Resolve Claim Exceptions

Resolve exceptions to claims.

Before you begin

If the Medicare Australia Online Claiming window is not displayed, from the Pracsoft Waiting Room, select Processing > Online Claiming.

Procedure

  1. In the Medicare Australia Online Claiming window, select the Request Reports tab.
  2. Click Request. Medicare will send you any processing reports or payment reports they have for your practice. New processing reports will open automatically upon being downloaded from Medicare. These reports might contain claim exceptions.
  3. To resolve exceptions listed in the Request Reports tab window, click Resolve.
  4. In the Resolving Claim Exceptions window, in the Claims to resolve list, select a claim. The exceptions for that claim are displayed in the Exceptions to resolve list.
  5. In the Exceptions to resolve list:
    • To accept an exception, select it. Click Accept > Yes.
      Tip:
      If a partial payment has been made, you must accept the exception. You can't edit and resubmit it.
    • To accept all exceptions, click Select All. Click Accept > Yes.
    • To edit and resubmit the claim, click Resubmit/Edit. In the Verify Resubmit and Edit Voucher window, you can enter a comment. Comments are optional.
  6. Click Yes.
  7. In the Edit Visit from Claim window, make the changes needed to resolve the exception.
  8. Click Voucher.
  9. In the Resolving Claim Exceptions window, click Resubmit/Edit to remove the voucher from the claim. The voucher can be edited and batched in a subsequent claim.
  10. Continue accepting or resolving the claim exceptions.
  11. Click Close when you have accepted or resolved all of the claim exceptions.
    Tip:
    Any items with a $0 payment need to be billed again.

Results

The claims are ready for reconciling, receipting, and reporting.