Use the Medicare Claim History Report

The Medicare Claim History report displays any claims that have been submitted to Medicare via Patient, DVA or Bulk Bill claiming.

Locate Reports from the left-hand menu in Bp Allied.
Select Medicare.
Select Medicare Claim History Report.

Field	Description
Select a date range	Enter the date range to find claims for. Clicking on Selected Range enables the From and To date fields.
Get Data	Click Get Data to search for claims for the date range above.
Process Flow	Pending – shows claims that have been sent to Medicare but not yet paid. The most recent claims are displayed at the top. Failed – shows any claims that have been Delayed, Rejected or Lost. Claims are able to be resubmitted from this screen. Complete – shows all completed claims. All – shows all claims. + - can be clicked to include any claims that failed to be sent to Medicare because they were rejected at the time of submission. These display within the ALL tab only.
Find a claim	Use the Find field to search for a particular word within the report, i.e. to find a particular item.
Group by....	Use the Group By option to group the claims entered. An example would be to drag the Claim Type field upto the Group By header so that the claims can be displayed by type.
Reset to default	Resets the columns under each tab to the default layout.

Check Status

Checks the status of all claims. Use this to find out if a claim has been paid or not.

Field	Description
New	The initial status for all claims.
With Medicare	Status for DVA, Bulk Bill, once submitted. Note, if a claim stays at With Medicare for more than a week, it can be worth calling Medicare to find out why there is an issue with the claim. Because the claim is with Medicare and has stalled there is no information that we can pass back in an automated manner.
Invalid	There is a problem with the claim at time of submission. There is usually a message that pops up for the user at submission time so that they can review and fix the data and resubmit the claim. See the message field for details of what the issue is.
Processed	If an organisation is paying a benefit, it sits at processed until it is paid.
Complete	When a claim has been paid. If the benefit various organisations will pay for the claim = $0, the claim will be marked as COMPLETE and no more information is expected. If a DVA kilometres claim has been paid, the relevant Invoice will be updated.
Delayed	There is some other error with the claim, for example: error 9201 – Invalid format for data item. This is an error indicating that the pre-processing has found an error in the format of some element(s) in the claim. E.g with the format of the client's name.
Rejected	This means claim was rejected by Medicare (“benefitPaid”: 0) with assessment error code based on the standard Medicare rejection codes (link below).
Lost	When we successfully submitted the claim to Medicare but there was no response after 14 days, we change the status to LOST. There’s nothing at Medicare for us to retrieve and report on. Almost always this means the provider paperwork is not submitted or not yet processed.

Medicare and DVA troubleshooting resources can be found in the following links:

Fields available to be reported on include:

Timestamp - date and time the claim was sent.
Claim Type - whether its Bulk Bill, VAA (DVA), Medicare (Patient Claim).
Client - who the claim is for.
Invoice No. - invoice claimed.
Invoice Item - item description.
Item Code - Medicare or DVA Item Code.
Claim Amount - amount claimed.
Charge Amount - amount charged. For DVA and BB this must be the same as Claim Amount.
Appointment - appointment Date and Time.
Claim ID - Claim ID assigned by Bp Allied.
Message - any error messages relating to the claim will be stored here. If it has been successfully sent, then the message is "Claim queued for sending".
Transaction ID - ID assigned by our claiming provider.
Servicing Provider ID - the provider number of the medical practitioner rendering the service(s) as allocated by Medicare.
Referring Provider ID - the referring provider number.
Referral Date - the date the referral was issued.
Last Status Check - date and time when the status was last checked.
Check Status - click to check the status if an individual claim.

Assessment Note - includes any rejection codes that come back from Medicare if the claim could not be successfully processed.
Benefit Paid - amount paid by Medicare or DVA. This could include Loading and KM payments.
Status – as above, the current status of the claim.
Benefit Assessor – whether the claim has been assessed by Medicare or DVA.
Assessment Note Code – code returned from Medicare or DVA if the claim has been failed.
Assessment Note Assessor – ID of the person that has assessed the claim at Medicare.
Payment Run – payment batch number from Medicare.
Practitioner – practitioner assigned to the invoice that was claimed.
Notes – notes can be added if claim needs to be resubmitted.
Resubmitted – checkbox is ticked if the claim has been resubmitted.
Resubmitted date – the date resubmitted (if relevant).
Payment No – link to the payment record.
Link to Record – links to original claim if this claim was one that was resubmitted.
Patient Claim Option Selected – The option selected by the user when the claim is lodged and the claim details need alteration: Edit and Re-send, Re-send Now, or Cancel.