Online Patient Verification

Online Patient Verification

The OPV button allows you to verify that the Medicare, DVA and/or health fund details entered for the patient are valid.  It will only verify against data entered against the patient record.

This verification utilises the Medicare Online system to verifying that the Medicare details, Department of Veterans Affairs or Health fund details are accurate.

Verifying these patient details is essential when invoicing and claiming through CareRight.

To Verify Patient details

1. Search for a patient.
2. Click Show.
3. Under the Patient Banner will be a series of buttons, select OPV.
   1. The process will commence, this sends the verification details to Medicare.
4. It will confirm with a return message.
   1. The verification may take a few minutes to complete. If you feel that the process is taking too long, then you can cancel the verification by clicking the "X" icon to close the processing window.

Patient Summary: Semi-automated Online Patient Verifications

CareRight is capable to trigger OPV requests automatically following changes to

• Medicare Numbers & IRNs
• DVA numbers
• Where a medicare number was verified more than 12 months ago

User can view the Medicare Last Verified details under the Government Benefit section of patient summary screen. Once user performed an OPV this details will change accordingly.

If there are details for a patient available and an OPV is possible, but has not yet been performed, the OPV control will appear as an info/action needed control.

Where an OPV is possible but it could not be automatically verified by the system, the OPV button will appear as a warning control. Users should perform a manual OPV and review the details.

Medicare Checks OPV at two levels.

1st Level checks:

• Medicare Card Number
• Medicare Ref Number
• First Name

If any of the above details are wrong, then 2nd level checks are done:

• DOB
• Surname

1. If all 3 correct in first check: PASS
2. If 1 wrong and both 2nd level correct: PASS
3. If 2 wrong at first level: FAIL
4. If 1 wrong at 1st level then 1 wrong at second level: FAIL

NB: OPV checks that pass after level 1 may still be rejected at claim level which checks all 5 items