Retrieving Reports for the Claim

Two reports are produced for each claim:

1. A Payment report

2. An Exception report.

The payment report provides such information as the Date Paid, the Run Number and the Amount Paid.

The exception report provides details about any exceptions found in the claim. Examples of exceptions might be

All exceptions for a claim should be dealt with (as described in the next section Reviewing Exceptions for a Claim) before attempting to receipt the claim.

Select Awaiting Reports from the Show drop-down list on the Claims Control window to list all claims for which payment and/or exception reports have not yet been received.

Select the claim(s) for which to retrieve payment and/or exception reports by highlighting them in the list (additional claims can be selected by shift-clicking or control-clicking on them).

Click on the Retrieve Reports button. If this button is greyed out, it means that either the claim was created using MedClaims, and therefore the reports must be downloaded using your Mednetwork or Optus Messenger software, or that the reports have already been retrieved.

Once the reports have been retrieved, the claim will be moved to either the Exceptions to Review list or, if the claim did not have any exceptions, the Ready to Receipt list.

The Payment Report will fill in the Date Paid, Run No, and Paid columns on the Medicare Claims Control Window.

The Exception Report will fill in the Exceptions column on the Medicare Claims Control window, i.e. change it from 'N/A' to a number.

Note: When retrieving reports, it is common for several claims to be paid with the one Payment Report. This means that claims which you have not selected may have their Payment Reports returned when retrieving reports for a different claim.

The same is not true for Exception Reports, i.e. only the Exception reports for those claims you have selected when you click the Retrieve Reports button will be returned.

The result of this phenomenon is that you will likely end up with claims which have Payment Reports but do not have Exception Reports. These claims will remain in the Awaiting Reports list until their Exception Reports are retrieved.

When the Retrieve Reports button is clicked for these claims, the following window will appear.

At this point you should click the No button as there is no need to re-retrieve the Payment Report.

If, for some reason HIC had to pay you for the batch or part thereof manually, ie. sent you a paper statement of payment rather than an online report, then these can still be receipted simply by clicking the Receipt button. You will get an alert to the effect that there has not yet been a payment report received or that the claimed does not match paid, you may have outstanding exceptions. Are you sure you want to receipt? to which you select OK and proceed to the receipt window where you can receipt the claim as appropriate.