Reading the Medicare processing and payment reports
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 how the workflow operates so your practice can prepare; we will update it when certification completes.
Once you've submitted a Medicare claim, two reports show you what Services Australia (SA) is doing with it. The Processing Report tracks claims that SA has assessed but not yet paid. The Payment Report tracks claims that have been paid out, grouped by SA's remittance date so it lines up with your bank statement. Together they're how you reconcile your Medicare income each day, week, or month.
This page is a column-by-column reference. It covers what each field means, the common discrepancies you might see between the reports and your bank, and the right place to start when something doesn't reconcile.
Where to find them
Open Medicare reports in Praxi at /finance/medicare-reports.
Choose Processing report or Payment report:
- Processing Report —
/finance/medicare-reports/processing - Payment Report —
/finance/medicare-reports/payment
The reports are populated by background polling jobs that fetch data from SA every 15 minutes. The timestamp at the top of each report shows the last successful refresh. If the timestamp is more than 30 minutes old, Praxi's monitoring alerts our team — open a support ticket if it persists for longer than that.
Processing report (BPRW)
The Processing Report sits one step earlier in the claim lifecycle than the Payment Report. It shows claims that SA has assessed but not yet paid out. This is where rejections, pendable states, and pending-review claims surface first.
Columns
The report uses a two-level layout. Each top-level row is a batch of assessed claims; expand it to see the individual claims within.
Top-level row:
| Column | What it shows |
|---|---|
| Assessed date | The date SA assessed the batch. |
| Claims | Number of claims in this batch. |
| Outcome | Aggregate status (e.g. ASSESSED, REJECTED, MIXED). |
| Expected benefit | Total benefit SA approved for the batch. |
Expanded (per-claim) row:
| Column | What it shows |
|---|---|
| Reference | Praxi-side reference linking back to the invoice. |
| Client | The client's name. |
| Status | SA assessment status (ASSESSED, REJECTED, PENDABLE, PENDED). |
| Item | The MBS item number claimed (e.g. 80100, 91167). |
| Service date | The date the service was rendered. |
| Claimed | What you charged on the invoice (dollar amount). |
| Benefit | What SA approved (zero if rejected, lower than charge if a gap applies). |
Status meanings
The status column maps directly to the lifecycle described in Understanding Claim Statuses. The most common patterns you'll see in the Processing Report:
- All ASSESSED, awaiting payment — claims are working through to payment. No action needed; they'll move to the Payment Report within 2–3 business days.
- Mixed ASSESSED and REJECTED — start with the rejections. Sort by status, click each REJECTED row to see SA's verbatim reason, then fix and resubmit.
- Many PENDABLE — only possible on PCIW (patient claim) submissions. These need confirmation within 1 hour of submission, so act fast. The pendable countdown shows on the claim detail.
- Stuck SUBMITTED for more than 24 hours — escalate via support. Most likely a PRODA auth drift or an SA upstream incident.
Filtering
Use the date-range picker in the toolbar to filter the report (defaults to the last 90 days). To narrow by practitioner, status, or item, export to CSV and filter in your spreadsheet application.
Payment report (BPYW)
The Payment Report is where you reconcile against your bank statement. It groups claims by SA's remittance date — the date SA actually wired the funds — so each row maps to a deposit on your bank account.
Columns
The Payment Report also uses a two-level layout, grouped by SA payment date.
Top-level row:
| Column | What it shows |
|---|---|
| Paid date | The date SA processed the remittance. Drives the order of the report. |
| Claims | Number of claims in this payment batch. |
| Total benefit | Total amount SA paid for the batch. |
Expanded (per-claim) row:
| Column | What it shows |
|---|---|
| Reference | Praxi-side reference linking back to the invoice. |
| Client | Client name. |
| Type | Claim type (BBSW / PCIW). |
| Item | The MBS item paid. |
| Service date | The date the service was rendered. |
| Benefit | What SA actually paid (in dollars). |
Expand a row to see the underlying claims that made up the day's remittance.
Reconciliation flow
The standard daily/weekly/monthly flow:
- Open the Payment Report.
- Filter by the date range you're reconciling (e.g. last week, or this month).
- Each row is one day's SA remittance.
- Expand a row to see the per-claim breakdown.
- Compare the day's total against the corresponding deposit on your practice bank statement.
DVA reports — same shape, different endpoint
DVA payments use the same workflow but a different data source:
- DVA Payment Report (DVYW) —
/billing/dva-reports/payment
The columns, statuses, and reconciliation workflow are identical. The only visible difference is that DVA payments always go to the practice bank account (DVA pays the provider directly, never the veteran), so the Bank account column always shows the practice account for DVA rows.
DVA reports are filtered separately from Medicare reports — if you bill both, you'll see two sets of figures. Some practices reconcile them together by exporting both to CSV and combining in a spreadsheet; others treat them as separate income streams.
For the DVA-specific claiming rules (Gold vs White Card, accepted disabilities, referral requirements), see DVA Claims.
Common discrepancies and what to do
Processing report shows REJECTED with no error code
The error code column should always populate on a REJECTED row. If it's blank:
- Refresh the report (toolbar → Refresh, or wait for the next 15-minute poll).
- If still blank after the next poll, click the row to open the claim detail. The full returned response is in the History panel, including the verbatim returned messages.
- If the SA response itself doesn't include a code, the assessment is partial. Contact support and reference the claim ID.
Payment report total doesn't match my bank deposit
Most common causes, in order of frequency:
- Chargebacks or reversals. If SA reversed a previously paid claim on the same remittance day, the report shows the gross outflow but the bank only shows the net. Look for negative rows in the expanded view — they're the reversals.
- Currency rounding. SA pays exact cents; bank statements sometimes round to the dollar. Unlikely for individual claims but possible for batched remittances.
- Date mismatch. SA pays in batches overnight on weekdays. The "SA payment date" in Praxi is the date SA processed the remittance, which may be one business day before the date the deposit clears your bank. Reconcile by SA payment date, not bank deposit date.
- Multiple gateways. If your practice uses both MCOL and Tyro, the Payment Report shows both. Some accountants prefer to reconcile them separately — use the gateway filter.
Claim shows ASSESSED on processing report but missing from payment report
The claim has been assessed but SA hasn't run its payment cycle yet. SA pays in batches overnight on weekdays (typically Tuesday through Friday runs). Tuesday-morning ASSESSED claims usually appear on the Payment Report by Wednesday or Thursday.
If the claim has been ASSESSED for more than 5 business days without appearing on the Payment Report, escalate via support — there may be a SA-side hold (e.g. compliance review, audit, or banking issue) that needs investigation.
Patient says they were paid but Praxi shows still ASSESSED
This is most common with PCIW (patient claims). SA pays the patient's bank directly. The patient sees the deposit before Praxi sees the status update, because the patient's bank notifies them in real time but SA doesn't push the status change to Praxi until the next 15-minute poll.
Wait one poll cycle (15 minutes). If the status still shows ASSESSED after the next poll and the patient confirms the deposit cleared, raise a support ticket referencing the claim ID — the status will be updated on the next polling run.
Two claims for the same session show on the same payment report
Two possibilities:
- Bulk-bill incentive item. If you billed the bulk-bill incentive (10990 or 10991) alongside the service item, the incentive is a separate claim with its own payment. Both rows are expected and reconcile to the same total deposit.
- Genuine duplicate. If you accidentally submitted the same claim twice (e.g. once via MCOL, then once via Tyro), one of them is a duplicate. SA usually rejects the second submission as a duplicate claim; if it didn't, lodge a Medicare correction request and refund the duplicate payment to SA.
Failed-claim triage
REJECTED claims surface on the Processing Report. The full workflow is:
- Sort the Processing Report by Status → REJECTED.
- Click each REJECTED row to open the claim detail.
- The claim detail shows SA's verbatim returned reason text. SA requires this be displayed exactly as received, no truncation.
- Cross-reference the error code against Medicare Error Codes for the resolution step.
- Fix the underlying issue (e.g. correct the item number, capture a missing referral, fix the Medicare card number on the client profile).
- Resubmit. Praxi creates a fresh claim attempt — SA doesn't see it as a duplicate because the original claim is in REJECTED state, not ASSESSED.
The resubmitted claim returns to the Processing Report at the top of the list (newest first). Track its progress like any new submission.
Notification triggers
Praxi can send a notification each time the Processing Report or Payment Report changes state in ways that need your attention:
- Pendable claim — sent immediately when SA returns a PENDABLE status. The 1-hour confirmation window starts then.
- Claim rejected — sent when a previously-submitted claim moves to REJECTED on the Processing Report.
- Payment landed — daily summary of claims that moved to PAID overnight.
Configure these under Settings → Notifications → Billing. The default profile sends pendable alerts (high urgency) and rejection alerts (medium urgency); payment-landed is opt-in.
Cross-references
- Medicare Claiming — the canonical Payment Report section.
- Understanding Claim Statuses — what each status means.
- DVA Claims — DVA-specific rules.
- Medicare Error Codes — the full error code catalogue.
- Reconciliation — Praxi's broader reconciliation workflow across Medicare, DVA, and other funding sources.
- Per-claim Audit Trail — what's logged behind each row.
Verified against the current Praxi product surface and TECH.SIS.MEDICARE.03 V2.0.9 (BPRW / BPYW Reports), TECH.SIS.DVA.04 V1.0.04 (DVA Reports) on 2026-06-05.