Claims with incorrect information

Claims with incorrect information

Most claims can't be cancelled electronically. Once they've been sent you generally need to wait to see if they are accepted or rejected, then request a manual adjustment with Medicare.

Bulk Bill Claims
  1. You can call the Medicare provider enquiries line on the same day on 132 150 (option 2) to request them to delete a claim you submitted. This service is available 24/7.
  2. For older claims you can request an adjustment of a previously paid bulk bill claim if the date of service is within 2 years.
  3. See https://www.servicesaustralia.gov.au/adjust-mbs-bulk-bill-claim?context=20 for more information
Medicare Patient Claims (PCI)
  1. In some circumstances we may be able to request a Same Day Delete (SDD) of a Medicare Patient Claim. Contact support@cesoft.com.au as soon as possible on the same day if you need an SDD. In our experience the success rate is low, in which case the points below for other claim types apply.
ECLIPSE, Bulk Bill and DVA Claims
If you've sent a claim with an error e.g. in the patient details, dates of service or item numbers, your only option is to wait for it to be processed.
  • If the account is rejected in full, you can then fix it and resubmit.
  • If the claim has been accepted, write to the Fund (for ECLIPSE claims) or Medicare (for other claims), with a hard copy of the corrected invoice, requesting a manual adjustment.
  • There is no provision in Medicare Online or ECLIPSE to resubmit claims for correction once they have been accepted
IMPORTANT NOTES
  • Amending and resubmitting a claim will not override a claim that is currently processing. The second claim should get rejected as "Duplicate service already paid", or worse case both get paid and you will have to arrange a manual refund to the fund.
  • Deleting the invoice or claim from Cutting Edge doesn't delete the claim with Medicare or the Fund. 

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