Common error messages for rejected Medicare claims

When transmitting claims to Medicare through coreplus, from time to time you may receive an emailed Bulk Bill/DVA report that contains various responses or error messages. These can refer to claims that have not been rebated by Medicare. These should appear under the 'Processing' section of the emailed report, which should be on the top portion of the email you have received.

Understanding what these responses and messages can sometimes be tricky. So, below is a glossary of the more common messages from Medicare as well as what needs to be done in order to re-submit the claim successfully.

If the error you have received is not in the glossary below, you are able to call Medicare's processing line on 132 150 further assistance with rejected claims. You are also welcome to contact our Customer Service Team.

 

The report is not available yet or is no longer available for retrieval
This is a common response that users often receive. This response can mean one of two things

  1. The claim has not yet been processed by Medicare. The claim will generally in the next few business days, which can be determined by viewing subsequent emailed reports
  2. There is another underlying issue with the claim. If you continue to receive this response for the same invoice for more than 3 or 4 days then it would likely be best to call Medicare on 132 150 and ask about the status of the claim

 

The signing Location is unknown
A response like this generally means that the PIC code or email address has not been entered correctly during the Site Certificate setup process. The PIC code generally contains symbols which are often overlooked and not entered. As a result a response like this may appear. Steps on how to enter a new PIC code can be found here.

This error may also occur while submitting claims to Medicare. When this occurs, it usually means there is a temporary connection problem with the servers at Medicare. Usually this can be solved by waiting a few minutes and resubmitting the claim. 

 

Benefit has been previously paid for this service

The rebate for this service has already been paid. This may have likely occurred because the invoice was submitted to Medicare more than once.

 

Claim cannot be submitted because it has not been authorised

This message is typically displayed when the 'Claim Authorised by Client' radio box is set to 'No'. This field can be located under the service information section on the invoices. Setting this field to 'Yes' and resubmitting the claim should resolve the matter.

 

The provider is identified as inactive for Online Claiming purposes

This error typically occurs when there is a configuration issue with Medicare. More specifically, it means that the practitioner provider number used on the claim is not registered for online claiming with Medicare. Contacting Medicare so they can make the appropriate changes is recommended to resolve this issue. Once the changes have been made, it is best to resubmit the claim.

 

Details of requesting provider not shown on account/receipt

This would mean that the referring provider's details were either not included within the claim or are inaccurate. It would be required to update this information on the relevant invoice and re-submit the claim.

 

Maximum number of services for this item already paid

This error means that the patient has already received the maximum of consultations for the type of service item you are claiming for. This could indicate that this patient has received consultations elsewhere, for example.

 

Benefit assigned has been increased

This is not an error that indicates a rejected claim. This means that the dollar amount specified on the invoice is less than the benefit amount you are eligible. Medicare pick this up automatically and adjust the amount.

 

Associated service not claimed - no benefit payable

This typically indicates that the service claimed for needs an associate service to be claimed for at the same time. This associated service should be included on the same invoice and transmitted to Medicare all at once.

 

 

Adam Kluga -

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Comments 1

  • Avatar
    Debra Mainwaring

    Re: Details of requesting provider not shown on account/receipt - this came back to me for every client and yet the requesting provider details are typed in to the correct area on client details. Why is the requesting provider details not transferring on to the invoice??
    Many thanks
    Debra

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