Do I need PRODA to use RebateRight?
No. RebateRight manages PRODA for you: its organisation and B2B device are registered, and the authentication tokens are refreshed automatically. There is no PRODA setup on your side.
Guide
How to connect your software to Medicare
Connecting to Medicare runs on two things: PRODA, which proves who you are, and Web Services, which carry the claims. Building that connection means registering with Services Australia, passing integration testing to earn a Notice of Integration, then keeping up with schedule and rule changes for as long as you run it. The other route is to connect through an API that already holds the certification.
The foundation
PRODA and Web Services
Every connection to Medicare's digital channels sits on two pieces. PRODA (Provider Digital Access) is the identity layer: it verifies a person and an organisation, and issues the tokens that authorise each call. It is the front door, not the claiming system. Web Services are the channels that carry the work: patient verification, eligibility, and claiming.
This replaced the older adaptor and PKI-certificate channel, which was switched off for online claiming in 2022. Anything still describing PKI site certificates is out of date.
The build
What building the connection takes
To transmit real claims, a software product has to be integrated and certified with Services Australia. The path runs through a developer portal:
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Register for PRODA
An individual account for the responsible person, then an organisation account verified against your ABN.
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Get the development material
Register your organisation in the Services Australia developer portal to reach the APIs and test material.
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Build and test
Implement the authentication and each channel's endpoints, then test in-house before booking integration testing with Services Australia.
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Earn a Notice of Integration
Pass integration testing and Services Australia issues the Notice of Integration. Only then can the product send real claims.
There is no published timeframe for this; Services Australia sets no fixed clock, and in practice it runs to months, not weeks. The build is also not the end of it. Tokens have to be refreshed and rotated, endpoints maintained, and the MBS schedule and its rules tracked and updated as they change through the year. The connection is something you keep, not something you finish.
The channels
Each channel is its own connection
Medicare is not one switch. Each channel is registered, linked, and certified on its own:
- Medicare Online, for bulk-bill and patient claims and card checks,
- patient verification and eligibility,
- DVA claiming,
- the AIR, for immunisations,
- ECLIPSE, for in-hospital and private-insurer claims,
- PBS Online, for pharmacy.
Holding one does not grant the others. Each is its own linking in PRODA, and often its own agreement and conformance.
The shortcut
Or connect through one certified API
RebateRight holds the Medicare connection so you do not build it. Its organisation and B2B device are registered in PRODA, its tokens are cached and refreshed automatically, and it is Services Australia Certified, so the whole path above sits behind a single API key. There is no PRODA setup for you to do.
For patient verification and eligibility, that is the whole story: add your key and start. For claiming and the AIR, each clinic location needs a RebateRight-issued Minor ID and a one-time Services Australia form (the HW027) to register its bank details and provider number, which takes about five business days. After that, you claim.
What stays with you is what should: your provider numbers, and every clinical and billing decision. RebateRight covers Medicare, DVA, the AIR, MBS, and concession checks. In-hospital ECLIPSE claiming is on the roadmap, not offered yet.
Questions
Answered
What is a Minor ID, and do I need one?
A Minor ID identifies a clinic location to Medicare. For patient verification and eligibility, RebateRight handles it and you need to do nothing. For claiming or the AIR, each clinic location needs a RebateRight-issued Minor ID, set up once with the Services Australia HW027 form.
Is the old Medicare adaptor still supported?
No. Online claiming moved to Web Services, authenticated by PRODA, and the older adaptor and PKI-certificate channel was switched off in 2022.
How long does it take to get certified with Services Australia?
Services Australia sets no fixed timeframe, and in practice building and certifying a connection runs to months. RebateRight already holds the certification, so you connect through its API instead of building your own.
Connect in minutes, not months.
Patient verification and eligibility are a single API call away, with a free test environment to build against.