NOTE: This metric is available to our Best Practice software integration customers.
Practice managers, receptionists and nurses can use this metric weekly to:
- Keep a close eye on outstanding rejections, which is crucial for successful debt recovery, providing essential insights into pending Medicare and DVA rejections that require prompt action.
- Monitor this metric as a practical tool to stay proactive in addressing outstanding rejections, ensure a more streamlined billing process and minimise potential financial and administrative challenges for the practice and its patients.
This metric can be found in Clinic Insights tab > Today's clinic metrics > Outstanding rejections
This figure shows the number of outstanding Medicare and DVA rejections that require follow-up. Click through see a detailed list of these invoices and services.
The sections included in this article are:
TOP TIP! Review this metric daily or weekly to ensure all of the Medicare and DVA rejections are followed up promptly.
Understanding the metric and key components
The Outstanding Rejection metric focuses on outstanding Medicare and DVA rejections at your practice that need to be actioned.
This metric shows you at a glance the outstanding rejections based on:
- Outstanding Medicare/DVA rejections: This figure shows the number of outstanding Medicare and DVA rejections that require follow up.
- Outstanding rejections by Practitioner: This graph represents the number of outstanding rejections by Practitioner by time since rejection.
- Outstanding rejections by Payer: This chart shows the number of outstanding Medicare and DVA rejections by Payer.
At the bottom of the page you will find the detailed list of outstanding Medicare and DVA rejections. These are all claims that the Practitioners have requested to bill directly to Medicare or DVA (i.e. bulk bill), have been sent to Medicare or DVA, have been rejected by Medicare or DVA and now require review
TOP TIP! To select a specific practitioner, simply click on their corresponding bar in the interactive graph, which will filter the results to display data to that particular practitioner.
TOP TIP! You can custom select columns and download the list by clicking the download button
on the top right-hand corner of the table to then use this list to review and resend the claims to Medicare or DVA (as needed).Using the metric in your practice
1. Monitor and action any outstanding rejections:
Focusing on the List of Outstanding Medicare and DVA rejections, you can customise your table to filter and prioritise the information presented. This functionality allows you to focus on specific metrics that are most relevant to your practice's needs.
- For instance, you can filter the table based on the length of time since the claims were batched, enabling you to identify which rejections have been pending for an extended period and may require immediate attention.
- Additionally, you can highlight any claims that need urgent action, ensuring that critical rejections are addressed promptly to enhance your practice's revenue.
2. Continuity of Care
You will also be able to filter via item number, allowing you to review outstanding rejections for specific services, such as care plans. This is particularly important because if a care plan item has not been approved by Medicare, patients will be unable to access any associated allied health visits.
You can quickly identify which care plans are pending approval and take necessary actions to address these rejections. By monitoring these outstanding claims, you can minimise delays in patient care and enhance your practice's revenue.
For additional information on Medicare and DVA rejections and rejection codes go to Services Australia.