We use cookies to provide and improve our services, website, and customer support.
For more information on how we use cookies, please check out our Cookie Policy.

Decline Cookies
Accept Cookies
Manage Cookies

Integrations and Add-ons

Connect and automate your business with other tools and features.

Submitting Medicare Pendable Claims

Julee Written by Julee
... on a stunning September day.


When a Medicare Claim returns a Pendable status, it indicates that one or more items on the Claim need to be assessed by a human operator.

The User has a 60-minute time frame to decide to process the Medicare Pendable Claim as-is or amend it.

Rules for Claims returning Pendable status:

1. If you wish to proceed, submit the Claim to move forward to be assessed by a human operator.  The claim will move to a Pended status.

2. If you do not wish to proceed, cancel the Claim.  The claim will move to a Cancelled status.

3. If no action is taken in 60 minutes, the Claim will move to an Expired status.

Actioning a Pendable Claim

1. After Submitting a Medicare claim, if the claim returns a Pendable status, an alert will appear for a short time on the bottom left of the submitting User’s Nookal page.

Clicking on the alert will take the User to the Pendable Claim as it appears on the invoice.

2. A Notification in the Message Centre will also appear to indicate a Pendable Claim is awaiting further action. Expanding this Notification will allow the User to navigate to the Pendable Claim as it appears on the invoice.

3. The Pendable status will appear highlighted in orange.

4. After reviewing the correct details, move to the right of the Claim and click Submit.

5. This will move the Claim to a Pended status, which means a human operator will assess it at Medicare.

A human operator assesses Pendable to Pended Claims, and there will be no further processing or payment reporting available from Medicare.  Medicare will not inform anyone except the Patient/Claimant about what happens from there.

Cancelling a Pendable Claim

1. After Submitting a Medicare claim, if the Claim returns a Pendable status, an alert will appear for a short time on the bottom left of the submitting User’s Nookal page.

Clicking on the alert will take the User to the Pendable Claim as it appears on the invoice.

2. A Notification in the Message Centre will also appear to indicate a Pendable Claim is awaiting further action. Expanding this Notification will allow the User to navigate to the Pendable Claim as it appears on the invoice.

3. The Pendable status will appear highlighted in orange.

4. Navigate to the right of the Claim and click Cancel.

5. Complete the confirmation phrase (the phrase may appear differently than below) and then click Delete.

6. This will move the Claim to a Cancelled status.  The Claim will always remain in this status unless you choose to resubmit the Claim, meaning the process needs to begin all over again.

Pendable Claims can also be Reviewed, Submitted and Cancelled via the Medicare Report.

Expired Pendable Claims

1. If no action is taken in 60 minutes, the Pendable Claim will move to an Expired status.   The timer begins when Medicare returns the initial Claim to a Pendable status.

A Notification will appear in the Message Centre to indicate the Pendable Claim has expired.

Expired Claims can be resubmitted through the invoice following these instructions and returning to the steps outlined above if the Claim status appears as Pendable again.

Help Centre

How can we help?