Terminology #
vendor #
A vendor is any software vendor integrating with our API, that’s you!
Vendors are responsible for organising and maintaining their own lists of authorised users.
location #
A location is a group of providers. In general it can be considered synonymous with a group or practice site. Before the API can process transactions for your providers, you’ll need to create a location and link the providers to that location. A solo practitioner would need to be linked to their own location.
Minor ID #
The Minor ID value is uniquely associated with the location. It is generated by the API when you create a location, and needs to be registered with Medicare and linked to provider numbers (details below).
If you have dealt with Medicare before, you may equate location, ‘LocationID’ and ‘MinorID’, all three are equivalent for our purposes. The MinorID looks like SAP12345 and is a unique identifier used in electronic claiming to show where the claim is coming from.
IMPORTANT - the Minor ID used in development will not be used in production, do not use the development Minor ID to register providers with Medicare!
A ’location’ may be used for any of the following scenarios:
- an individual practitioner using a single provider number
- an individual practitioner using many provider numbers (e.g for work in different hospitals)
- a group practice with a combination of the above.
Separate locations and Minor IDs are required where a business operates a number of different offices or franchises that require separate banking arrangements or are in separate states.
provider #
In our terminology, a Provider is a medical or allied health professional with a unique Medicare provider number, providing a type of service at a location.
This is distinct from a Practitioner - we define a Practitioner as a person who may have several provider numbers when:
- rendering services at different locations,
- providing different types of service (a Dentist who is also a Surgeon, or a Physiotherapist who is also a Dietitian),
- working for different businesses (and therefore in different locations).
A provider number can only be linked to one location.
claim #
Once linked in Medicare, each provider can submit electronic claims using our API.
A claim is a submission to a Registered Health Fund, Medicare Australia or the Department Of Veterans Affairs for services provided to a patient, which may result in the provider, the patient or a third party receiving a payment.
In the API each claim is for:
- one servicing provider
- one patient
- services at one location
- one referrer (if one is required)
Generally a claim can have any number of service items, which can be on different dates of service (some restrictions apply in special cases)