Track Medicare claims online 133-24020907

Customers can track claims that:

• they have submitted for:
• themselves, and/or
• someone else listed on their Medicare card
• their health professional/medical practice has submitted on their behalf

Paid claims that customers can view online (if they or a child under 14 years were the patient) are on the Medicare claims history page.

Go to Medicare claims history and claims history statement online for more details.

Claims can be tracked online if they were submitted via the following channels:

• Customer channels:
• Medicare online account (MOA)
• Express Plus Medicare mobile app
• Health professional/medical practice channels:
• Inpatient Medical Claiming Patient Claims
• Patient Claims Easyclaim
• Patient Claims Interactive
• Patient Claims Store and Forward
• Patient Claims Web Claim/HPOS

Claims that cannot be tracked online:

• manual patient claims
• bulk bill claims
• simplified billing claims
• Veteran Affairs treatment accounts

Latter day adjustments do not display online. Go to Latter day adjustments (LDA) and HELD payments for patient claims for more details.

If a customer contacts Services Australia to enquire about the status of their:

• online claim, Service Officers must tell them they can view the progress of their recently submitted claims online
• Closed claim, go to the Process page for details

Go to Enquiries received via telephone for digital self service claims for more details.

There are 2 view types to show claim details:

• Full view, and
• Limited view

Full view

Full view of claim details show if the customer is aged 18 years or over and submits a claim for:

• themself, or
• someone else listed on the same Medicare card

The following claim details show:

• Date submitted
• Current claim status
• Patient’s name
• Provider name
• Provider number
• The channel that it was claimed through, for example:
• Express Plus Medicare mobile app, or
• Medicare online account
• If the current status shows Completed:
• Date completed
• Payment method, if the benefit amount is greater than zero
• Benefit amount
• Claim ID
• Additional information

Limited view

Due to privacy and security reasons, limited claim details show if a:

• health professional/medical practice submits the claim, or
• customer is aged between 14 - 17 years old claiming for themselves or another person on the same Medicare card

The following claim details show:

• Date submitted
• Current claim status
• The channel that it was claimed through, for example health professional
• If the current status shows Completed:
• Date completed
• Benefit amount
• Claim ID
• Additional information

There are 3 status types that customers can view. These include:

• Submitted - claim is successfully submitted by the customer or the health professional, and is waiting to be processed
• Completed:
• claim is processed with a status of paid. The customer will get a statement of benefit. In some cases, no benefit is paid (that is, a Statement of zero benefit). The benefit shows when the customer selects View details
• claims stop showing after 30 days
• Closed:
• claims cannot be finalised or the health professional has requested to cancel the claim
• claims stop showing after 30 days

The Process page contains details for Service Officers when a customer enquiries about a claim with a status of Closed.

The Resources page contains a table with the corresponding details between Mainframe claim status and the customer online claim status.