Follow these steps to find out why your claim has been rejected or only partially paid by Medicare:
- Open the Medicare Claiming dashboard
- Click Accounts at the top of the page
- Click Claiming
- Make sure you are in the "In Progress" module
- Click the Tick-box next the claim that been rejected or partially paid
- Click View Services
- Refer to the Status to locate which services are Unpaid
- Look at the Description to find out the reason it was rejected
- Take appropriate action based on the reason the claim was rejected
- Resubmit the claim to Medicare
Providing you have taken appropriate action, your claim should now be processed by Medicare.
Example of Medicare rejections reasons -
- The current claim has already been processed (submitted or accepted). Get details then clear the claim
- The claim type is not valid
- A claim or request already exists. Another claim or request cannot be created until the current claim or request is cancelled or completed.