You may have a Medicare / DVA claim that has moved into Exceptions to Review where the item(s) was still paid, however, it was paid a different amount to what you claimed. This can be for numerous reasons, such as the item being sent through with outdated fees.
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 benefit has been increased in line with the fees that were current as of the service date.
- With the item highlighted, click the button.
- In the Sales window, click Edit and adjust the Total Charge to the amount that was Paid.
- Click Save to close the Sales window.
- With the item still highlighted in the Claim Exceptions window, click the button.
- Click Delete.
- 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 fully paid or fully unpaid exceptions, these must be dealt with before the claim can move to Ready to Receipt.