If Medicare or DVA claims have been stuck in Pending status for longer than usual, you can Reset and Resubmit the claims. Please take a look below for step-by-step instructions on completing this.
Before you start...
The rules for resetting claims:
- For Medicare, claims must be Pending for more than 72 hours before resetting.
- For DVA, claims must be Pending for more than 7 days before resetting.
If the claim has not been pending for the times mentioned above, the Reset button will not display.
It's a good idea to...
Double check your Medicare or DVA claims to ensure that the data you're submitting, e.g. Provider name and number, referral date, reference number, etc., is correct before resubmitting the claim.
This will minimise the risk of the claim being rejected.
It's a good idea to...
Check the Medicare report via Reports > Financials > Medicare to track and reset Pending claims.
Resetting a Claim from the Invoice
1. Open the invoice and click Pay Via then Medicare Claiming.
2. This action will take you to the Online Claim screen. Next, click on the Claims tab.
3. Click on the Reset button.
4. Select both checkboxes to acknowledge the decision to Reset the claim, then click Yes.
Your claim is now Reset and ready for you to Resubmit.
Resetting a Claim from the Medicare Report
1. Go to Reports.
2. Under Financials, click on Medicare.
3. When generating the report, select claims with a Pending status.
4. Click the Reset button and confirm the decision to Reset the claim.
Hot Tips
You will need to scroll to the far right of the Medicare report to see the Reset option.
5. The report will re-generate after this action, updating your view to reflect your action of resetting the claim. Repeat this process for all claims that need to be reset.
Your claim is now ready for you to Resubmit!