Medicare claiming errors
Praxi is completing Services Australia conformance testing for Medicare Online Claiming. Production claiming becomes available once Services Australia grants the Notice of Integration (NOI). This page describes the workflow so your practice can prepare.
Read the code and returned message together. Services Australia's message explains the specific problem; a short numeric code alone may not identify it.
Find the returned reason
- Open Finance > Claims and choose Medicare.
- Select the rejected claim under Needs action.
- Read Rejection reason and any guidance shown.
- Correct the relevant information before resubmitting.
Resolve common situations
| Returned problem | Next step |
|---|---|
| Client details do not match | Check the client's Medicare number, individual reference number, name and date of birth. |
| Provider or location is not authorised | Check the provider number for that location and the HW027 status in Medicare setup. |
| Invalid or missing value (9202) | Read the message for the specific field; this code is not limited to provider numbers. |
| Daily claim limit reached (3004) | Submit the remaining bulk-bill claims tomorrow. |
| Transaction already received (9777) | Check the existing claim before sending another submission. |
For provider-location preparation, follow Set up Medicare and Lodge an HW027. For consent messages, check Record bulk-bill consent.
Patient or Medicare card problems
Compare the client's Medicare number, individual reference number, name and date of birth with their current details. Correct mismatches before verifying again.
Item not payable for this provider
Review the MBS item and the practitioner's eligibility to claim it. Check the provider number for the service location. Do not substitute another provider merely to make an ineligible service payable.
Associated service not claimed (reason 550)
Services Australia paid no benefit because the item depends on another service that wasn't on the claim. This reason appears per service in the processing report.
- Check the item's descriptor in MBS Online for a required associated service.
- If you provided the associated service, add it and claim again. If you chose the wrong item, choose the item that matches what you provided.
- If you believe the item is payable on its own, query the assessment with Services Australia and quote the claim reference and reason code.
Service date problems
Medicare pays only for services already provided. Check that the session is completed and its date isn't in the future. If the date looks wrong, check the appointment time against your practice's time zone, correct it and claim again.
Referral or treatment plan missing or expired
Review the referral required by the MBS item and correct missing or inaccurate referral details before resubmitting. Ask the client for an updated referral when the existing referral does not cover the service.
Session limit reached
Review the client's session usage and the requirements of the claimed item. A new referral does not automatically reset an annual scheme limit.
Duplicate claim
Search Finance > Claims for the client, invoice or claim reference before submitting again. Check the original claim's result to avoid claiming the same service twice.
PRODA connection and authentication
First check Settings > Medicare > PRODA & claiming > How claims are sent. Your next step depends on that choice:
- Praxi's PRODA: Praxi manages the connection. Read the setup status and contact Praxi Support if the connection remains blocked; you do not manage Praxi's device in your own PRODA account.
- Your own PRODA: check your organisation and device connection in Settings. Use Use your own PRODA to check activation and renewal. If you need help with a locked device, contact Services Australia using the contact details shown in PRODA.
- Tyro: check your Tyro Health connection and provider approval. Follow Tyro setup.
Ask for help
Keep the claim reference, code and returned message available when you contact support. Avoid submitting the same claim repeatedly while the result is unclear.