What does code 179 (Benefit not payable - associated service already paid) mean?

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Explanation

DVA has already paid a benefit for this service for the same day, item number and patient.

Action

If the claim is correct, reprocess the claim and add explanation text in the Additional Information field (you may need to check with DVA to confirm what is an acceptable reason). Click Process when you are done. The additional information will be flagged for someone to check at DVA.

After a few days, run a Medicare Claims report to confirm if the reprocessed claim has been paid:

  1. Under Reports, click Finance.
  2. Click New Report in the top-right of the page.
  3. In the Report Type drop-down menu, select Medicare Claims.
  4. Enter the patient's name and other search parameters (such as DVA) to filter the report.
  5. Click Run.

If the claim has not been paid, you need to undo the payment and start again. To do this:

  1. From the report page you just generated, click Submitted next to the claim to see what the status is.
  2. Click Reset.
  3. Confirm that you wish to reset the claim.
  4. The invoice will refresh with the Get Report button. Click to retrieve the payment report from Medicare.

If the claim has still not been paid, you may wish to change the fee to a private fee.

Alternatively, the claim may not have been paid due to actions taken by the patient. Please contact Medicare if you are still unsure what to do.

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