April 24, 2014

CLAIM NUMBERING – Each activity created within the 5CPA Registration and Claiming Portal is allocated a unique system generated number. This includes registrations, claims, payments, updating details and activities that are duplicated or submitted in error or as a test. While these numbers may appear to be sequential, it is important to note that the claim number is not an indicator of position in a claim processing queue.  Due to the transition period between the claiming systems there is a backlog of claims. All valid claims are being assessed and processed for payment (if approved). Payments for services have commenced, multiple payment runs have been made recently and will continue to clear the backlog as quickly as possible.

REGISTRATION STATUS – If your registration is not complete (does not have an active status) any claims submitted cannot be processed for payments.  For information on what each status means please refer to the news item Using the 5CPA Portal – Status definitions.

SUBMITTING CLAIMS WITHIN 30 DAYS – HMR, MedsCheck and RMMR claims are not considered valid if they have a status of Submitted, Pending Documents. Therefore the claim submission date is the date the completed claim template is uploaded and submitted.   Only valid claims can be assessed and processed for payment (if approved).

SUBMITTING MULTIPLE CLAIMS IN A MONTH – There is no limit on the number of claims you can submit per month for HMR, MedsCheck, RMMR, and/or QUM. All claims must be eligible as per the relevant Programme Specific Guidelines.

HMR SERVICES CONDUCTED IN JAN/FEB 2014 – Claims for HMRs conducted in January or February that were not submitted to DHS (Medicare) or have been returned to you by the Department of Health as they were not received by DHS by 14 February need to be submitted via the 5CPA Registration and Claiming Portal. The timeframe for submitting claims for HMRs conducted in January or February has been extended to 30 April 2014.