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Claiming FAQs
Claiming FAQs

Frequently asked questions related to private health fund, Medicare and DVA claiming

Updated over a week ago

Our FAQs are based on the most commonly asked questions by our coreplus community. This section focuses on questions asked about claiming with Medicare. Each collection has its own FAQ article, simply navigate to the collection to find each article for our most frequently asked questions!

Can I verify if my client is eligible for Medicare or DVA benefits?

Yes you can! This can be achieved by utilising the Online Patient Verification or Online Veteran Verification tool, click here to be taken to our help centre article.

I practice from multiple locations, does that mean I need one Public Key Infrastructure certificate per location?

The answer is no, you will only require one Public Key Infrastructure certificate even if you are practising from more than one location.

How can I cancel a bulk bill claim?

You might be wondering why there's no 'Same day delete' function for bulk bill claims just like there is for patient claims, reason being it's not something Medicare supports. The process for cancelling a bulk bill claim is to contact the eBusiness line on 1800 700 199. In most cases, you will need to provide them with the following information:

  • Your Minor ID

  • Servicing provider number for the claim

  • Practice address

  • Claim ID

  • Date of service

Is coreplus integrated with HICAPS, ECLIPSE and/or PRODA?

We aren’t integrated with HiCaps or ECLIPSE. But we are integrated with PRODA. You can find details about how to set up PRODA on your coreplus account here: Setting up Medicare & PRODA

Do I need to delete an invoice in order to make changes and resubmit it to Medicare/DVA?

The answer is no! You can still edit the pre existing invoice and resubmit it to Medicare! The workflow on how to do so is outlined below!

Why aren't my claims being paid by Medicare?

If you have noticed some of your bulk bill or DVA claims that you are transmitting to Medicare aren't being paid, there's a chance the listed payee provider number on the invoice hasn't been linked with your Minor ID and/or banking details. To confirm this, you can contact the Medicare eBusiness hotline on 1800 700 199.

💡 Once the Minor ID and banking details are linked to the listed payee provider number, all outstanding claims must be re-submitted.

My claim has been rejected by Medicare, why?

Claims can occasionally get rejected by Medicare. When this happens, Medicare will respond with an error code that can help in diagnosing what needs to be corrected in order to submit the claim successfully. To find out what the error codes mean, you can download the 3 digit and 4 digit error codes spreadsheets.

How can I resubmit an invoice with PRODA?

Unfortunately, it's currently not possible to resubmit a rejected claim through PRODA. But we're working on releasing a resubmission function for PRODA as well, until then recreation is the way to go.

I keep getting errors with a red icon when I try to submit a claim, how can I fix this?

These errors occur when PRODA identifies an error in the invoice or within the client's file. PRODA has some strict requirements when it comes to the information in the invoice and the client's file.

Please, visit this article to learn how to troubleshoot the most common PRODA errors: Troubleshooting PRODA

I have sent claims twice incorrectly, how can I fix this?

To retract an invoice that was sent to Medicare twice by mistake, follow these steps:

1. Unlock the invoice.
2. Edit the invoice to correct any errors or duplicate submissions.
3. Resubmit the invoice to Medicare.

This process should help you resolve the issue with the duplicate invoice submission.

🛑 You can only resubmit the claim if it is a PENDABLE claim. If the claim has gone through to Medicare as is not 'pendable' then you will need to call Medicare to cancel the claim. The Medicare eBusiness phone number is 1800 700 199 and they’re open Monday – Friday between 8am – 5pm local time .

You may also be interested in:

📝 FAQs about Reports and Data Management

Please let us know if you have any questions and don't forget to rate this help article below so that we can continue to improve our support to you!

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