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 the correction.
- Name
- Rose Riviera
- Date of birth
- 12 Oct 1985
- Medicare card
- 4951 52556 1IRN 2
Verified
Matches Medicare’s records
A sample verification, returned in real time.
Services Australia Certified
Used by GP, specialist, and diagnostic practices across Australia
When the card has changed
The card on file isn’t 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’s one of the common causes Services Australia lists, and what we see across the practices we work with.
What you can verify
Three checks, one connection.
Most often you’ll check a Medicare card. You can also check veterans and patients with a concession card, all 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.
Checking whether Medicare will pay for an item is a different job. That’s 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.
Matched
The details match Medicare’s record. You’re clear to claim.
Details differ
Medicare accepted the check but holds a different value. We return the correction so you can update the record.
Couldn’t verify
The card or details didn’t match. The reason says what to fix, before you resubmit.
Every reason is tagged [Medicare] or [RebateRight], so you always know who said what. See the full response in the API documentation.
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 and details, 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 don’t 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 doesn’t pass, with a plain-English reason for what to check.
Can I verify veterans and concession entitlement too?
Yes. The same connection verifies Department of Veterans’ Affairs (DVA) status and confirms a patient’s concession entitlement on the date of service, so you can bulk bill with confidence.
Do I need a Minor ID or any setup with Services Australia?
No. Patient verification needs no Minor ID setup, no HW027 form, no clinic-level registration. 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. Australian-hosted on Microsoft Azure’s Australia East region (IRAP PROTECTED). The only thing we keep is billing metadata (endpoint name, outcome), never patient details.
What about patients with a single name?
Supported. Submit the single name as the family name, and the check runs as normal.
Verify before you claim.
Start free for 14 days. Unlimited requests, no credit card. The web app, the API, and the test environment.