Resolving Claim Exceptions
Medicare processing reports can include exceptions to claims.
After sending bulk claims to Medicare Online and requesting the associated processing
reports, you might receive a Medicare processing report that contains exceptions to claims.
Possible causes of exceptions include:
- The refund Medicare issued is different from the amount claimed.
- The patient's Medicare Card has expired.
- The practitioner is not entitled to claim a particular item number.
All exceptions must be resolved in Pracsoft by accepting the exception, or editing and resubmitting the claim.
Tip:
If Medicare returns an exception on a claim for which a
partial payment has been made, you must accept the exception. You can't edit and
resubmit the claim.
After all exceptions in a claim are resolved, you can:
- Reconcile your accounts.
- Receipt the claims.
- Request payment reports on the Request Reports tab.