Medicare Claim History Report

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

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

Check Status

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

Status - whether the claim is: NEW, INVALID.....

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 will be 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 all = $0, the claim will be marked as COMPLETE and no more information is expected
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.

Please refer to the Human Services website here for information on common Medicare Rejection Codes and here for details on all reason codes.

For DVA rejection reason codes information please click here.

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.

Search Results for date range

Search results for the above date range.

Fields available:

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 Claiming.com.au

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