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The Medicare and DVA benefits reports records information about Medicare and Department of Veterans’ Affairs (DVA) funded services provided to an individual.

Medicare DVA Benefits Report in the Australian context

The benefits you receive from Medicare are based on a schedule of fees for medical services set by the Australian Government. The Medicare Benefits Schedule (MBS) lists a wide range of consultations, procedures and tests and the schedule fee for each of these items (for example, an appointment with your GP or blood tests to monitor your cholesterol level). The Australian Immunisation Register (AIR) is administered by the Department of Human Services (DHS). It records vaccinations administered through general practice and community clinics. This includes vaccines funded under the National Immunisation Program and privately funded vaccinations.

Context in digital health

When a consumer registers for access to their Medicare information through their digital health record, the DHS will register the consumer’s Medicare documents in their digital health record which includes the Medicare and DVA benefits report if applicable.

The Medicare CDA documents will be created by the DHS as the sole supplier of Medicare information within the My Health Record system.

The consumer, and healthcare providers with access to the consumer’s Medicare information, will be able to retrieve the Medicare and DVA benefits report CDA document through the consumer’s digital health record. Additionally, the data items in the Medicare and DVA benefits report document will be loaded into the My Health Record system to be used as source of data for the consumer’s Medicare overview.

There are a number of key business flows that occur within digital health in Australia, as outlined in Figure 1 below.

Medicate/DVA Benefits Scheme

Figure 1: Medicare and DVA benefits report high-level overview

These flows are described below:

  1. Upon providing a funded Medicare and DVA service, the details of the service are sent to the DHS system
  2. The DHS system uploads the Medicare and DVA benefits report document to the consumer’s My Health Record.
  3. The Medicare and DVA benefits report can be retrieved in My Health Record by the consumer or clinicians using the appropriate mechanisms.

 

Feature specifications

The Australian Digital Health Agency has provided the following specifications that apply to the Medicare and DVA benefits report described:

Medicare DVA Benefits Report v1.1

EP-1706:2015

When a consumer registers for access to their Medicare information through their digital health record, Services Australia will register the consumer’s Medicare documents in their digital health record which include the Medicare/DVA Benefits Report.

Wednesday, 21 Jan 2015

Supporting specifications

Medicare Overview v1.2

EP-1795:2014

Medicare Overview v1.2

Medicare Overview documents provide an overview of Medicare-sourced information stored in an individual’s My Health Record.

Wednesday, 31 Dec 2014

Related specifications

Roadmap

Roadmap: 
January, 2015
Completed
This release is for clinical information system vendors who are designing and developing systems to parse, extract and process information contained in the Medicare and DVA benefits report CDA documents retrieved from the PCEHR system using the business-to-business (B2B) gateway.