Claims with incorrect information

Claims with incorrect information

Most claims can't be cancelled electronically

Once a claims has been submitted you should wait to see if it gets paid. If it is, contact the fund to amend the invoice. The fund will also advise medicare.

If the invoice is rejected you can then amend the original invoice and resubmit.

Important Note

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. Call the fund to discuss.
Deleting the invoice from Cutting Edge doesn't delete the claim with Medicare or the Fund.

Medicare Claims

  1. A Medicare claim that has a status of MEDICARE_ASSESSED can be deleted through CE on the day it was submitted. This is called a Same Day Delete, and if it is available for this claim, a 'Delete Claim' button will appear in the Account Handling box.
                  
  1. You will be prompted to select a reason for the Same Day Deletion request.

                  
  1. If the 'Delete Claim' button isn't visible, then the conditions for a Same Day Delete request haven't been met and the PCI claim can't be deleted.

Bulk Bill Claims and Inpatient Medical Claims

  1. You can try calling the Medicare provider enquiries line on the same day on 132 150 (option 2) to request them to delete a claim you submitted. This may not be successful.
  2. For older claims you can request an adjustment of a previously paid 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

DVA Claims

  1. 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.
  2. If the account is rejected in full, you can then fix it and resubmit.
  3. 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.
  4. There is no provision in Medicare Online or ECLIPSE to resubmit claims for correction once they have been accepted

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