Easyclaim: Not so easy for doctors

By Federal AMA President, Dr Rosanna Capolingua

Back in June, Australian Doctor reported the AMA as saying there would be no losers with the Government's latest online claims system, Medicare Easyclaim. The thinking has been revised. Please allow me to inform you of the AMA's new thinking on Easyclaim. In short, it is not an easy deal for doctors and patients.

The fact of the matter is that Easyclaim is not all that easy for medical practice. For a start, it won't be available from all banks. Currently, two banks have a product which does not integrate with practice software, and Tyro (not a bank) have an integrated system with some practice software providers.

Our receptionists will need to spend more time processing each patient. Even if it takes only one extra minute per patient, this could be an extra three hours work per day in a busy four-doctor practice. It may well take more than a minute.

There will be additional keying in and processing failures almost certainly, and the system will take a long, long time to reach maximum efficiency. There are 20 per cent claim rejection rates at the moment.

The bottom line

Patients will have an expectation that they will be able to receive their Medicare rebate from the doctor's surgery at the point of service. We will be expected to deliver for the government and Medicare.

While the objectives of Easyclaim are worthy, perhaps advantageous for the patient, the bottom line is that it will save government huge dollars. The ability to save through the closure of Medicare offices and processing of claims, is substantial. The costs, however, to doctors and their practices are real, and we will become the agents of Medicare and will assume its burden.

Despite all the question marks, the Federal Government is planning to go ahead with a multi-million dollar advertising blitz to launch Easyclaim in the next few months.

Meanwhile, the AMA is in deep discussion with Human Services Minister Senator Chris Ellison over our many concerns. Our argument is potent - and hopefully persuasive.

Easyclaim is all about shifting a mountain of work from Medicare offices to doctors' surgeries.

Doctors providing care to patients via a Medicare rebatable service will be asked to be Medicare agents in their practices. If we privately bill, the patient will pay the account by cash, credit card or cheque. This is processed as per usual.

The patient will then be able to ask for their rebate on the spot. They will produce their Medicare card, which will be swiped, and appropriate keying of provider item number and other information will occur and the patient's eligibility status/concession status confirmed.

The patient then produces a savings or cheque debit account card - and we will swipe again for the rebate to be paid directly into that account for the patient. In some situations, a third swipe may be required.

For many GPs, it would be a case of three swipes and "you're out" as there may be confusion on the patient's behalf, rejection of a claim, and much angst between patient and front desk while all the usual business of trying to run a practice occurs.

The great irony of this process is that Medicare Australia will make huge savings by shifting this workload onto medical practices.  The medical practices, however, will be presented with considerable human burden and additional costs.

If Medicare Australia was shifting this work to another Government Department, the shift would be accompanied by an appropriate budget transfer to the new department to cover costs. I fail to understand why we are expected to take on Easyclaim without a similar shift to under pin our costs.

Pharmacists are getting paid to take on the electronic component for them at around 40c an item on script.

System unattractive

The banks and financial institutions will make huge profits from Easyclaim - every swipe of a card will set the cash registers ringing.

Doctors, too, are entitled to be paid for doing Medicare Australia's work. Every medical practice would need to make a huge time and resource commitment to make Easyclaim work for their patients.

As it stands, though, the system is not attractive for doctors - it will cost money and valuable patient and practice time. The banks and the pharmacists will be winners no doubt.

My message to the government is simple: without the support of doctors Easyclaim faces a very hard road. The burden that the government puts on doctors may well be transferred onto patients. The Federal Government needs to reconsider carefully.