Find a Patient

Find a Patient allows providers and practice staff to search and immediately confirm:

• patient Medicare numbers
• concessional eligibility
• patient details.

It saves time because you don’t need to call us to confirm these details.

You need a Provider Digital Access (PRODA) account to access and verify patient details using HPOS.

If you can’t use PRODA, please contact the eBusiness Service Centre for assistance.

Who can use Find a Patient

You can use an individual PRODA account to access Find a Patient if either:

• you have a Medicare provider number
• you’re delegated access by someone with a Medicare provider number.

The following services can set up an organisation PRODA account to access Find a Patient:

• hospitals
• approved Indigenous and Remote Health Services with a Medicare claiming need
• pharmacies.

Your organisation’s administrator will need to do both the following:

• link HPOS to your organisation in PRODA
• add you as a member of the organisation PRODA account.

If you’re a pharmacy, you’ll need to link HPOS using your pharmacy approval number. You can then log in to your individual PRODA account to access Find a Patient.

Confirming patient details

To confirm patient details, type in the patient’s Medicare card number, Individual Reference Number (IRN) and first name. HPOS confirms these details and the Medicare card number, IRN and patient’s first name is displayed on the screen.

HPOS will tell you if the first 9 digits of the Medicare number and the patient’s first name match. This feature helps you find the patient even if you make:

• issue number errors, for example if the 10th digit of the Medicare number is incorrect
• IRN errors
• minor spelling errors in the patient’s first name.

If there’s a mismatch between the patient’s first name and the IRN fields, HPOS shows the IRN linked to the name.

Use the date of birth field to help you identify the correct patient. This helps if two patients on the card have the same name, such as a father and son both called John.

How to confirm patient details

• Select the find a patient tile.
• Select Medicare card details from the use dropdown menu.
• Enter patient details using Medicare data.
• By accessing this service you’re confirming that you’ve obtained the patient’s consent to search for or confirm their Medicare card details for claiming purposes only. You also agree to maintain the confidentiality of the information you obtain as outlined in HPOS’s terms of use.
• Select the declaration check box to declare the search is for claiming purposes only.
• Select find.
• The results table will display the patient’s Medicare details. You’ll be prompted if you need to update your records.
• From the results table, select next to view the patient’s profile page.
• From the patient’s profile page, select either claims or confirm. Use claims to create a new Medicare bulk bill webclaim or Medicare patient webclaim or confirm to verify a patient’s concessional entitlement status.

Searching a patient’s details

When a Medicare card number is unavailable, you can enter personal information to search for a patient. Use the optional fields to refine your search if the system can’t find a unique match on a patient.

The mandatory fields used for searching are:

• surname/family name
• first name
• date of birth.

The optional fields are:

• if the patient is legally known only by one name
• postcode
• locality or suburb.

When HPOS finds a unique match, it will only display the patient’s Medicare card number, IRN and first name.

It’s important to note:

• if HPOS finds a unique match but the first name on the Medicare card is different, HPOS will advise that it identified differences and will ask you to check the information and update your records
• HPOS won’t be able to confirm a match if your patient is on more than one Medicare card.

If HPOS indicates that it can’t find a record, it means a unique record couldn’t be identified. It doesn’t mean the person isn’t enrolled or not eligible for Medicare.

We have access to more fields that may help identify your patient in the system. If you can’t find a match for:

• Medicare, contact the Medicare provider enquiries line
• Pharmaceutical Benefits Scheme (PBS), contact the PBS general enquiries line and select option 2.

How to search patient details

• Select the find a patient tile.
• Select patient name and date of birth from the use dropdown.
• By accessing this service you’re confirming that you have obtained the patient’s consent to search for or confirm their Medicare card details for claiming purposes only. You also agree to maintain the confidentiality of the information you obtain as outlined in HPOS’s terms of use.
• Enter patient details using patient’s name and date of birth.
• Select the declaration check box to declare the search is for claiming purposes only.
• Select find.
• The results table will display the patient’s Medicare details. You’ll be prompted if records need to be updated.
• From the results table select next to view the patient’s profile page.
• From the patient’s profile page, select either claims or confirm. Use claims to create a new Medicare bulk bill webclaim or Medicare patient webclaim or confirm to verify a patient’s concessional entitlement status.

Multiple patient verification requests

You can complete multiple patient verification requests with Find a Patient. This is not available for pharmacies.

Using multiple patient verification requests, you can:

• search and confirm multiple patient details in a single request
• search and confirm up to a maximum of 50 patients in a request upload.

You’ll get the results in your HPOS inbox within 24 hours. You can only submit one request per day.

How to submit a multiple patient verification request

• Select menu.
• Select multiple details request.
• By accessing this service you’re confirming that you’ve obtained the patient’s consent to search for or confirm their Medicare card details for claiming purposes only. You also agree to maintain the confidentiality of the information you obtain as outlined in HPOS’s terms of use.
• Download and complete the multiple details request template file and save this file to your computer.
• Select browse and find your saved file.
• Select the declaration check box to declare the search is for claiming purposes only.
• Select upload to upload the file.

Concessional verification service

You can use HPOS Find a Patient to confirm a patient is eligible for the following:

• concessional Medicare services
• pharmaceutical items.

Concessional patients must hold or be listed on a Commonwealth concessional card at the date of service. We base a patient’s concessional entitlement eligibility on the information we hold at the time the check is completed. If you’re a pharmacy, you must still action all PBS Online claiming rejection and warning messages.

How to confirm a patient’s concessional status

• Search the patient’s details in the find a patient service.
• By accessing this service you’re confirming that you’ve obtained the patient’s consent to search for, or confirm their Medicare card details for claiming purposes only. You also agree to maintain the confidentiality of the information you obtain as outlined in the HPOS terms of use.
• From the results table, select next to view the patient’s profile page.
• Select the concessional entitlement tab on the left hand menu.
• Enter date of service.
• Tick the declaration box to declare the search is for verification and claiming purposes only.
• Select verify.

The check will return:

• date of service
• a concessional entitled result of Yes or No
• a verification receipt number.

You can use the verification receipt number to contact us about the verification results. This is not available for pharmacies.

You can print the concessional entitlement verification results.

Confirming Department of Veterans’ Affairs (DVA) concessional details

You can use Find a Patient to confirm a patient is eligible for DVA concessions.

How to confirm a DVA patient’s concessional status:

• Select the find a patient tile.
• Select DVA patient as a search type.
• Enter the Veteran file number, first name and surname.
• Read the declaration box and tick to declare the search is for verification and claiming purposes only.
• Select Find.

If the patient is eligible for DVA concessions the check will return their:

• first name
• surname
• Veteran file number.