Medicare Claim Payment Status - Patient Claims

When you submit a Patient Claim Medicare will supply you with a status response which will include the claim status. If the claim is not successful you should see an error code which will give instructions on how to resolve the issue before re-submitting the claim.

The status' are as follows: 

  • Assessed: The claim has been accepted and has responded as successful. Medicare will pay the rebate the to client. 
  • Referred: There was a non critical warning. If you have ticked 'Accept Non-Fatal Warnings' this will force the claim to be processed and it will be referred to a Medicare Representative for examining.
  • Warned: There were non critical warnings and the claim was not accepted, you will be provided with an error code which will give you information on what will need to be fixed so that you can submit the claim again, or you can submit the claim by ticking 'Accept Non-Fatal Warnings'.
  • Rejected: There was a critical error and the claim can't be accepted.
  • Prepared: The claim has been stored for later transmission.