Bulk bill claims in Medicare 011-43030000
Functions of bulk billing control lines
Table 1
|
Control line |
Topic |
Function |
|
DAPI |
Pend |
Use the A modifier after background assessing to add another voucher |
|
DASI |
Pend |
Supervisor level for DAPI |
|
DBEI |
Claim entry |
Used by branch office staff to key claims |
|
DBGA |
Background Assessing |
Bulk bill processing - Background assessing. Can only be initiated in CICSQ environment |
|
DBGB |
Background Assessing |
Bulk bill processing - Background assessing. Can only be initiated in CICSQ environment |
|
DBPI |
Pend |
Browse Claims assessed with errors can be reviewed online |
|
DCEI |
Enquiry |
Returns all unpaid claim status for health professional specified. Various modifiers may be added to refine the information returned |
|
DCPI |
Claim processing |
Claims in progress for an operator Changes the status of the claim |
|
DDEI |
Claim entry |
Menu screen to access claims |
|
DEAI |
Pend |
Used by branch office staff to add the A modifier after background assessing to add another voucher |
|
DHCI |
Claim |
Mail room received claim status |
|
DHDI |
Claim Delete |
Allows deletion of a header online |
|
DHAI |
Latter Day Adjustment |
Bulk bill latter day adjustment assessment - recalls from Pend and reassesses the claim |
|
DLBG |
Latter Day Adjustment |
Used to push a bulk bill latter day adjustment through background |
|
DHRI |
Latter Day Adjustment |
Same day reversal of a bulk bill latter day adjustment |
|
DHSI |
Latter Day Adjustment |
Bulk bill latter day adjustment |
|
DOPI |
Pend |
Process a bulk bill scanning claim |
|
DOSI |
Pend |
Process a bulk bill scanning claim at Supervisor level |
|
DPPI |
Pend |
Pay claim with 'no error OK to pay' |
|
DPSI |
Statement enquiry |
Can look at and request (or delete a request for) a duplicate health professional statement |
|
DQAI |
Enquiry |
National Office level |
|
DQOI |
Enquiry |
Display Claim Status |
|
DQRI |
Enquiry |
Region level |
|
DQSI |
Enquiry |
State level |
|
DSDI |
Same Day Adjustment |
Same day reversal screen, can be reversed if assessed today |
|
DXEI |
Claim entry |
Menu screen to key claims, and DUPE keying |
|
DZOI |
Claim Delete |
Deletion of bulk bill claims in PEND/ASSESSED status |
Resubmitting a totally rejected bulk bill claim
Table 2
|
Resubmitted information |
Mandatory paperwork |
|
DB1 form |
Services Australia will accept a photocopy of the header originally submitted. The declaration on the DB1 form must:
|
|
Vouchers |
Where the original vouchers are not available, copies are acceptable but copies of all the vouchers must be provided for the claim to be processed. |
|
Voucher Count |
The voucher count must be the same as the claim originally submitted. |
Resubmitting a voucher rejected from a bulk bill claim
Table 3
|
Resubmitted information |
Mandatory paperwork |
|
DB1 form with vouchers attached |
Services Australia will accept a photocopy of the header originally submitted. A new header is also acceptable for resubmitted vouchers. If a new header is submitted, the declaration on the DB1 form must:
|
|
Health professional letter (acts as a DB1) with claim voucher information |
Letter is acceptable for a resubmission, but must:
|
Retaining assignment of benefit forms - health professionals
National Archives of Australia - Agency specific records authorities.
Table 4
|
Document Type |
Retention period |
|
Claim forms for health and medical payments including:
|
Destroy 2 years after date of claim if not required for investigation |
Forms
Application for bulk bill claim adjustment form (DB018)
Application for late lodgement of a claim for assigned Medicare benefits (DB019)
Assignment of benefit Medicare bulk bill Webclaim form (DB020)
Bulk bill voucher - electronically transmitted claims form (DB4E)
Customer enquiry form (PP040)
Manual EFT Payment Request form (PP048)
External websites
Department of Health, Disability and Aging > Voluntary acknowledgement of incorrect payments
Medicare Benefits Schedule - Bulk Billing Incentives - Changes to Eligibility
Medicare Benefits Schedule - Note GN.7.17, Billing procedures
Medicare Benefits Schedule - Note PN.7.1, Assignment of Medicare Benefits - Patient Assignment
National Archives of Australia - Agency specific records authorities
Contact details
Medicare Claims and Assessing
Bulk bill claims
My Health Record
Provider Services Support
Accounting Operations (AO) team
Medicare Cash Management
Medicare Treasury Helpdesk