MOC - Request Details

Any fields not required for the particular claim being lodged will be greyed out.
MOC - Request Details
1

Request Provider Details

1. Request Provider Details
 
Requesting Provider Number IS The provider number for the requesting provider (allocated by the Medicare).
  • DVA Required when Flags > ServiceType is "P" - Pathology
Requesting Provider Type Indicate if the requesting provider is GP or Specialist.
 
2

Request Type

2. Request Type
 
Request Type Indication of the type of a request
Options:
P: Pathology
D: Diagnostic Imaging
3

Request Date

3. Request Date
 
Request Date is the Date the request was issued.
4

Request Override Code

4. Request Override Code
 
Request Override Code Indicates why requested services were provided without a request from another practitioner. Must be one of 'L,E,H,N,G,R,V'.