10

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

108

Benefit is not payable for the service claimed. Check that the item number and service details on the invoice are correct. If Medicare won't pay a benefit, you can change the fee to a private fee.

111

No benefit payable - service over 2 years old. Medicare doesn't pay benefits for services more than 2 years old. You can change the fee to a private fee.

131

Date of service not supplied/invalid. Check the date of service on the invoice, correct it if needed, then reprocess the claim.

137

The details of the referral provider were not included on the invoice when submitted. Update the referring provider's details:

159

You cannot claim for this service until another item number has been claimed. Contact DVA to confirm the item number that needs to be claimed first.

160

The patient has reached the maximum number of appointments covered under the referral. Contact Medicare on 132 150.

162

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

179

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

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:

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

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.

206

Medicare is not paying a rebate for the item number at that date of service as it may have been ineligible at that time. Confirm the details on the invoice are correct. If necessary, change the item number and/or the date of service.

208

Card number used has expired. Obtain the patient's current Medicare card details and update them in the Medicare Claim section of the invoice (which updates the patient's Funding page), then reprocess the claim.

209

Claimants name stated is different to that on card number. Check that the patient's name matches their Medicare card exactly. Update it in the Patient section of the invoice (which updates their patient profile), then reprocess the claim.

211

Patient not covered by this card number at date of service. Check that the patient was on this Medicare card on the date of service and that their reference number is correct. Obtain the patient's current Medicare card details and update them in the Medicare Claim section of the invoice (which updates the patient's Funding page), then reprocess the claim.

212

Date of service used is in the future. Correct the date of service on the invoice, then reprocess the claim.

214

Claim form not complete. Check that the invoice has all the details Medicare needs (patient, Medicare card, provider number, item number and referral, if needed), then reprocess the claim.

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).

226

Date of service is prior to patient’s date of birth. Check the patient's date of birth on their patient profile and the date of service on the invoice. Correct whichever is wrong, then reprocess the claim.

227

Date of service prior to date eligible for Medicare benefit. The patient wasn't eligible for Medicare on the date of service. Confirm the patient's eligibility with Medicare on 132 150. If Medicare won't pay a benefit, you can change the fee to a private fee.

232

Service claimed not covered by Medicare. Check that the item number on the invoice is correct. If Medicare won't pay a benefit, you can change the fee to a private fee.

233

Provider not entitled to benefit at date of service. Check that the provider number on the invoice is correct and was registered with Medicare on the date of service (see code 338).

238

As you have only submitted the travel allowance for this claim and not an associated service, DVA will not pay the allowance. You should resubmit this claim along with the claim for the service that was performed.

246

Patient cannot be identified from information supplied. Check that the patient's name, date of birth, Medicare card number and reference number on the invoice match their Medicare card. You can confirm the details by performing an Online Patient Verification, then reprocess the claim.

249

The veteran's number that was entered may not be correct or may not have the correct number of digits.

Confirm with the patient that you have the correct DVA card number:

250

Explanation/voucher will be forwarded separately. Halaxy does not have further information; please contact Medicare for assistance.

252

Medicare has rejected the claim as they believe this is possibly aftercare.

If the claim is eligible for a Medicare benefit and the service is not normal aftercare, you can make a note of this by following the steps below:

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.

267

Medicare will not pay this specific item without another associated item in the claim. Check the invoice and add the second service that must be claimed with this claim.

279

Approval must be sought from DVA before this claim can be processed. Contact DVA at 1800 550 457.

280

Cannot identify service - resubmit with correct mbs item. Check that the item number on the invoice is a valid MBS item for the date of service, correct it, then reprocess the claim.

298

A reduced amount has been paid, as Medicare does not pay the first 10 kilometres for DVA travel (or 50 kilometres for OT80). The benefit has been paid, so no action is required.

306

Card not valid at date of service - future claims may reject. Obtain the patient's current Medicare card details and update them in the Medicare Claim section of the invoice (which updates the patient's Funding page) so future claims aren't rejected.

307

Claim not paid - card number not valid at date of service. Obtain the patient's current Medicare card details and update them in the Medicare Claim section of the invoice (which updates the patient's Funding page), then reprocess the claim.

320

Quoted Medicare card number is incorrect. Verify the patient's Medicare card number by performing an Online Patient Verification, update it in the Medicare Claim section of the invoice, then reprocess the claim.

338

The practitioner's Provider Number was not registered with Medicare or DVA for the item number at the date of service.

You need to reconfirm your Provider Number and/or check with Medicare or DVA. Once you have done that, update your details.

342

Referral expired - paid at unreferred (gp) rate. The claim was paid at the lower unreferred rate because the referral has expired. Ask the patient for a new referral from their referring practitioner for future claims.

343

Card number quoted for this claim has been cancelled. Obtain the patient's current Medicare card details and update them in the Medicare Claim section of the invoice (which updates the patient's Funding page), then reprocess the claim.

356

Documentation required to process service. Medicare needs supporting documentation before it can process this service. Contact Medicare on 132 150 to confirm what to send.

358

Documentation not received - unable to process service. Medicare needs supporting documentation before it can process this service. Contact Medicare on 132 150 to confirm what to send.

359

Documentation not received - unable to process claim. Medicare needs supporting documentation before it can process this service. Contact Medicare on 132 150 to confirm what to send.

373

Expired card - benefit not payable. Obtain the patient's current Medicare card details and update them in the Medicare Claim section of the invoice (which updates the patient's Funding page), then reprocess the claim.

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).

376

The Medicare card number entered into Halaxy is incorrect. Verify the patient's Medicare card number by performing an Online Patient Verification.

If the verification is successful, the icon changes to a plus circle icon and you can reprocess the claim.

If verification is unsuccessful, Medicare provides you with a message saying why the details are not correct so you can obtain the correct Medicare details from the patient.

377

The number of patients seen has not been entered on the invoice.

378

The referring practitioner has not provided Medicare with details of the referral. You should speak to the referring practitioner, who will need to forward the referral to Medicare.

390

Documentation not received. Medicare needs supporting documentation before it can process this service. Contact Medicare on 132 150 to confirm what to send.

401

Benefit not payable - charge amount missing or invalid. Check the fee charged for each item on the invoice, correct it, then reprocess the claim.

404

Benefit not payable - referral/request details required. Add the referral details to the invoice (see code 137), then reprocess the claim.

414

Provider practice location is closed at date of service. Check that the provider number and Medicare Location ID on the invoice are correct for where the service was provided. If they are, contact the Medicare eBusiness Service Centre on 132 150.

418

Item cannot be claimed more than once in one attendance. Remove the duplicate item from the invoice and reprocess the claim. If the services were separate attendances, reprocess the claim and add explanation text in the Additional Information field.

429

Patient cannot be identified from the information supplied. Check that the patient's name, date of birth, Medicare card number and reference number on the invoice match their Medicare card. You can confirm the details by performing an Online Patient Verification, then reprocess the claim.

434

Expired or invalid card - benefit not payable. Obtain the patient's current Medicare card details and update them in the Medicare Claim section of the invoice (which updates the patient's Funding page), then reprocess the claim.

447

Evidence is required. Resubmit with account/voucher. Contact Medicare on 132 150 to confirm what evidence to send.

475

Patient/service details invalid or missing. Check the patient and service details on the invoice, correct anything missing or incorrect, then reprocess the claim.

502

Patient is not eligible to claim benefit for this item. Check that the item number on the invoice is correct and confirm the patient's eligibility with Medicare on 132 150. If Medicare won't pay a benefit, you can change the fee to a private fee.

504

Charge amount missing/invalid - no benefit payable. Check the fee charged for each item on the invoice, correct it, then reprocess the claim.

505

More information required - evidence of condition. Medicare needs evidence of the patient's condition before it can pay this claim. Contact Medicare on 132 150 to confirm what to send.

529

The bulk bill benefit is applicable for concession holders and the patient may not have valid concession details entered.

If the unreferred Medicare service and related bulk bill additional item are eligible for a Medicare benefit, make sure you lodge both items together in the same claim for the patient. Use the correct bulk bill incentive item that applies to the unreferred Medicare service.

532

The provider number used for this claim is not registered for GST with DVA. You need to register your provider number with DVA for GST. Please be aware that each provider number needs to be registered with DVA for GST.

535

Missing data. Check that all the patient, provider and service details on the invoice are complete, then reprocess the claim.

540, 550

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 132 150.

581

The condition treated and the type of card has not been recorded on the claim.

As the patient is a DVA white card holder, the Condition Treated / Accepted Disability needs to be recorded. You also should specify that the card type is "White" or "White Card".

583

Under DVA's rules, the patient is not eligible to claim these item numbers. Check with DVA or the referring practitioner for eligibility.

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.

604

Service over 6 months old - late lodgement form required. Medicare needs a late lodgement form before it can process this claim. Contact Medicare on 132 150 for the form and how to lodge it.

605

The referral has expired. Check the date of the referral provided by the referring practitioner or confirm with Medicare.

606

Referring provider practice location is closed. You should speak to the referring practitioner, who will need to advise the correct Provider Number or details.

608

Referring and servicing provider same - no benefit payable. Check the referral details on the invoice. The referring practitioner must be different from the practitioner providing the service (see code 137 to update the referral).

609

The practitioner or their representative has called Medicare and cancelled the claim. The invoice should be updated, so you can reprocess the claim if you choose.

611

Referral/request details not supplied - no benefit payable. Add the referral details to the invoice (see code 137), then reprocess the claim.

613

Card number cannot be identified from information supplied. Check that the patient's name, date of birth, Medicare card number and reference number on the invoice match their Medicare card. You can confirm the details by performing an Online Patient Verification, then reprocess the claim.

618

The practitioner's Provider Number was not registered with Medicare or DVA for the item number at the date of service.

To update the provider number:

620

Duplicate transmission - no further payment made. Medicare has already received this claim, so no further payment will be made. Run a Medicare Claims report to check whether the original claim was paid (see code 179).

621

Item not claimable electronically. This item can't be claimed through online claiming. Contact Medicare on 132 150 to confirm how to claim it.

654

The invoice submitted may have have been submitted with the wrong item number or may not be eligible for online claiming. Confirm that you have used a DVA item number if the claim is for DVA and a Medicare item number for a Medicare claim. Alternatively, call Medicare.

700

Benefit cannot be determined for this service. Contact Medicare on 132 150 for assistance.

703

Duplicate of item already quoted. Remove the duplicate item from the invoice, then reprocess the claim.

704

Provider not permitted to claim this item. Check that the item number and provider number on the invoice are correct. If they are, confirm with Medicare on 132 150 whether you can claim this item.

718

Provider location not open at date of service. Check that the provider number and Medicare Location ID on the invoice are correct for where the service was provided. If they are, contact the Medicare eBusiness Service Centre on 132 150.

720

Eligibility cannot be determined for this item. Contact Medicare on 132 150 for assistance.

748

The initial consultation was not claimed as part of this referral but the invoice is claiming end of cycle report. Please contact Medicare for further assistance.

9006

The provider number is not authorised to take this action. Contact the Medicare eBusiness Service Centre on 132 150 and request that bulk billing be enabled for your Medicare Location ID (CLKXXXXX) for this provider number.

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.