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RebateRight APIMedicare ClaimingInteractive Patient Claims

Interactive Patient Claim — General

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How do I lodge a Medicare patient claim for general services?

Through this endpoint: an interactive claim for professional services that need no referral or request, with Medicare’s outcome in the response.

The general interactive patient claim endpoint submits a Medicare patient claim for professional services that do not require a referral or request. The claimant authorises the submission and receives the Medicare benefit; the patient received the service. They may be the same person.

Response handling

Every 200 response carries a status indicating the claim outcome — MEDICARE_ASSESSED, MEDICARE_PENDABLE, MEDICARE_PENDED, or MEDICARE_REJECTED. Per-service outcomes are reported via assessmentCode on each medicalEvent[].service[]. See the response schema for the full handling tables.

Error codes

Medicare reason codes appear on three fields: claim-level claimAssessment.error.code, per-service claimAssessment.medicalEvent[].service[].error.code, and serviceMessage[].code on 400 responses. Map all of them to user-facing descriptions via the Services Australia reason-code lookup.

Authentication

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

Your Minor ID is three uppercase letters followed by five digits, such as MDE00001. Send the Minor ID exactly as issued. A malformed value gets a 400 with “The Minor ID is not valid.” on every endpoint.

Request

This endpoint expects an object.
patientClaimInteractiveobjectRequired
correlationIdstringOptional

Optional. Supply a unique transaction ID in the format urn:uuid:{MinorId}{16 hex chars}. If omitted, RebateRight generates one automatically.

Response

Claim submitted successfully.
statusenum

Overall claim outcome. The value drives response handling on your side:

StatusMeaningTypical handling
MEDICARE_ASSESSEDClaim assessed by Medicare. One or more services have a benefitPaid and an assessmentCode of ASSESSED.Treat as paid; payment is in progress to the claimant.
MEDICARE_PENDABLEClaim held by your software; Medicare has not yet received it for assessment. Typically triggered by a service returning ACCEPTABLE_ERROR (e.g. possible duplicate).Surface the reason to the claimant. Within 60 minutes, resubmit with the same correlationId to either (a) send it to a Medicare operator for manual assessment (→ MEDICARE_PENDED), or (b) auto-resolve it by adding the appropriate override indicator or service text (→ may go to MEDICARE_ASSESSED).
MEDICARE_PENDEDClaim accepted by Medicare and queued for manual operator assessment. No assessmentCode or benefitPaid will follow via the API.Record the claimId for reconciliation and issue the claimant a printed Lodgement Advice (legislatively required). Medicare notifies the claimant directly of the outcome — no downstream API notification is sent.
MEDICARE_REJECTEDClaim rejected outright. Check claimAssessment.error (claim-level) or per-service error for the reason.Do not resubmit without correcting the underlying issue.
Allowed values:
correlationIdstring

Echo of the request correlationId (or the one generated by RebateRight when the request omitted it).

claimAssessmentobject
Medicare's assessment of the submitted claim.

Errors

400
Bad Request Error