RebateRight Medicare eligibility intelligence

The right way, the first time.

Medicare claims, checked before you submit. For Australian healthcare providers.

Before we begin

Talk us through your biggest problem today.

We shape the rest of this demo around it.

hello@rebateright.com.au

What RebateRight is

Connect to RebateRight once. We take care of the rest.

Your software connects to RebateRight, and RebateRight connects to everything else. Patient verification, eligibility, claiming, immunisation records and the MBS, with the complexity on us.

See every integration

Eligibility check

Check eligibility before you submit.

Add the patient, the provider and up to 50 items. Each item comes back with its answer, its benefit and every check that ran on it.

Sent fromRebateRight appYour softwareBrowser extension

RebateRight

Home
Connection Settings
Patient Verification
Eligibility Check
Bulk Eligibility Check
MBS Item Lookup
Benefit Calculator
RebateRight Insights

Eligibility Check

1Patient details Enter the patient’s details as they appear on their Medicare card.

Patient has one legal name? One name

Given Name Jane Rose

Family Name Citizen Riviera

Date of Birth DD12 / MM10 / YYYY1985

Medicare Card Details 1234567890 2987654351 e.g. 1 2

Sex Select Female

2Provider details The healthcare professionals involved in this service.

Servicing Provider Number e.g. 123456XX 1234561Y

Referrer Provider Number e.g. 123456XX 2345672Y

3Billing details Medicare items and billing configuration for this check.

Medicare Item Item number 104 58121 Add

In Hospital Treatment

Bulk Billed

By submitting the request, you confirm patient consent has been obtained. Check Eligibility

Patient verified The patient’s details match Medicare’s records.

Item 104Not checkedEligible

All 4 checks passed

Patient ageThis check found no age limit for this item.
Patient sexThis check found no limit by sex for this item.
In-hospital statusMedicare pays this item for patients in hospital and out of hospital.
Frequency of serviceMedicare found this item within its limits on how often it is paid, including limits based on the patient’s earlier claims.

Item 58121Not checkedNot eligible

5 checks · 1 flagged

Patient ageThis item has no age restriction
Referrer eligibilityA physiotherapist can refer this item
In-hospital statusAvailable in and out of hospital
Patient sexThis item is not restricted by patient sex
Frequency of serviceMaximum number of services for this item already paid

RebateRight API

Rules engineMBS rules, turned into code
MBS itemsAbout 6,000 items and rules
Providers directoryEvery registered provider

Services Australia

PRODAAuthentication, on us
MedicarePatients, eligibility, claims

Play the demonstration from the start Play the demonstration from the start Pause the demonstration Skip to the answer Skip to the answer

Type in the patient and provider details.
Add the items and click Check Eligibility.
Get a clear answer, check by check.

Try it in the app

Patient verification

Verify the patient against Medicare’s records.

Check Medicare, DVA, a concession card or the health fund before you bill. When a Medicare detail has changed, you see the current value and apply it in one click.

Sent fromRebateRight appYour softwareBrowser extension

RebateRight

Home
Connection Settings
Patient Verification
Eligibility Check
Bulk Eligibility Check
MBS Item Lookup
Benefit Calculator
RebateRight Insights

Patient Verification

1Verification type

2Patient details Enter details as they appear on the patient’s Medicare card, then verify with Medicare.

Patient has one legal name? One name

Given Name Jane Rose

Family Name Citizen Riviera

Date of Birth DD12 / MM10 / YYYY1985

Medicare Card Details 1234567890 2987654351 e.g. 1 2

Sex Select Female

By submitting the request, you confirm patient consent has been obtained. Verify with Medicare

Patient verified The patient’s details match Medicare’s records.

RebateRight API Services Australia

PRODAAuthentication, on us
MedicarePatients, eligibility, claims

Play the demonstration from the start Play the demonstration from the start Pause the demonstration Skip to the answer Skip to the answer

Type in the patient’s details.
Click Verify with Medicare.
Get a clear answer.

Try it in the app

Two more answers

What Medicare pays, and who may claim.

Benefit Calculator

It returns the schedule fee, the benefit for each patient and the total, with the working. It is in the web app and the API.

5010

Medicare pays $160.05 $53.35 per patient × 3 patients

Schedule fee: $53.35per patient
Setting: Out of hospital

Servicing Provider Eligibility

It answers whether this provider may render and claim the item, before the claim is lodged. It is in the API.

Not eligible
Item 23 · Physiotherapist

The provider is not eligible to render this Medicare item.

Provider
Physiotherapist

Eligible to render
General Practitioner

Claiming

Lodge claims through one connection.

Bulk bill

General, specialist and pathology, with the signable Assignment of Benefit agreement.

Patient claims

The patient has paid, and Medicare assesses the claim in real time.

DVA

Veteran claims for holders of a Gold or White Veteran Card.

In-patient (ECLIPSE)

Admitted patients, assessed by Medicare and then the health fund, in 5 claim types.

Bulk bill and DVA claims have a processing report and a payment report. In-patient claims have a claim report, and a remittance advice for each payment. Each payment is matched to its deposit.

See the claiming guide

Insights

See your usage, month by month.

Pick a period and see your total requests, your eligibility and verification results, the reasons behind them, your top items, and your daily activity.

Open insights in the app

Not eligible reasons

Medicare or our rules found a reason the item would not be paid.

1,236 reasons

Maximum number of services for this item already paid 431 34.9%
Referrer specialty ineligible 288 23.3%
Requires in hospital 201 16.3%
Age out of range 154 12.5%
Coning applied 92 7.4%
Patient sex mismatch 41 3.3%

Sample data

Data and compliance

We never store patient data.

Zero Data Persistence by design. Patient details pass through to Medicare and back, and are never copied, logged or kept.

No AI on patient data

Eligibility runs rule by rule against the published schedule. Patient data never reaches an AI.

Hosted and stored in Australia

Your data never leaves the country. We host in Azure Australia, on infrastructure assessed to IRAP PROTECTED.

Customer-held API keys

You generate your own keys. We store only an irreversible hash, never the key itself.

We keep a record of each request for billing and Insights, and it never includes patient details.

Read about our security

By the numbers

Impact.

$26M+ in claim rejections prevented

152,000+ hours saved on rework

The impact figures are calculated from real customer API usage. We count 10 minutes saved for each rework we helped avoid. We value each caught item at its Medicare benefit: its schedule fee at its rate of 75%, 85% or 100%.

See the figures on our home page

Pricing

Every feature, on every plan.

Six plans from $190 a month, and the only difference between them is the number of requests. Here are the two smallest, and the plan we build with you.

Tier 1$190a month + GST
- 200 requests a monthAbout 10 a business day
- Unlimited MBS lookups in the app
- Unlimited users and clinics
- Every RebateRight feature
Tier 2$290a month + GST
- 1,000 requests a monthAbout 50 a business day
- Unlimited MBS lookups in the app
- Unlimited users and clinics
- Every RebateRight feature
Custom planBuilt with you
- Unlimited MBS lookups in the app
- Unlimited users and clinics
- Every RebateRight feature
Book a 30-minute call

Switch plans or cancel at any time. No exit fee.

See all six plans

Annual plans

The full year’s requests are yours from the first day.

Monthly

200 requests each month $190 a month + GST Resets every month. Unused requests do not carry forward.

AnnualSave 10%

2,400 requests for the year $2,052 a year + GST Use them at any pace. Busy months and quiet months even out.

Shown for Tier 1. The year of requests and the 10% saving apply to every plan.

See full pricing

What is included

There are no other fees.

No setup fee, no support fee, no per-user or per-clinic charge.

Every feature

On every plan, whatever its size.

Unlimited users

And unlimited clinics.

Support

And staff training.

Test environment

Included and full-fidelity.

MBS updates

Applied automatically.

Web app and API

Both, on every plan.

Price drops reach existing customers automatically, and a fault in your software will not cost you requests.

See full pricing

Your usage

See where your plan stands, every day.

The web app’s home page shows your billing cycle, day by day.

This billing cycle

Used: 308 / 1,000requests since 1 Oct

See your billing cycle in the app A sample practice on Tier 2

Free trial

Try the full product for 14 days, at no cost.

No credit card

You do not need a credit card to start.

Unlimited requests

Use it as much as you need.

Full support

For your entire team.

Start free trial Book a demo

One last thing

Tell us your biggest concern about RebateRight.

You get the answer now. Where we cannot help, we say so.

Start free trial hello@rebateright.com.au