Medicare DVA Benefits Report

Product

Context

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.

 

Specifications

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

Current Specifications: 
Identifier: 
EP-1706:2015

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

Supporting Specifications: 
Identifier: 
EP-1795:2014

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

By operation of the Public Governance, Performance and Accountability (Establishing the Australian Digital Health Agency) Rule 2016, on 1 July 2016, all the assets and liabilities of NEHTA will vest in the Australian Digital Health Agency. In this website, on and from 1 July 2016, all references to "National E-Health Transition Authority" or "NEHTA" will be deemed to be references to the Australian Digital Health Agency. PCEHR means the My Health Record, formerly the "Personally Controlled Electronic Health Record", within the meaning of the My Health Records Act 2012 (Cth), formerly called the Personally Controlled Electronic Health Records Act 2012 (Cth).

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