Medicare patient claims history or claims history statement has incorrect or missing information 011-43010130

A customer may become aware that their Medicare claims history is either incorrect and/or is missing information by viewing their history via:

• their Medicare online account
• their myGov app
• their digital health record in the My Health Record system
• a statement received from Release of information

See Table 5 in Accessing and using Medicare self service for more information.

The Process page contains information on how to respond when a customer makes an enquiry by phone or at a service centre about incorrect and/or missing information on their Medicare claims history.

Service Officers should consider that the customer may not understand the information on their statement.

The Resources page contains a link to the Services Australia website 'Understand your Medicare Claims History Statement.’

Note: there are restrictions on who can request information relating to claims history.

See Release of claims information in Medicare for more information.

If a Service Officer cannot resolve a customer enquiry, they must request Local Peer Support (LPS) help. See Tier 0 technical support - self-sufficiency.

The Process page contains information on the procedures that LPS undertake regarding claims history that contains incorrect or is missing information.

The Process page contains a table outlining the different ways for gathering information based on the claiming method.

If the claim affects other service lines, or the maximum number of adjustments has been made on that claim, refer to Medicare Claims Helpdesk.

See Latter day adjustments (LDA) and HELD payments for patient claims for more information.