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How to look up prior Medicare claims on PRODA?

Searching for patient's prior Medicare Claims

Updated this week

To do this should should have an HPI-I and be linked with PRODA, or a delegate of a person with that set up (a delegate is able to use PRODA on behalf of the Healthcare Professional).

Delegates

These steps are only necessary if you are a delegate, otherwise skip to Provider.

  1. Go To My Providers

  2. Select The Provider You Are Looking Up

  3. You will now be on your Provider's Page and should see An Acting On Behalf Of banner

Provider

  1. Click Items

  2. Click MBS Items Online Checker

  3. Fill In The Required Details:

    1. Medicare Number (Mandatory)

    2. Medicare IRN (Mandatory)

    3. First Name (Mandatory)

    4. Date of Birth (Not Mandatory, but helps look up)

    5. Check The Declaration Checkbox

    6. Search for the item numbers you want to check (if they are not available, check the item number is correct. If it is, you are unable to search for this online)

    7. Check the item number (you can repeat this step up to 5 times)

    8. Click Check Items

  4. You will then see a returned list of eligibility along with any errors. A list of errors can be found at Services Australia. You can either print this, cancel or run a new check after.

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