DVA claims: Troubleshooting and Frequently Asked Questions
Important
You must fill out your HW027 form to register for Online Claiming. If you or any providers that submit claims through your account have not filled out this form previously please do so immediately. Details on how to fill out the form and submit it to Medicare can be found here. Please keep Question 3 on the form blank.
Sometimes you may get a response from DVA other than ‘Referred’ which generally means that the claim has been unsuccessful. Usually, these responses will be accompanied by a reason code (ie. ‘257’). You can use these codes to discern why the claim wasn’t successful and, in some circumstances, what changes you need to make in order for the claim to go through successfully when resubmitted.
You can find an explanation of each of these codes on the Services Australia website.
Hint 💡
You can press Ctrl + F (Command ⌘ + F on a Mac) on your keyboard to search the page for a specific item code - just input the reason code’s number and hit enter, your browser should then take you to that reason code.
Which type of claim should I submit?
Generally speaking, most users will submit DVA Allied Health claims, though General Practitioners, those providing Pathology Services, or Specialists will need to use the DVA Medical/Paperless claiming method.
The service type for the Provider is not consistent with the type of claim being submitted. Please click “Edit Provider” > Insurers > Edit the insurance and select a service type that matches the type of claim being submitted
The service type selected for the provider's insurance (Medicare or DVA) will need to be updated. The service type includes the type of claim that it can be used for in brackets after the service type name as shown in the list of service types below:
- General Practitioner (Medicare / DVA Medical)
- Specialist & Allied Health (Medicare / DVA Medical)
- Pathology (DVA Medical)
- Community Nursing (DVA Allied Health)
- Speech Pathology (DVA Allied Health)
- Allied (DVA Allied Health)
- Psychology (DVA Allied Health)
If you are submitting a Patient Claim or Bulk Bill, then you will need to choose a service type with the (Medicare / DVA Medical) label (i.e. General Practitioner or Specialist & Allied Health).
If you are submitting a DVA Medical/Paperless claim you will need to choose a service type with the (Medicare / DVA Medical) or (DVA Medical) label. (i.e. General Practitioner, Specialist & Allied Health, or Pathology)
If you are submitting a DVA Allied Health claim you will need to choose a service type with the (DVA Allied Health) label (i.e. Community Nursing, Speech Pathology, Allied, or Psychology).
9202: Invalid value of [N] supplied for referral period code. The value supplied must be S (Standard). Error located in medical event 01.
If submitting a DVA Allied claim where a referral is being used, then the referral period must be a Standard period of either 3 or 12 months. This error is being returned because the referral does not have a standard referral period of 3 or 12 months. Please edit the referral linked to the invoice being claimed and update the referral End date to reflect the referral period.
2030: Additional information required. If Service Type Code is set to F (Community Nursing) then Admission Date must be supplied. Error located in Medical Event {m}, Service {s}.
The Admission Date is the date the patient was admitted to hospital. It must be supplied to Medicare for Community Nursing service type. Note: For DVA community nursing, this is the admission date to the nursing service.
To add the Admission Date, generate the DVA claim and click on Show More at the bottom right. Enter the Admission Date as required.
2030: Charge Amount must only be set when Service Type Code is set to G (Dental), L (Optical), I (Speech Pathology), J (Allied) or K (Psych). Error located in Medical Event {m}, Service {s}.
For the DVA community nursing service type, the claim Charge Amount should be left blank when submitting the claim:
2030: Referral Override Code must only be set when Service Type Code is set to G (Dental), L (Optical), I (Speech Pathology) or J (Allied). Error located in Medical Event {m}.
When this error notification is returned, it means that a referral is required for this type of claim. Please add the referral in Client Profile > Referrals.