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RebateRight APIMedicare ClaimingIN Patient Claims

In-Patient Claim Report

Beta

How did Medicare and the health fund assess this in-patient claim?

That is the question this endpoint answers, for up to 1,000 claims in one submission. For every claim type except Patient Claim, the report gives the benefit for each service.

Test environment only. Services Australia is certifying this service, and it reaches production once certified.

Retrieve an in-patient claim’s report once Status Report gives its reportStatus as READY or REPORTED. Send the claim’s transaction ID, which is its correlationId without urn:uuid:.

Retrieval status

Each transaction ID gets its own entry in content, with one of these values in status:

ValueMeaning
SUCCESSThe claim’s report is in report.
REPORT_NOT_READYMedicare or the health fund is still assessing the claim. Check its status again later.
REPORT_NOT_FOUNDNo claim from this Minor ID has this transaction ID, or the claim was lodged more than 6 months ago.
INVALID_CONTENT_TYPEThe transaction ID belongs to another kind of record.

The report gives Medicare’s assessment of each service, then the health fund’s. A Medicare Only (MO) claim has no health fund assessment, and neither does a claim on which Medicare paid no benefit for any service. A Patient Claim (PC) report carries only the claim’s status, because the assessment goes to the patient.

In the Medicare Rejected example, Medicare rejected the claim because item 30195 is not in the current MBS.

Follow the claim to its outcome gives the steps from claim to payment, and how long you may retrieve a report.

A malformed request, such as one with a transaction ID that is not 24 characters, receives a 400. See the 400 response examples.

Authentication

x-api-keystring
API Key authentication via header
x-minor-idstring

Your Minor ID is 3 uppercase letters followed by 5 digits, such as MDE00000. Send the Minor ID exactly as issued. A malformed value returns 400 with the text The Minor ID is not valid. on every endpoint.

Headers

x-minor-idstringRequired

The Minor ID of the clinic you act for. Send the Minor ID that lodged the claims. See Keys, Minor ID and environments.

Request

This endpoint expects an object.
transactionIdlist of stringsRequired

The transaction IDs of the in-patient claims to retrieve, up to 1,000, each sent once. Send an array, even for one claim.

A transaction ID is the claim’s correlationId without urn:uuid:. It is 24 characters: the Minor ID that lodged the claim, then 16 letters or digits, as in MDE000005b864a2b5f7a4538.

Response

OK
contentlist of objects
One entry for each transaction ID you sent, in the same order.
correlationIdstring
The ID RebateRight generated for this request. Quote it in a support enquiry. It is not a claim's transaction ID.

Errors

400
Bad Request Error