Bulk bill late lodgement claims in Medicare 011-43030020

Service Officers assess claim for:

• correct and completed documentation
• DB019 – application for late lodgement
• reason for late lodgement
• if compliance is listed as the reason for late lodgement, Service Officers must search for the listed case number and make sure that all services being claimed were a part of a NCO (Non Compliance)
• check culled history to make sure items have not been previously paid, see Culled history check table
• a copy of the culled history report must be uploaded to the PaNDA file

Can the Service Officer approve late lodgement?

• Yes, go to Step 3
• No, or documentation is incomplete, go to Step 2

Note: late lodgement applications must only be processed by appropriately skill tagged Service Officers.

Return the claim with the Z1664 – Provider late lodgement not approved letter and upload to PaNDA for filing.

Procedure ends here.

Enter a comment in PaNDA explaining the reason for recommendation to approve and pend the claim for delegation approval.

The delegate must enter comments in PaNDA stating whether the late lodgement is approved or rejected.

If the delegate:

• approves the late lodgement, the claim is allocated for assessing. See Bulk bill claims in Medicare for processing details and control lines
• does not approve the late lodgement, return the claim to the health professional with the Z1664 – Provider late lodgement not approved letter
• requires further escalation, refer to Medicare Claims Helpdesk for determination

If prompted, enter:

• Username = Logon ID (AAA123 or P12345)
• Password = Universal Password

Select the Parameter-Based Reporting tab.

Select Medicare Patient History.

Complete the web form and select Submit request.

Note:

• Pin/s field requires the Medicare PIN, minus the alpha
• Dates of service must be in DD/MM/YYYY format
• Report Format Types can be changed to suit processing style
• The system may take several minutes to produce the reports

The culled history report will be ready for use.

A copy of the report/s must be uploaded to the PaNDA file to support the assessment of the late lodgement claim.