After a claim is made you can see the Claim Statement, Processing Report and Payment Report in Gensolve. Also, you will be able to see Stored Medicare Online Claims in batches.

Claim Report Screen

GPM allows you view and retrieve the Claim Statement, Processing Report, Claim Payment Report (Specific payment details for that Claim) and the Payment Report (the related Medicare Payment Run) as follows:

1. Go to Medicare >> Claims
2. Select the Claim View if reviewing specific types of Claims such as Stored, or Patient Claims etc
3. Filter By Claim Type (Medicare or DVA Allied), Site and Provider or search the specific Claim Number if required. Note: if searching by a Claim Number, all filters will be ignored.
4. Select the date you want to include claims Created From and To >> Get Data
   

Claim Statement

These reports show information related to claims just submitted or historically submitted. They include details related to services, patients, payees and referrals.

Medicare Bulk Bill Claim Statement - The Claim Statement can be generated at time of submission as well when prompted. The report indicates successful transmission of the Bulk Bill Claim to Services Australia only.

Note: It is NOT a confirmation that the claim will be paid.

DVA Allied Claim Statement -The Claim Statement can be generated at time of submission as well when prompted. The report indicates successful transmission of the DVA Allied Claim to Services Australia.

Note: It is NOT a confirmation that the claim will be paid.

Medicare Patient Statement of Claim and Benefit - The Patient Statement of Claim and Benefit can be generated at time of submission as well when prompted.

Note: Patient Claims are generally Assessed at time of submission.  A Claim that has been marked as ASSESSED will be paid from Medicare to the client's Services Australia registered Bank Account.  

If no payment is received the Client will need to contact Medicare directly.  Medicare does NOT provide Processing or Payment reports for Patient Claims.

 

Processing Reports

Note: Processing reports are only available for Bulk Bill or DVA Allied claims.

These reports show information related to claims submitted and processed by Services Australia. They include details related to the service, patients, payees and paid or rejected benefit amounts.  Reason for rejection is listed under the Service Item.

To inquire regarding rejected claims you will need to contact Medicare.  Gensolve Support is unable to advise as to why Medicare has rejected a claim.

Medicare Bulk Bill Processing Report

DVA Allied Processing Report

DVA Allied Processing Report with a GST Flag

Payment Reports

These Reports Show information related to approved payments against a particular claim. There are 2 types.  The Payment Report and the Claim Payment report.  The Payment Report shows details of the entire Medicare payment run, that the claim payment was included on.

Medicare Bulk Bill Payment Report

DVA Allied Payment Report

Medicare and DVA Claim Payment Report

The Claim Payment Report is accessed by clicking . It provides payment details about the selected claim only.