When a private health fund claim is submitted via a Tyro Health EFTPOS terminal, the member ID sent with the claim comes from the patient file associated with the invoice in PracSuite, not from the card being swiped on the terminal. Only the member number itself comes from the card swiped at the terminal. If you've created the invoice on the wrong patient file, PracSuite will pass through whichever member ID is saved on that patient's file, regardless of whose card was actually swiped.

What needs to happen next depends on whether the member ID on the wrong patient's file matches the member ID on the correct patient's file.

Health fund cards list each family member under the same card with their own member ID, and for most funds this numbering starts at 00 or 01 for the first person on the card, then 02, 03, and so on. Because the vast majority of funds follow this same convention, it's common for the member ID on the wrong patient's file to match the member ID on the correct patient's file purely by coincidence, particularly for single-member patients who are very likely to both be recorded as member ID 00 or 01 regardless of which fund or family they actually belong to. A matching member ID doesn't mean the two patients are related or on the same policy, it just means the digit happens to be the same.

If the member ID does match on both files, the claim itself was submitted correctly as far as the health fund is concerned. Nothing needs to be reversed.

This is simply a case of the invoice and payment sitting on the wrong patient record. Delete the invoice and payment (both the health fund benefit and any gap payment) from the incorrect patient, then recreate them on the correct patient, keeping the same invoice, item, and payment dates so the financial history stays accurate.

If the wrong patient and the correct patient have different member IDs (for example, the claim was submitted under a different family member on the same health fund card), the claim has gone to the health fund under the wrong member ID. This can't be fixed by simply moving the invoice and payment. The claim itself must be reversed.

A same-day reversal is initiated from PracSuite, not the terminal directly. Open the patient file the health fund payment appears on, go to the Invoices tab > Payment subtab, select the health fund payment, and choose Refund. This gives the option to initiate the same-day reversal via the terminal.

See Tyro's own documentation on this process: Cancelling Private Health claims (Tyro Health Help Centre).

If the patient has already left and a same-day reversal isn't possible, the practice will need to contact the health fund directly to have the claim corrected or reversed on their end. This falls outside what can be resolved through PracSuite or Tyro at that point.

Once the original claim has been reversed (either same day via the terminal, or by the health fund directly), the invoice and payment can be corrected on the correct patient's file and the claim resubmitted correctly.

This article covers claims submitted via a Tyro Health EFTPOS terminal. Health fund claims processed via Tyro Health Online (without a physical terminal) can't currently be reversed or cancelled once submitted. If a Tyro Health Online claim has been submitted on the wrong patient with a mismatched member ID, the practice will need to contact the health fund directly to have it corrected.