Biomaterial Database

MedClaims: electronic submission of direct billing claims. 1997

J Cooper

Information and Communication Technology Department, University of Wollongong, New South Wales, Australia.

In 1994 the Australian Health Insurance Commission introduced MedClaims, an electronic system for submission of "direct billing" medical claims. This report contains a description of MedClaims, how it has progressed since its implementation in 1994, its current status, and future directions. To provide a complete picture of MedClaims and the environment in which it operates, this report also contains an overview of Medicare, the federally funded health insurance system in Australia.

UI	MeSH Term	Description	Entries
D007344	Insurance Claim Reporting	The design, completion, and filing of forms with the insurer.	Claim Reporting, Insurance,Reporting, Insurance Claim
D007345	Insurance Claim Review	Review of claims by insurance companies to determine liability and amount of payment for various services. The review may also include determination of eligibility of the claimant or beneficiary or of the provider of the benefit; determination that the benefit is covered or not payable under another policy; or determination that the service was necessary and of reasonable cost and quality.	Claims Review,Insurance Audit,Insurance Claims Processing,Analysis, Claims,Claim Review, Insurance,Claims Analysis,Insurance Claims Analysis,Review, Claims,Review, Insurance Claim,Analyses, Claims,Analyses, Insurance Claims,Analysis, Insurance Claims,Audit, Insurance,Audits, Insurance,Claim Reviews, Insurance,Claims Analyses,Claims Analyses, Insurance,Claims Analysis, Insurance,Claims Processing, Insurance,Claims Reviews,Insurance Audits,Insurance Claim Reviews,Insurance Claims Analyses,Processing, Insurance Claims,Reviews, Claims,Reviews, Insurance Claim
D009313	National Health Programs	Components of a national health care system which administer specific services, e.g., national health insurance.	National Health Insurance, Non-U.S.,Health Services, National,National Health Insurance,National Health Insurance, Non U.S.,National Health Services,Services, National Health,Health Insurance, National,Health Program, National,Health Programs, National,Health Service, National,Insurance, National Health,National Health Program,National Health Service,Program, National Health,Programs, National Health,Service, National Health
D003195	Computer Communication Networks	A system containing any combination of computers, computer terminals, printers, audio or visual display devices, or telephones interconnected by telecommunications equipment or cables: used to transmit or receive information. (Random House Unabridged Dictionary, 2d ed)	Cognitive Radio,Computer Network Management,Databases, Distributed,Distributed Systems,Extranets,Intranets,Network Communication Protocols,Telecommunication Networks,Cognitive Radios,Communication Network, Computer,Communication Networks, Computer,Communication Protocol, Network,Communication Protocols, Network,Computer Communication Network,Database, Distributed,Distributed Database,Distributed Databases,Distributed System,Extranet,Intranet,Management, Computer Network,Network Communication Protocol,Network Management, Computer,Network, Computer Communication,Network, Telecommunication,Protocol, Network Communication,Radio, Cognitive,System, Distributed,Telecommunication Network
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001315	Australia	The smallest continent and an independent country, comprising six states and two territories. Its capital is Canberra.	Canton and Enderbury Islands,Christmas Island,Christmas Island (Australia)