After submitting a Medicare patient claim, you may notice that some claims will sit in a "Pending" state and attached to the claim will be a 4 or 3 digit return code. These return codes will tell you more on what has happened to the claim or how is being assessed.
What to do
In most cases, the description of the return code will indicate why the claim was rejected and how to resubmit the claim so that it doesn't get rejected in future. For example, "9607 - This item is only claimable via Bulk Bill".
Some return codes may be unclear like "9641 - A restrictive condition exists" (shown above) and may be automatically resubmitted to Medicare for manual assessment. If the return code is unclear and you're unsure how to proceed, please contact us through the chat bubble on the bottom right of your Medipass portal. We can check for you and advise you accordingly.