Claim Status

Once a Scheme or Agreement claim is submitted it gets processed between Medicare and the health fund until a processing report and remittance advice are available. See the section on Report and Process Status for more information.

The claim will move through a variety of statuses throughout this process, as indicated in the Claim Status drop-down menu.

NOTE: Patient Claims get moved straight to Exceptions to Review if there is a problem, or Finalised once they have been processed.

Status	Meaning	Action
Submitted	The claim has been transmitted to Medicare but no processing report is available at this time.	See if the processing report is available by highlighting the claim in the list and clicking the Get Report Status button.
Awaiting Processing Report	The processing report for the claim is ready and available to be retrieved from the Medicare servers.	Retrieve the processing report by highlighting the claim in the list and clicking the Get Processing Report button.
Exceptions to Review	The processing report has been retrieved and the report indicated that there are some problems with the claim.	Review the exceptions by highlighting the claim in the list and clicking the Review Exceptions button. The action to take will depend upon the nature of the exceptions.
Awaiting Remittance Advice	Any exceptions with the claim have been dealt with but the ECLIPSE Remittance Advice (ERA) has not been received for the claim.	See if the ERA is available by clicking the Get Remittance Advices button. This will retrieve all ERAs which have been produced since the last time this button was clicked.
Ready to Receipt	The claim's ERA has been retrieved and it is ready to be receipted.	Receipt the claim by highlighting it in the list and clicking the Receipt button.
Part Paid	The claim has been receipted but there is still a balance outstanding from either Medicare or the health fund.	Apply for a top-up payment from the fund or Medicare and receipt the balance when you receive it through Open > Account Holders or credit the balance through the Account History.
Finalised - All	The claim has been fully processed and receipted.	None.
Stored	The claim has been created but has not yet been transmitted to Medicare for processing. A claim is given this status if Later (Batch) is selected when you transmit the claim.	Transmit the claim by highlighting it in the list and clicking the Transmit button.
Deleted - All	The claim has been deleted, and is stored within this section for future reference. The claim retains previously retrieved reports in a read-only state.	None.