When a Medicare or DVA claim is rejected, an incorrect provider number is one of the most common causes, and usually one of the quickest to fix. This guide takes you through checking the number, correcting it in Halaxy, and working out whether the problem is the number itself or your registration with Services Australia.
Note
Most provider number errors come down to one of three things: a character typed incorrectly, the wrong number used for that practice location, or a number that is not registered for what you are claiming. Work through this guide in order.
Most rejected claims come down to a simple transcription error. These checks take under a minute and do not require you to contact Medicare.
Go to Finances > Fees > Identifications tab and find the Medicare row for the practice location on the claim.
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Compare the number against your Medicare correspondence or Health Professional Online Services (HPOS), rather than a handwritten note or an email.
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Count the characters. There should be 8, with no spaces, dashes or full stops. If you have 7, add a zero to the front.
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Look for the letters I, O, S and Z. None of these are ever used in a provider number. If you see one, it is a misread digit: replace I with 1, O with 0, S with 5 and Z with 2.
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Check that the last character is a letter, never a digit.
Tip
The characters most often confused are 0 and O, 1 and I, 5 and S, and 2 and Z. Because I, O, S and Z are never valid in a provider number, any of those letters is a misread digit. This one check catches many transcription errors.
Practitioners often hold more than one provider number, and Halaxy stores them separately. Using the wrong one will cause a rejection even when every character is correct.
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Each provider number is registered to a single practice location. If you practise at more than one location, you have a different provider number for each. The first six characters usually stay the same and the last two change.
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The servicing provider number belongs to the practitioner who delivered the service and must match the practitioner on the invoice.
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The payee provider number is the number registered to receive the practice's rebates. It is entered separately and is not a substitute for the servicing provider number.
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Claims that need a referral also depend on the referring practitioner's provider number being correct. This is separate from your own provider numbers and has its own error codes.
Important
If you have recently moved practice locations or added a new one, you need a provider number registered for that location. A number from another location will be rejected.
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Go to Finances > Fees > Identifications tab.
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In the top-right, select the practitioner from the dropdown if you manage more than one practitioner.
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Click Edit.
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Enter the corrected provider number in the Medicare row for the relevant practice location.
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Click Save.
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Reprocess the rejected claim.
Note
You can also correct a provider number directly on an invoice. Open the invoice and click the in the Identification section.
If the provider number is typed correctly and is the right one for the location, the problem is with your registration rather than the number. The error code on the rejected claim tells you which.
|
Error code |
What it means |
What to do |
|---|---|---|
|
10 |
The provider number is not linked to a bank account. |
Contact Services Australia to add your bank details. |
|
338 or 618 |
The provider number was not registered with Medicare or DVA for that item number on the date of service. |
Check the item number is one you are registered to claim, and that your registration covered the date of service. |
|
532 |
The provider number is not registered for GST with DVA. |
Register your provider number with DVA for GST. |
|
9006 |
The provider number is not authorised to take this action. |
Call the Medicare eBusiness Service Centre on 132 150. |
If the error code on your claim is not listed above, see Bulk Bill and DVA Error Codes and Medicare error codes for the full list. Claims that need a referral have their own error codes covering the referring practitioner's details and the referral date.
Warning
A provider number that looks correct can still be rejected. The checks in this guide confirm the number is well formed. They cannot confirm it is active or registered for the item numbers and dates you are claiming. Only Services Australia can confirm that.
Contact Services Australia on 132 150 about anything to do with the registration itself: activating a provider number, linking bank details, bulk billing, and confirming which item numbers and dates your number can claim. Halaxy cannot see or change your Medicare registration.
Contact Halaxy support if you are not sure where to enter a number in Halaxy, a saved number is not appearing on invoices, or you need help reprocessing a claim after correcting it.
Updated