Medicare
Confirm the card, name, date of birth and IRN against Medicare’s record. When a detail has changed, the corrected value comes back with the result.
Patient verification
Identity,
Identity,
checked right.
Right the first time.
Match the patient’s Medicare card and details to Medicare’s own record, in real time. When they differ, we return Medicare’s correction where it shares one.
- Name
- Rose Riviera
- Date of birth
- 12 Oct 1985
- Medicare card
- 4951 52556 1IRN 2
Patient verified
Details verified with Medicare
A sample verification, returned in real time.
Services Australia Certified
Used by GP, specialist, and diagnostic practices across Australia
How it works
Enter the details.
Enter the details.
RebateRight does the rest.
Watch the web app verify a sample patient, from the first detail typed to a clear answer.
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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
4951525561
e.g. 1
2
Sex
Select
Female
By submitting the request, you confirm patient consent has been obtained.
Patient verified The patient information matches Medicare’s records.
RebateRight API
Services Australia
- PRODAAuthentication, on us
- MedicarePatients, eligibility, claims
-
Type in the patient’s details.
-
Click Verify with Medicare.
-
Get a clear answer.
When the card has changed
The card on file is not always the card Medicare holds.
Cards get reissued. Names change. The detail in your system drifts from the record Medicare pays against. We check the live record, and when something has moved, we hand back the current value so you can set it right.
On file
6951 39326 1
Medicare’s record
6951 39335 2
The new reference number and given name come back too, so the record updates in one step.
5–10%
of claim rejections trace back to invalid patient identity. It is one of the common causes Services Australia lists, and what we see across the practices we work with.
What you can verify
Four checks, one connection.
Most often you will check a Medicare card. A veteran’s DVA card, a concession card and a health fund membership are checked on the same connection.
Veteran (DVA)
Check a patient’s Department of Veterans’ Affairs status, by their details or a known DVA file number.
Concession entitlement
Confirm a patient holds a valid concession on the date of service, before you bulk bill.
Health fund
Confirm the patient’s membership with their private health fund, or check Medicare and the fund in one request. The fund confirms a membership that includes hospital cover, and answers in its own words.
Checking whether Medicare will pay for an item, or what the fund pays for an admission, is a different job. That is the eligibility check.
What comes back
One of three answers.
One of three answers.
Never a guess.
Every check returns a clear result, with the reason in plain English.
Patient verified
The patient’s details match Medicare’s record.
Details don’t match
The details you hold do not match Medicare’s current record. Where Medicare shares the right value, we return it.
Cannot determine
The details could not be checked against Medicare’s record. The reason says what stopped it.
Every outcome comes back with its reason in plain English. A health fund check returns the fund’s answer in its own words, beside Medicare’s when you check both. The API documentation shows the full response.
Consent and care
You hold the consent.
You hold the consent.
We hold the line on the data.
Consent stays with you
Before you run a check, you confirm the patient has agreed to it, the same as any Medicare interaction. We ask for only the details the check needs, and nothing more.
Their data stays in Australia
The check runs in real time and is discarded the moment the answer returns. It never leaves Australia, and we never store it. The only thing we keep is billing metadata, never patient details.
Pricing
Patient verification is in every plan.
You pick the volume you need. Every plan gets every feature.
Verification questions
Answered, in full.
What does patient verification check?
It confirms the patient’s Medicare card number, name, date of birth, sex and Individual Reference Number (IRN) against Medicare’s own record. You get back one of three answers, and when a detail has changed, the corrected value, so you can update the record before you claim.
How is this different from the eligibility check?
Patient verification confirms the patient’s identity and card are valid and current. The eligibility check confirms whether Medicare will pay for a specific MBS item. Most practices verify the patient first to fix the record, then check item eligibility.
What happens when the details do not match?
It depends on the field. If only the given name or the IRN differs, Medicare accepts the check and returns the correct value. If a new card has been issued, you get the new card number, IRN and given name. A date-of-birth difference is accepted with a prompt to confirm it. A wrong card number does not pass, with a plain-English reason for what to check.
Can I verify veterans, concession cards and health fund membership too?
Yes. The same connection verifies a veteran’s Department of Veterans’ Affairs (DVA) status and confirms a patient’s concession entitlement on the date of service. It also confirms a patient’s membership with their private health fund, on its own or with Medicare in the same request.
Do I need a Minor ID or any setup with Services Australia?
No. Patient verification needs no Minor ID setup, no HW027 form and no registration for your clinic. We handle the setup with Services Australia on your behalf. Sign up, get your API Key or open the web app, and verify your first patient in the same session.
Who is responsible for patient consent?
You are. Before you run a check, you confirm the patient has agreed to it, the same as any Medicare interaction. We pass only the details the check needs, and we store none of them.
What happens to the patient’s data?
Zero Data Persistence. The request runs in real time and is discarded the moment the answer returns. The service is hosted in Australia, in Microsoft Azure’s Australia East region, which is assessed to IRAP PROTECTED. The only thing we keep is billing metadata, such as the endpoint name and the outcome, never patient details.
What about patients with a single name?
A single name is supported. Send it as the family name, and the check runs as normal.
Verify before you claim.
For 14 days you have unlimited requests at no charge, with no credit card. The web app, the API and the test environment are all included.