Steps for fixing Claiming error
This article is a guide on the necessary steps to fix a Claiming error. When contacting Clinic to Cloud for Claiming Support, please provide the following:
- the invoice number
- full error message
- provider name
- provider number
- Minor ID
Example A The error message is in the individual item number
Example B The error message is in the status of the claim
Note: We recommend using ctrl F or command F to search for a particular error and match them with the appropriate steps
Error Message Table
INVALID This provider appears to have an issue with Medicare paperwork. Contact Medicare to confirm before submitting further claim
|Contact Medicare and confirm the correct provider number, minor ID and bank account have been linked together. If all correct, contact Clinic to Cloud Support
|ERROR AUTH Provider number is not linked with the current location
|Provider # is not active
|Medicare response: Minor ID is not yet linked for electronic claims. Contact your application support for assistance.
|MEDICARE ERROR 732
Referral period not valid for referring provider
|Please check the dates with the referring provider as a new referral may need to be issued
|ERROR INVALID referral.date: Must be on or before [item.date]
|Please check that the referral date is valid. For example, it is before or on the item service date in the invoice
|INVALID referral.provider: Must have no more than 8 characters and not equal [provider.servicing]
|The referrer's provider number in the invoice is the same as the Doctor for that location.
Try using a different provider number for the referring Doctor in the contacts/referral and try again.
The error message indicates that the doctor is referring his own patient to himself
|HF ERROR 1008
EFT Details have not been registered with Fund
|Contact Healthfund and register the doctor's bank details.
|HF ERROR 2020 fee invalid : no provider registration
|Contact Healthfund to see if doctor is registered with them
|Patient is eligible to claim for Medicare with details provided.
HF ERROR 0
Patient is known to the Health Fund specified in the request.
|Please ensure the doctor and the patient is registered with the Healthfund and re-attempt claiming
|HF ERROR 2007 INCORRECT CHARGE - CHARGE EXCEEDS ALLOWABLE AMOUNT
|Charge input is greater than the agreed rate for an agreement or scheme claim - Please confirm the amount with Healthfund
|HF ERROR 1001
Provider not attached to an Org ID
|Contact Healthfund and advise of the doctor's details for the location and if it specifically for BUPA, check if Fund Payee ID is in user settings>provider number
|Submitted over 14 days ago
Please contact Medicare
|Please contact Clinic to Cloud Support
|INVALID provider.servicing checksum didn’t match
|The servicing provider number was not valid or enabled as at the date of service. Please check the provider number for the doctor is correct
|Medicare error 360 - No benefit payable by this provider
|Please check with Medicare why these claims got that rejection reason
|9650: The card number and/or patient details submitted did not match Medicare checks. Please verify the details and resubmit with additional information if available.
|9781: Unknown medicare status code: 
|MEDICARE ERROR 252 Service possibly aftercare
|Please adjust invoice, delete item number and add it again, this time ticking "Not Standard Aftercare".
|Error 9602 - This claim cannot be lodged through this channel. Please submit the claim via an alternative Medicare claiming channel
|Please check whether the doctor is set up as a General Practitioner or a Specialist and adjust accordingly
|Error Code: INVALID item.serviceText
|If you see this error, it means you have exceeded the 50 character limit for notes when adding item numbers.
Please go back in and edit the notes to be 50 characters or less.
|Error Code: invalid referral.provider: Checksum didn't match
|This error usually means that there is some kind of detail incorrect for the referrer, and you will need to check the details in the "contacts" section, especially the provider number.
|MEDICARE ERROR 160 Maximum number of services for this item already paid
|Reach the maximum amount paid from Medicare, to fix this contact Medicare - ask Medicare to check the system for this particular patient. Or the client can log into HPOS and list all the patient claiming lining to the particular doctor to find out more information
|MEDICARE ERROR 606 Referring provider number not open at date of referral
|Error 606 means the referral provider number was not registered with Medicare when the referral was issued. The practice may need to speak with the referring doctor to confirm the provider number or correct the provider number for referring doctor provider number to use for this referral
|MEDICARE ERROR 402 Benefit not payable- number of patients attended required
|Attempting to bill for more patients but only have provided information for 1 patient, so Medicare dont know who the other patients are. Refer to https://trust.clinictocloud.com.au/hc/en-us/articles/115006343967-How-to-Invoice-Multiple-Patients-with-the-same-item-numbers-Proceed-with-Items- It will make copies of the invoice under the other patients names
|Validation Error: Patients with failed age validation
|When a patient claim is submitted to Medicare in a private invoice, it will provide the following error if the patient is under 14 years old and does not have a parent or guardian over 18 as the account holder.The parent/guardian must be a patient in the system and must be verified.
The parent/guardian must be added as Account Holder in the minor’s demographics.
|Error 9202 - Invalid Value For Data Item
|There are a few reasons why this error can occur:
1. The patient has a PO Box as the address setup in the file
2. The account holder of the patient has a PO Box attached to their file.
A physical address is required, as a PO Box is not accepted by Medicare. This will need to be changed to a physical address.
3. If there is no date of birth entered or an invalid date of birth
|9698: Service is possible aftercare, check the account and resubmit with a valid indicator if not normal aftercare.
|This claim may have item codes for post-operative care and treatment after an operation.
These item codes need to include details such as the aftercare period or GP attendances. If this transaction is not related to normal aftercare you may be able to re-submit the payment request. To be 'not normal aftercare', the treatment would need to be an unrelated condition or complications arising from the operation
|Error 9602 - This claim cannot be lodged through this channel. Please submit the claim via an alternative Medicare claiming channel/ Patient's card has been locked
|If you find that this error happens when you try to submit claims for a specific patient you will need to speak to Medicare to confirm whether there are any issues with that patient's Medicare card which could be causing this error to appear. If Medicare confirm that the issue relates to the patient's card the patient will need to contact Medicare themselves to confirm that their details are correct and amend if required.
|Medicare Response 9710: This item number has specific restrictions that cannot be overriden. Benefit not payable for this service.
|This item number has specific restrictions that cannot be overridden. Benefit not payable for this service, please see the following:
1. Is the referral attached to the invoice (ensure referral is valid)
2. ensure patient details are correct
If these are correct, then please contact Medicare. Medicare will be able to explain what is missing or not allowed to claim.
|Error Code: INVALID item.date: Required and must be after [patient.dateOfBirth] and be before today item.date:
|This error usually appears when you invoice for an item in the future. You are not able to invoice for something that has not yet occurred.
If this is accidental, please check the item dates within the invoice and adjust as required.
If you are wanting to receive payment in advance, you will need to take a deposit from the patient, and then invoice after the procedure/consultation has taken place. Here when choosing the payment type, you are able to apply the deposited amount.
|MEDICARE ERROR 162
Benefit has been previously paid for this service
|This error means the claim has been sent to Medicare multiple times and was rejected as the first claim was processed and paid.
Check the patient, item and date of service. It’s possible that incorrect details were submitted.
If you are unsure of the duplicate item and claim, log into Medicare HPOS and search for prior claims from all origination channels. For select items, you can also use the MBS Items Online Checker in Medicare HPOS to check eligibility of duplicate services before you lodge the claim
|MEDICARE ERROR 605
Referral expired - no benefit payable
|Medicare flag these referrals as expired in their database, meaning that even though we send the referral as indefinite they won't treat it as indefinite. The fact that these referrals are now flagged unfortunately means that Medicare will most likely continue to reject claims with these referrals.
You can try contacting Medicare and see if they can unflag the referrals and claims and get them paid. If Medicare is not willing to unflag these referrals the only option is for the patient to get a new referral. Unfortunately there isn't a way for Clinic to Cloud to unflag these referrals as this is entirely governed by Medicare
|MEDICARE ERROR 374
Old card issue used - benefit not payable - also refer @
|This can sometimes occur when the patient's Medicare Card number has changed by one digit when a new card has been issued. There is a 3 month period between when a patient's Medicare Card has expired where you can still claim using this number because it is still valid, and then following this time, Medicare will reject any claims that are submitted using the old card number.
Generally this is resolved by changing the last digit on the end of the Medicare card (not the reference, but the card number itself) up one digit. Please try to do this for this patient, verify the patient's record, and then re-submit the claim. If you receive the same error after assessment from Medicare, we advise contacting the patient to confirm their Medicare Card details over the phone.
|INVALID: 2030 Number of patients seen must not be set when referral details are set. error located in medical event 01. Service 0001
|In the invoice, under the Admission and Discharge dates, there is a section for location type, this has been set to Hospital.
If this is incorrect, then you would be best to reverse the invoice and then create a new invoice, ensure it says Rooms and not Hospital, then add the item numbers, payments and then claim.
If it is a hospital location and Medicare would expect the item numbers to be completed at an actual hospital, then you will need to enter a facility ID under the location settings of the Hospital, where the invoice has been created for.
This article guides you through adding the facility ID, just ignore the creation of a new location and instead click the pencil icon for the location: https://trust.clinictocloud.com.au/hc/en-us/articles/115001569748-Adding-a-Location