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Claim statuses

Each claim on an invoice shows its status until it’s paid, such as submitted, awaiting report, partial, rejected or error. A paid claim shows the payment date and the benefit paid.

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Refresh a claim and read its reports

Medicare sends a processing report, usually overnight, and a payment report after its payment run. Bilby checks for them every night. To check now, open the claim’s menu and select Refresh status. The same menu opens the reports. If Medicare updates the patient’s card details in its report, Bilby saves them to the patient. Check them on the patient’s record.

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Find claims Medicare hasn’t accepted

Admins can open the Outstanding Medicare report on Reports. It lists every rebate and bulk bill Medicare hasn’t accepted yet, oldest first. A claim stays on it until Medicare accepts it. See Reports and records.

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When Medicare returns an error

Bilby shows Medicare’s or DVA’s own message on the claim.
  1. Read the message. It usually names what Medicare didn’t accept.
  2. Fix that detail in Bilby, such as the patient’s card, the provider number, the referral or the item.
  3. Resubmit the claim.
Don’t resubmit without changing something. Sending the same claim again gets the same answer.
If the message is about the PRODA device or the security key, an admin needs to fix the connection in Settings › Medicare. Don’t keep trying, because PRODA locks the device after repeated failures. See Troubleshooting Medicare.