We’ll assess a patient claim when it is submitted. When we are unable to assess a claim immediately, the EFTPOS terminal will display a 4-digit return code.
In some cases we may need to manually review complex or special claims. We’ll indicate on the terminal that the claim is pending. We try to manually review complex claims within 24 hours.
We’ve provided information for troubleshooting Medicare Easyclaim claims.
For some practices, there’s a chance of data entry errors. This is because of the need to double key some claim data, first on the EFTPOS terminal, then in your practice management software.
You can reduce the chance of data entry errors by:
- swiping Medicare and EFTPOS cards through the EFTPOS terminal instead of keying them in
- using a Medicare Easyclaim enabled EFTPOS terminal which has claim data such as provider numbers and common item numbers hard-coded in.
Medicare Easyclaim works best for simple claims, such as those with one item number, where less data is involved.
If the EFTPOS terminal times out or there is a communication failure during a patient claim, a bank-initiated auto-cancel will occur.
When this happens, you should issue an account or account receipt to the claimant. They can use this to claim their benefit using Medicare Online, by phone or at a Medicare Service Centre.
A Medicare card flag value is an indicator that shows a problem with the submitted Medicare card. This indicator may appear on the bulk bill processing report against a claim.
Medicare card flag values are:
- A = patient identification amended
- I = patient Medicare issue number changed
- C = patient Medicare card number changed
- W = patient card used will expire shortly
- S = patient card expired and we may reject future services
- X = old Medicare issue number for patient and we may reject future services.
You may need to cancel a claim after we’ve assessed it and shown a benefit amount if:
- the claimant doesn’t have an EFTPOS debit card
- the EFTPOS terminal can’t read their debit card
- the claimant doesn’t wish to continue with the claim.
When you cancel a claim it’ll show a cancel indicator.
In a small number of cases, the person who paid for the service may not get their Medicare benefit claimed using Medicare Easyclaim.
If this happens, you should complete a Medicare Easyclaim enquiry form (HW059) and send it to us.