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 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. The 'signing location' error can usually be resolved by waiting 3 to 5 seconds or so and then resubmitting the claim to Medicare.
108: Item claimed not payable at date of service
Means DVA has determined they can not pay this item at the specified date. You may need to contact DVA for more information
137 - Details of requesting provider not shown on account/receipt
The referring doctor/GP's details were not listed on the invoice, this should be just under Referral \ Request Information, ensure that the Start date, Referring Period, and referring provider number are all entered in.
159: Item associated with other service which is payable
This usually means you cannot claim for this service until another item number has been claimed. You may need to contact DVA to determine what item needs to be claims.
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.
255 - Benefit assigned has been increased
The Medicare/DVA benefit schedule has changed, and as a result the item codes benefit has increased, you can adjust your item code fees within the Setup > Settings > Service Types area of coreplus.
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.
578: Item number cannot be determined from information supplied
This means DVA doesn't know what item you're claiming for. You may need to check that the item number is correct (including any letters required).
581 - Condition treated has not been stated.
Accepted Disability Text has not been filled out for this claim/invoice, this can be found under the 'Client Information' area, for accepted disability select Yes, and supply further info within the Accepted Disability Text field.
642: Benefit paid for derived and other item claimed
643: Derived item assessed with other item on statement
This combination of errors means that Medicare has not paid a rebate for the 'derived item', but instead they've paid an extra amount for the other item claimed. This error usually means that the claim has been paid and no further action is needed.
654: Item transmitted via incorrect online claiming channel
This usually means you have selected the wrong channel for your DVA claim. Make sure you have selected DVA Allied Health in the Medicare claim menu. If you have Selected DVA Medical, you will need to recreate the invoice using the correct Allied Health channel.
📝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.
📝 For Medicare error codes see Troubleshooting Medicare claims