Australian Government - Department of Health - Office of Hearing Services
Hearing Services Program

Most Common e-Claim Rejections

This fact sheet is developed as a guide to assist Contracted Service Providers (providers) in solving some of the commonly observed e-Claiming errors identified by the Department of Health (the Department).

Key points

  • Before re-submitting your e-Claim, please delete the rejected claim from your system before entering the claim correctly. Failure to do so may result in further rejections of the same e-Claim.
  • If you are unsure about submitting a claim, refer to the claiming rules under the Schedule of Service Items, Schedule of Fees and the Conditions for claiming.
  • If a rejection code continues to appear, please email hearing@health.gov.au or call 1800 500 726 with details of error codes, client voucher details and screenshots (if possible) of the error messages.
  • For any technical assistance with e-Claims submitted on the Department of Human Services (DHS)/Medicare Health Professional Online Services, contact the e-Claim Help Desk on 08 8274 9370. Refer to the e-Claim handbook for more information.

Code

Reason and Meaning

Remedy

017

3FAHL missing

  • 3FAHLS have not been entered for this item.

Check that 3FAHLS have been entered correctly for the left and/or right ear.

3FAHLS entered must be between 1 to 120 dB.

024

Voucher number invalid or incomplete

  • The incorrect voucher details have been entered on the e-Claim.

Check the voucher number and voucher issue date are correct by accessing the client details on the Hearing Services Online Portal (the portal).

Please wait two working days from the issue date of the voucher before re-submitting the item.

046/ 047

Restrictive Item/Item has already been claimed

  • Records show that the service item has previously been claimed for the same client and cannot be claimed again against the current voucher.

Check if a claim or notes about a claim are on the client’s file from the previous provider.

Check the client’s claim history by accessing the client details on the portal. 

050

Duplicate item

  • Records show an identical claim item for the client has already been approved against the current voucher.

If it is an e-Claim, check whether the payment is already appearing on the statement/remittance advice from DHS.

If it is a manual claim, contact your Head Office for the remittance advice, which is emailed weekly.

060

Date of service < 12 months from initial fitting

  • Date of service entered is less than 12 months from the initial fitting date.

Check on the portal if the date of service is within 12 months of the date of fitting.

The date of service for the claim should be more than 12 months after the date of fitting.

061

Date of service < 12 months from previous maintenance

  • Date of services entered is less than 12 months from the previous maintenance claim.
  • Maintenance claim item 700 or 710 has already been claimed.

Please submit item 700 or 710 on or after the date of service of the previous item 700 or 710 or initial fitting item. 

If the client has relocated within this time to a new provider, claim either an item 711 or 722.

063

Client must be fitted with binaural aid

  • A binaural claim item has been submitted when the client is monaurally fitted.

Check on the portal the client fitting and claim history.

If client has only been monaurally fitted previously, refer to the Schedule of Service Items and the Schedule of Fees to determine the correct claim item and cost for a subsequent fitting to the unaided ear.

115

Previous reassessment/refitting item claimed using this voucher

  • This item has already been claimed by the client against this voucher.
  • Only one assessment and fitting per voucher can be claimed.

Check the client’s claim history on the portal before any fitting proceeds.

If the same provider has claimed an item 820 to one ear, the refitting of the other ear A recovery of the approved item 820 should be initiated before an item 830 is submitted in its place, using the “Manual Claims” tab.

A voucher cannot be issued to the client to facilitate claiming for services already provided.

122

No previous fitting recorded for this ear

  • The claim item submitted is not recognised by the DHS e-Claim system. DHS/Medicare holds no record of a hearing aid fitting to one or both ears.

Before submitting any fitting claims check the client file for a previous Assistive Listening Device (ALD) fitting or whether the client has bought aid/s privately.

If an ALD was previously fitted to the client, please submit a manual claim via the portal, using the “Manual Claims” tab.

311

Practitioner not employed by Contractor at date of service

  • The practitioner number entered on the e-Claim is not valid at the date of service.

Check the start and end date of the Practitioner against your Service Provider Number to ensure a valid practitioner number is entered on the claim form.

The start and end date are located on the Department’s confirmation email sent to the Practitioner when the Practitioner registers with the Contractor.

806

Item GST/Benefit is incorrect

  • The item amount entered on the e-Claim is incorrect.

Check the Schedule of Fees that the correct item benefit amount has been entered against the appropriate financial year.

Delete the rejected claim, enter the claim with the correct item amount and re-submit the e-Claim.


807

Device GST/Benefit is incorrect

  • The device amount entered on the e-Claim is incorrect.

Check the Schedule of Fees that the correct device benefit amount has been entered against the appropriate financial year. 

Delete the rejected claim, enter the claim with the correct item amount and re-submit the e-Claim.

Please note

Device Categories C1 and C2 devices attract a dispensing fee per aid (Behind the Ear) which must be added to the device benefit. 

Device Category C3 devices do not attract a dispensing fee.

816

Error on Claim form

  • One of the two items on the e-Claim has been submitted with incorrect information.

If one item is rejected on the claim form, all items will be rejected. Check whether all claim items are correct before re-submitting the e-Claim.

Delete the rejected claim, enter the claim with the correct item amount and re-submit the e-Claim.

997

Client is not eligible

  • The “No” box for the client certification question has either been selected or skipped on the e-Claim.

The client certification section on the e-Claim screen reads: “I am still eligible to receive full services under the Commonwealth Hearing Service Program”.

Check that ‘Yes’ has been ticked on the e-Claim screen to the above question.

 

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Most Common e-Claim Rejections (PDF 124 KB)

Claiming Rejection Codes

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