Resend unpaid Medicare and DVA claims

A practice must have their minor ID registered with Medicare before Medicare can begin processing any claims. If a claim is sent prior to this, Medicare cannot link the claim to the practice and the claim will continue to be listed in your Online Claiming screen as unpaid.

Follow the steps in this section if you have batches that are still marked as 'unpaid' for more than a few days, and Medicare has advised that these batches should be resent.

For additional information on resending claims that have been rejected by Medicare, see Correct a Medicare Online claim.

The online claiming process

After a claim is sent to Medicare, the status of the batch remains 'unpaid' until Medicare receive and process the batch. Each day, a staff member at your practice clicks Check for Payments from the Online claiming screen, which contacts the Medicare server, identifies which batches have been processed, and changes the status of the batches.

If the practice has not registered correctly with Medicare, batches may remain 'unpaid' indefinitely. Batch may also remain unpaid if an error occurred during sending. In these cases, Medicare may request that batches be resent.

Common reasons for needing to resend a claim include:

Reason

Explanation

Minor ID has not been registered with Medicare

Before being able to submit claims to Medicare, you will need to have your minor (location) ID registered to identify who the claims are coming from. If you have not registered these details with Medicare, they will not receive any claims from you.

Provider numbers have not been registered with Medicare

Before being able to submit claims to Medicare, you will need to register the provider numbers of all doctors who will be providing claims. If you have not registered these details with Medicare, they will not receive any claims from you.

Practice has moved location

If the practice has moved location, or added another practice location, you will need to contact Medicare to receive new provider numbers and site certificates. New Medicare certificates will need to be imported into Bp Premier, and new provider numbers updated, before you can claim at your new location.

Certificates registered under an old practice name

If the practice changes their name, Medicare will issue new site certificates. These will need to be imported into Best Practice before you can claim with the new practice name.

Payer allocations incorrectly set

If a doctor's payments are being paid into a different provider's bank account, ensure these details are accurately reflected in Best Practice.

To set payer allocation details, from the main menu select Setup > Configuration > Payer Allocation.

Transmission Errors

Due to errors in the transmission (an Internet connection dropout, for example), Medicare may not receive the claim and will require the claim to be resent.

Incorrect bank details

If incorrect bank details have been recorded with Medicare, the batch may remain unpaid until the issue is resolved. Contact Medicare to correct the details before resending the batch.

Manual direct bill batch

The Manual direct bill batch process should be followed if you do not wish to register for online claiming and want to send claims to Medicare manually.

If a batch has been created through the Manual Direct Bill Batches screen, the batch will not be transmitted electronically. A report is printed when a batch is created this way. The report is intended to be mailed to Medicare for payment.