What payment streams does an optometry practice need to reconcile?

Typically three: Medicare benefits for eligible eye examinations, HICAPS payments from private health funds for items like contact lenses or special procedures, and direct patient payments for retail purchases like frames. Each arrives differently and needs separate tracking.

How often should Medicare and HICAPS settlements be reconciled?

Ideally weekly, or at minimum monthly before any reporting is finalised. Leaving reconciliation for months makes it much harder to trace discrepancies back to a specific patient visit or claim.

What happens if a Medicare claim is rejected?

Rejected claims need to be identified, corrected and resubmitted. Without active reconciliation, rejected claims can sit unnoticed, meaning the practice has provided a service but never actually been paid for it.

Medicare and HICAPS Reconciliation for Optometry Practices

Q: Can a bookkeeper take this reconciliation off an optometrist's plate?

Yes — this is exactly the kind of recurring, detail-heavy task that's well suited to a bookkeeper who understands the specific payment flows for optometry, rather than something the practice owner should be doing themselves.

Published June 2026By True Tally Bookkeeping6 min read

Three Payment Streams Running at Once

An optometry practice typically juggles three distinct payment flows: Medicare benefits for eligible eye examinations, HICAPS payments from private health funds for items like contact lenses, and direct patient payments for retail purchases such as frames. Each arrives on a different schedule, through a different system, and needs its own tracking — lump them together and reconciliation becomes guesswork.

Reconcile Often, Not Eventually

Ideally this happens weekly, or at minimum monthly before any reporting is finalised. The longer reconciliation is left, the harder it becomes to trace a discrepancy back to a specific patient visit or claim — what would have taken five minutes after a week becomes a genuine investigation after three months.

        The real cost of delayed reconciliation: rejected Medicare claims that sit unnoticed mean the practice has provided a service and never actually been paid for it — and the longer it's left, the harder the claim is to track down and resubmit.
      

Setting Up the Reconciliation System

Separate clearing accounts for Medicare and HICAPS settlements, matched against individual patient records.
A regular cadence — weekly is ideal, monthly is the minimum.
A rejected-claims process — flagging, correcting and resubmitting promptly rather than letting them accumulate.

Why This Is a Bookkeeper's Job, Not the Optometrist's

This is exactly the kind of recurring, detail-heavy task that's well suited to a bookkeeper who understands the specific payment flows for optometry — freeing up the practice owner's time for patients rather than chasing payments.

True Tally — bookkeeping for Melbourne optometry practices

We handle Medicare and HICAPS reconciliation for Melbourne optometry practices so nothing falls through the cracks. Book a free call to review your current setup.

Book a Free 20-Minute Call