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Track Medicare claims online 133-24020907

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This document explains how customers can track the progress of their recently submitted Medicare claims online. Customers can do this in their Medicare online account through the myGov website or myGov app.

On this page:

View progress of recent online claims

Closed claims

View progress of recent online claims

Table 1: explains how customers access the claims tracker in their Medicare online account.

Expand table

Step

Action

1

Access service
  • Sign in to myGov > under Services, select Medicare
  • From the homepage, select:
    • View recent claims under Recent Medicare claims, or
    • History and statements > Recent Medicare claims

The View recent Medicare claims page shows.

2

Select View details
  • Select View details under each claim to view more details about recent Medicare claims
  • For privacy and security reasons, limited details display for claims submitted by health professionals or children aged 14 to 17 years
  • Claims show here for 30 days after the date it was completed
  • Customers can view paid claims by selecting Medicare claims history

Note: Medicare claims history only show claims if:

  • the customer is the patient, or
  • the patient is under 14 years

Go to Medicare claims history and claims history statement online.


Closed claims

Table 2: explains what Service Officers must do for customer enquiries about claims with a status of Closed.

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Step

Action

1

Authenticate (security check) the customer

See Authenticating a Medicare customer.

2

View recent claims > Additional Information field

Ask the customer what displays on their View recent claims > Additional Information field page.

If the Additional information shows:

  • We can't process this claim. For more information, call the Medicare program. Go to Step 3
  • You don't need to do anything. The health professional has either cancelled this claim or may have submitted another one. Go to Step 4

3

Check CDMS

Check CDMS to see if the customer has an end date on their:

  • Consumer ID, or
  • Entitlement

Is there an end date?

  • Yes, escalate to Local Peer Support (LPS)
  • No, tell the customer to submit a new claim

Go to Step 5.

4

Determine if the customer if expecting a payment

Is the customer expecting a payment?

  • Yes, tell the customer:
    • the health professional has made an error and has requested for the claim to be removed. The health professional may re-submit the claim
    • to contact the health professional for more details
  • No, tell the customer:
    • the health professional lodged a claim in error and asked for the claim to be removed
    • they do not need to do anything further

Go to Step 5.

5

Closed claims online view

Tell the customer Closed claims remain on their View recent claims page for 30 days and will then no longer display.

Procedure ends here.