Pabau lets Australian clinics submit and track insurance claims to Medicare, the Department of Veterans’ Affairs (DVA), and private health funds (via HealthPoint) directly from the patient’s record — powered by Tyro Health. This guide is the starting point: it explains how the Australian insurance-billing workflow fits together and links you to each step.
NOTE: This guide is for clinics in Australia. Clinics in the UK bill through Healthcode and clinics in the US bill through Claim.MD — see the UK and US sections of the Insurance Billing category for those.
You’ll need a Tyro Health Online (THO) account. Pabau connects to it with your business API key — there’s no per-claim charge from Pabau; Tyro bills its own fees directly.
How Australian insurance billing works in Pabau
Claiming in Pabau follows the same four stages as the UK and US workflows, adapted for Tyro Health:
Step 1: Set up Tyro Health & your billing essentials
Connect Tyro Health, add your practitioners’ Medicare provider numbers, choose which funders you claim to (Medicare, DVA, private health), and load the MBS item codes you bill so they can be attached to your services.
→ Insurance Guide Part 1 (Australia): Set up Tyro Health & billing essentials
Step 2: Add the patient’s funder & Medicare details
On the patient’s record, open the Insurance tab and add a policy. Australian clinics pick from three fixed funders — Medicare, DVA, and Private health (HealthPoint) — then record the patient’s Medicare number and Individual Reference Number (IRN) (or DVA file number / fund member number).
→ Insurance Guide Part 2 (Australia): Client insurance setup
Step 3: Connect the appointment to the claim
Book the appointment and raise the invoice as usual. The MBS-coded service line and the patient’s funder flow straight onto the claim — no re-keying.
→ Insurance Guide Part 3 (Australia): Connect appointments to insurance
Step 4: Submit and track the claim with Tyro Health
Open the claim, choose the funder and practitioner, set bulk bill (Medicare) if applicable, and click Submit via Tyro Health. Tyro’s secure window handles patient verification and lodgement; Pabau then tracks the outcome (Outstanding → Approved / Declined → Completed).
→ Insurance Guide Part 4 (Australia): Submit and track claims with Tyro Health
TIP: Anything you don’t pre-fill in Pabau (for example a missing IRN) is simply prompted inside Tyro’s window at submission — so you’re never blocked, but recording it in Pabau means one less thing to type each time.
Frequently asked questions
Which funders can I claim to?
Medicare (bulk bill and patient claims), DVA, and private health funds through HealthPoint. Card payments and EFTPOS terminals are not part of this workflow.
What’s an MBS item number?
The Medicare Benefits Schedule (MBS) item number is the billing code for a Medicare/DVA service (for example item 23 for a standard GP consultation). You attach the right item number to each service in Pabau, and it’s sent on the claim. See Part 1.
What is the IRN?
The Individual Reference Number is the single digit next to a person’s name on a Medicare card — it identifies which family member the claim is for. Record it alongside the Medicare number on the patient’s policy.
How long do claims take?
Patient claims and HealthPoint (private health) usually return an outcome within seconds. Medicare bulk bill and DVA are assessed by Services Australia and typically settle in 1–2 business days — Pabau keeps the claim status in sync until it’s paid.
Does Pabau charge per claim?
No. Australian claiming is included with your Pabau subscription; you bring your own Tyro Health account and Tyro bills its own fees directly.
TIP: New to this? Work through Parts 1–4 in order the first time — once Tyro Health is connected and your services carry MBS codes, day-to-day claiming is just Steps 3 and 4.