RebateRight instantly verifies a patient's Medicare eligibility and available rebates for prescription drugs. By automating the process of deciphering complex Medicare rules, the platform provides reliable information to help patients and providers make informed decisions about medication costs.
Funding
Funding not disclosed
Founders
Product
Problem
Healthcare providers face challenges in accurately determining patient eligibility for Medicare rebates due to the complexity of Medicare rules and frequent updates to the Medicare Benefits Schedule (MBS). Manual verification processes are time-consuming, prone to errors, and can lead to claim rejections and financial losses.
Solution
RebateRight offers an API solution that automates Medicare eligibility checks, providing healthcare providers with instant and accurate information on patient eligibility and available rebates. The API deciphers complex Medicare rules and translates them into actionable insights, enabling providers to quote patients accurately and efficiently. By integrating with existing healthcare systems, RebateRight streamlines workflows, reduces billing errors, and prevents financial losses caused by claim rejections. The platform also provides up-to-date information on MBS changes, ensuring compliance and maximizing revenue potential for healthcare practices.
Target Audience
RebateRight primarily targets healthcare providers, including general practitioners, specialists, and administrative staff, who need to verify patient Medicare eligibility and rebate information quickly and accurately. The platform also caters to healthcare systems and software vendors looking to integrate Medicare eligibility checks into their existing solutions.
Features
- Instant Medicare eligibility checks for all ~6000 Medicare items across nine categories, enriched with MBS notes.
- Medicare-certified patient verification, matching patient details against Medicare's records.
- Claim limit alerts, notifying providers when patients reach their claiming thresholds.
- Referrer eligibility checks based on provider number, integrated with the Australian Provider Directory.
- Patient age eligibility checks, ensuring patients meet age restrictions for specific items.
- Real-time rebate calculations, providing accurate rebate amounts per item.
- Seamless API integration with any healthcare system.
- Automatic MBS data updates, keeping providers informed of the latest changes.
- Checks for same-day item restrictions, closed provider alerts, and in/out of hospital item restrictions.
- Medicare item search functionality, allowing users to search the MBS directly within their system.