What to do when paid and claimed values differ

Use this process when the fund has paid a different amount from what was claimed - either more (overpaid) or less (underpaid).

1. In the Batch Billing History window, click the Finalise button to open the Advanced Finalise Batch Billing window.
2. Confirm the correct Health Fund, Location, and MO are selected.
3. Click Receive New Payment.
4. In the Receive Payment window, confirm the Date of Payment (per the Remittance Advice Report) and Location.
5. Select the payment method - Cheque, EFTPOS, or Direct Deposit - enter the actual amount received, then click Save.
6. Optionally enter a Payment Memo.
7. Click Receive Payment to return to the Advanced Finalise Batch Billing window.
8. In the bottom half of the window, expand the batch: double-click the batch row or click the + on the left-hand side. All items within the batch become visible.
9. For each item paid in full, click the + button on the right-hand side of the item row to allocate the full claimed amount.
10. For each item where the amount paid differs from the amount claimed, double-click the item row or click the … button to open the Input Value window. Enter the actual amount paid for that item, then select the appropriate action.

• Overpaid: enter a reason for the overpayment (e.g. fee schedule change), then click OK.
• Underpaid - Medicare or DVA: choose to adjust the balance to zero or leave it outstanding for further action. Enter a reason (e.g. Multiple Service Rules), then click OK.
• Underpaid - health fund or other organisation: choose to adjust to zero, leave outstanding, or move the balance to the patient. Enter a reason (e.g. Out of Pocket/Gap Payment), then click OK.

11. Repeat step 10 for any other items where the paid and claimed amounts differ.
12. Click Save Allocations & Reload to save the payments recorded so far.
13. If an underpaid item will be resubmitted: un-tick the checkbox on the left-hand side of the item row, select Release for Rebatching, then click OK. The item can now be included in a new batch.
14. Click Save Allocations & Close.