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Resetting Medicare Claims

Sam Written by Sam
... on a joyful July day.

📖 In This Article

Resetting an Online Claim via the Client’s Claiming Screen
Resetting Claims from the Online Claiming Report:

If Medicare or DVA claims have been stuck in “Pending” status for longer than usual, reset the claims and resubmit them. See below for step by step instructions on this.

The rules for resetting claims:

  • For Medicare, claims must be Pending for more than 72hrs before resetting
  • For DVA, claims must be Pending for more than 7 days before resetting

If the claim has not been pending for the aforementioned times, the Reset button will not display. 

Doublecheck your Medicare or DVA claims to ensure that the data you’re submitting e.g. Provider name and number, referral date, reference number, etc.. is correct before resubmitting the claim. This will minimise the risk of the claim being rejected.

Check the Online Claiming report via Reports > Administration > Online Claiming to track and reset “Pending” claims.

Resetting an Online Claim via the Client’s Claiming Screen

1. Once you’re in the Client’s Accounts page, click on the invoice to open it then click Online Claims. 

2. This action will take you to the Online Claiming screen. Next, click on the Claims tab. 

3. Once on this screen, click on the Reset button.

4. Confirm the decision and your invoice will be unlocked.

Resetting Claims from the Online Claiming Report:

1. Go to Reports.  

2. Click on Administration, then Online Claiming.

3. When generating the report, ensure that you select claims with a Pending status.

4.  Click the Reset button and confirm the decision.

5. The report will re-generate after this action, which will update your view to reflect your action of resetting the claim. Repeat this process for all claims that need to be reset. 

If you have a Medicare claim that has been Pending for over 72 hours or a DVA claim that has been pending for over 7 days and there is no Reset button available, please contact support@nookal.com with the Invoice Number.

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