Bulk Bill and DVA Error Codes

Follow

This page relates to error codes for bulk bill or DVA rebates. Please click this link for information about patient-paid Medicare rebate error codes.

Table 2. Common bulk bill and DVA error reason codes

Code

Description and action

10

"Status Invalid". The provider number is not linked to a bank account. Contact Medicare.

160

The patient has reached the maximum number of appointments covered under the referral. Contact Medicare on 1800 700 199.

162

You have already claimed for this service, so you cannot claim again.

217

The patient information is incorrect or missing. Edit or update the patient's name or address in the Patient section of the invoice (which updates their patient profile). Edit or update the Medicare card or reference number in the Medicare claim section of the invoice (which updates the patient's Funding page).

255

The amount payable for this service has increased from the amount you claimed. You have been paid at the higher level, but you should update your fees by editing them on your Fee List.

374

An expired Medicare card has been used - obtain the patient's updated Medicare details and add them on the Medicare claim section of the invoice (which updates the patient's Funding page).

540, 550

Enhanced primary care plan item not previously claimed. The referring GP likely has not yet submitted the referral information to Medicare, or has submitted incorrect referral information to Medicare. Wait two days and process again. If the claim still cannot be processed, contact Medicare on 1800 700 199.

600

Requesting/referring provider unable to be identified. The referring GP's provider number is likely incorrect. Check it on the referral you received and edit the referral details on Halaxy so that the correct provider number is shown.

9119-9125

You usually receive this error when Medicare has not yet processed your Medicare online claiming registration. It usually takes 5 business days for Medicare to register practitioners, so wait until this time has elapsed before trying again (see here for more information on registering for Medicare).

If you are an allied health practitioner and the first claim you ever process is a DVA claim, you may receive error 9125 (this is a bug in DVA's claiming system that does not happen when the first claim you process is a Medicare claim). The way to overcome it is to run an Online Veteran Verification first (which allows you to check whether the DVA card details you have are correct or not), then process the claim. All future claims will be processed normally.


Bulk bill and DVA claim troubleshooting

If the amount you receive is less than you claimed, you can:

  • re-submit the invoice with a different item number if the reason for the difference is that the wrong item number was used; or

  • edit the fee amount so that it is the same as what was paid - this is preferable to doing nothing, as this way your invoice is balanced.

If the report shows that the claim was not paid, rectify any problems with the invoice based on the error codes provided. Medicare allows you only one attempt to reprocess the claim. If a rebate status remains "submitted" three business days after you tried to process it, you should contact Medicare on 1800 700 199 and confirm that Medicare has registered your Minor ID (see your Users page), provider number for this location (see Identifications) and bank account. The Online Claiming Provider Agreement form needs to be completed for each provider number you hold; if you have not done this, Medicare does not pay the rebate to you and the status remains submitted. After your Minor ID, your provider number for this location and your bank account have been registered by Medicare, reset and then resubmit the rebate.

Bulk bill and DVA reports also include card flags, which indicate that although a rebate has been processed, there is a problem with a Medicare/DVA card that you submitted. For example, flag W lets you know that the patient card used will soon expire. It does not prevent rebate processing.

The claim payment information at the bottom of the report that Medicare/DVA provides is in fact the daily claim amount paid to you, and not just the claim amount paid to you for this particular invoice.

0 out of 0 found this helpful

Comments

0 comments

Article is closed for comments.