [
            {
              "assessor": "Medicare",
              "benefitPaid": 0
            }
          ]
        }
      ],
      "type": "BulkBill"
    }
  ],
  "transactionId": "SAP00000Jh8DOXsaaK7Sm7gk"
}

Headers:

HeaderValue
Servernginx/1.19.3
DateTue, 08 Jun 2021 04:49:28 GMT
Content-Typeapplication/json
Content-Length741
Connectionkeep-alive
Access-Control-Allow-Origin*
Access-Control-Allow-MethodsGET, POST, OPTIONS

POST - Easyclaim not found #

If the EasyClaim is not found it will have a status of REPORT_NOT_FOUND

{{base_url}}/{{version}}/easyclaims?location={{location_id}}

Headers

Content-TypeValue
Acceptapplication/json
Content-Typeapplication/json
AuthorizationBearer {{oauth_token}}

Params

Paramvalue
location{{location_id}}

Body

{
    "provider": {
        "payee": "2441081A"
    },
    "transactionId": [
        "01021071412095573324722M"
    ]
}

Example Request:

curl --location 'https://sandbox.claiming.com.au/v2/easyclaims?location=25' \
--header 'Accept: application/json' \
--header 'Content-Type: application/json' \
--header 'Authorization: Bearer ' \
--data '{
    "provider": {
        "payee": "2441081A"
    },
    "transactionId": [
        "01021071412095573324722M"
    ]
}'

Example Response:

Body:

{
  "status": "OK",
  "total": 1,
  "records": 1,
  "offset": 0,
  "results": [
    {
      "status": "REPORT_NOT_FOUND",
      "transactionId": "01021071412095573324722M",
      "type": "BulkBill"
    }
  ],
  "transactionId": "SAP00000Go7EhKhduzU8lSWv"
}

Headers:

HeaderValue
Servernginx/1.19.3
DateTue, 08 Jun 2021 04:49:28 GMT
Content-Typeapplication/json
Content-Length211
Connectionkeep-alive
Access-Control-Allow-Origin*
Access-Control-Allow-MethodsGET, POST, OPTIONS