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Facing the Challenge of Medicare Ineligible

November 2023 

One of the many challenges facing the Australian public health care system is the loss of revenue through Medicare Ineligible presentations.  This is routinely one of the hot topics when Revenue Managers from around Australia get together to discuss their revenue management challenges.  This comes at a time when health care funding continues to be tightened from all angles.


PowerHealth’s billing system PowerBilling and Revenue Collection (PBRC) can help with the Medicare Ineligible challenge in a number of ways.  These include:


  • Supports Medicare eligibility checks so that ineligible patient procedures can be initiated
  • Facilitate upfront Private Health Insurance checks
  • Completes electronic claim submission with private health insurance providers via Medicare Web Services
  • Automates invoice generation and delivery, both via mail and electronically
  • Includes email and SMS reminder functionality to inform patients in a timely manner
  • Captures all debt recovery activities and notes within the system
  • Provides visual dashboards for aged debt reporting
  • Full integration with many forms of payment mechanisms can be achieved, including patient portals
  • Can be integrated with debt recovery services such as AusHealth or Illion facilitating:
    • Quicker referrals - time is of the essence with Medicare ineligibles so the quicker it is in the recovery process the better
    • Cleaner data - automation in data field mapping eliminates missed data which can be critical in the ability to recover funds
    • Auto receipting of debt referrals back into PBRC/GL
    • Reduced resourcing requirements by eliminating manual data entry


If you’d like to know more about how PBRC can support your Medicare ineligible recovery processes please contact