Claims can occasionally get rejected by DVA. When this happens, DVA will respond with an error code that can help in diagnosing what needs to be corrected in order to submit the claim successfully.
💡 You can find claims that have been rejected by running the Claim Status Report (Reports > Medicare > Claim Status)
The necessary steps to find your error codes and the accompanying explanation text can be found below.
1. From the client's file, click on Invoicing
2. You can now view any error codes (and even payment run information!) right from the status column
OR You can hover over the Actions button on the relevant invoice and select DVA Medical/DVA Allied Health depending on your claim type
3. Use your error code to correct your claim and click the re-submit button
📝Our guide on re-submitting can be found here
What do I do now?
Understanding what these responses and messages mean 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;
0001 - The signing location is unknown
The 'signing location' error can usually be resolved by waiting 3 to 5 seconds or so and then resubmitting the claim to Medicare.
The error is usually caused by a temporary connection issue with the Medicare servers due to the amount of high number of claims they're trying to process.
8005 - The individual has been matched using the submitted data however differences were identified. Please check the information returned and update your records.
Some of the clients details (Name, Address, etc.) must be updated to match Medicare's files before the claim will be accepted.
9617 - The referral has expired.
The referral is no longer valid and will not be accepted.
9616 - The BSB supplied is invalid, unknown or cannot be used for Medicare payments.
Check the clients bank details on the claim before re-submitting"
9650 - The card number and/or patient details submitted did not match Medicare Australia's checks. Please verify the details and resubmit with additional information if available.
The clients card number and/or address must be updated to match Medicare's files before the claim will be accepted. You can check your clients Medicare details by following this guide
9655 - An LSPN is required.
The LSPN must be entered using the Flags button on the invoice.
9675 - Current Medicare card has expired. Patient must contact Medicare as claims using this Medicare card may be rejected.
Client's Medicare card has expired. You can check your clients Medicare details by following this guide
9605 - Another Medicare Card may have been issued to the patient or the details you entered do not match those held by Medicare. Please update your records and resubmit the claim.
Client has been issued a new Medicare card. Contact client to update details and re-submit. Or you can check your clients Medicare details by following this guide
9701 - The maximum number of services for this item have been paid, if this service is not a duplicate please resend with correct item numbers as per MBS.
Client has already claimed the maximum number of services for this item.
162 - Service has been previously paid.
The rebate for this service has already been paid. This may have likely occurred because the invoice was submitted to Medicare more than once.
581 - Condition treated has not been stated.
Accepted Disability Text has not been filled out for this claim/invoice.
526 - Item only attracts a benefit when claimed through Medicare.
Claim has incorrectly been submitted as a DVA claim rather than bulk bill or patient.
📝The full list of possible Medicare error codes can be found below:
DVA reason codes - DVA Reason Codes
The 4 digit codes (DB4 - Client) can be found here; 4 Digit Codes
The 3 digit codes (DB4 - Processed) can be found here; 3 Digit Codes
(These will be downloaded as a .csv file and can be opened in Microsoft Excel)
You can call Medicare's processing line on 132 150 for further assistance with rejected claims. You are also welcome to contact our Customer Service Team.