If your Medicare / DVA claim has moved into Exceptions to Review but the Claimed and Paid amount still match, it's likely that there is a Medicare validation warning against a patient within the claim.
Highlight the claim in Medicare Claims Control > Exceptions to Review and click the option.
In the Claim Exceptions window that appears, highlight the item and assess the problem text in red. In the example above, the patient's Medicare number has been updated, but Medicare was still able to identify the patient and have paid the item.
- With the item highlighted, click the button.
- In the patient's demographics, click and verify the patient's Medicare card details. Once this is complete, you should notice the Medicare number and/or expiry is now updated.
- Click Save to close the patient's demographics.
- With the item still highlighted in the Claim Exceptions window, click the button.
- Click Delete.
You can re-retrieve the exceptions report prior to receipting if necessary.
- Click Close and the claim will now move to Ready to Receipt where you can receipt and finalise the batch.
If your claim has any other items that are either part paid or fully unpaid exceptions, these must be dealt with before the claim can move to Ready to Receipt.