Medicare: The what, why, and what’s next?

November 17, 2020 | Aged Care Management

The current Medicare digital platform or Services Australia has closed access to the current online claims and services on 20 November 2020.

What does this mean for me? 

Well in summary you currently have two (2) ways to access Medicare data. 

Number 1:

In real-time either by logging on to Medicare at the Resident Level, downloading an XML file on the resident page, or accessing via Mirus Metrics. You may have other systems as well that connect to Medicare. 

Number 2:

After the fact. The Medicare payment statement to assist with your reporting and reconciliation is available around the middle of the month reporting on the previous month. As an example, resident data relating to say the 1st January might not be available to review until the 14th February. That is a long time between New Year’s Day and Valentine’s Day! 

OK got all that and so how will I be impacted? 

Moderate Impact:

  • If you rely on the digital services platform for historical data, useful for financial & billing reconciliations processes then data older than 24 months will no longer be readily available.
  • If you use the Payment Statements although your data is rear-ward-looking and best used for financial reconciliations rather than operational insights. 
  • However, if you are using the Payment Statements you may only be able to access this file in a PDF format. 

Wait! No Impact:

  • If you use Mirus Metrics for your live Medicare data please feel confident that at Mirus Australia we have Business to Business (B2B) arrangements with Medicare that leverage the new, secure PRODA processes. 
  • If you use Mirus Metrics the data will not be affected and you will still have access to our nightly updates (Back to 2008!)

What can I do?   

As an immediate next step, if you feel you may be impacted by these changes or you are ready to try real-time insights with us, then we can provide a “stopgap” to mitigate any data process interruptions.  We can “light up” Mirus Metrics for you overnight and provide you access to your data as well as the full breadth of capability that Mirus Metrics offers. 

The Mirus Metrics tool is considered by many (including a third of the industry that is plugged in or around 78,743-bed licenses to be exact) to be a very powerful insights and data analytics tool leveraging Medicare data in real-time for a number of great reasons. 

You may know that Mirus Metrics is great for funding data, but you may be surprised to learn that because we leverage Medicare data, the source of funding truth, it’s extremely useful for the following activities: 

  1. Planning: understanding when assessments are due, when residents should be reviewed and when mandatory events are due. 
  1.  Managing occupancy: whether the optimisation of respite days, managing your concessional strategy, or reconciling leave events, all this data is available in our client’s reporting.
  1. Supplement recovery: Medicare will pay selected supplements to accompany your ACFI subsidy  

Wait Again! There is more . . .

Compliance reporting, risk & quality reporting, workforce management reporting, financial reconciliations, respite subsidy optimisation – track your respite in real-time to ensure you never miss the extra 20% higher care respite subsidy and what about annualised trends of your Medicare Payment Statement.

So what next?

Please contact us directly using this easy form – yes we know it’s another form – sorry about that – but it’s an easy one.

We are standing by and our goal is to help people + technology come together in #makingagedcarebetter and Mirus Metrics has been doing that since 2011. Thanks, Mirus Metrics!