Changes to claiming aftercare
Changes have been made to the application of the aftercare rule to Patient Claims Interactive (PCI) channel.
If you transmit a service where an aftercare period applies, you’ll receive a warning message of 9698 - Service is possible aftercare, check the account and resubmit with a valid indicator if not normal aftercare.
If the service is aftercare, you can’t claim a Medicare benefit. If the service is not aftercare, you must indicate this by setting the Aftercare Override Indicator in your software.
If you don’t know how to set this override indicator, please contact your software vendor.
If your software is unable to set the Aftercare Override Indicator, you may submit your claim using the Patient Claim Store and Forward (PCS) channel. You need to add ‘not normal aftercare’ in service text. Notations include:
- Not Normal Aftercare
Alternatively, you can now submit your patient claims online through Health Professional Online Services (HPOS) via Webclaims.
Read more about:
- the changes in the Aftercare or post-operative treatment education guide
- submitting patient claims via Webclaims
Read more Health professionals news.