This code is generated by Services Australia which indicates an error with Medicare or DVA systems. This error can be returned from:

According to Services Australia, 3004 errors are not uncommon. If this error is returned, it is likely this claim was submitted and a subsequent attempt may result in another error, such as '9632 Duplicate of service already paid.' If you experience multiple 3004 errors in a short period, contact Tyro Health Online support for investigation and escalation to Services Australia.

This claim was not processed automatically through Medicare Online. The claim will be manually reviewed and processed by Medicare and the patient/claimant will be informed of the outcome.

The patient/claimant should be informed of this outcome and provided the Medicare Lodgement Advice PDF. If they wish to check on the status, the patient/claimant can contact Medicare by phone on 132 011 and cite the Claim Reference listed on the Lodgement Advice.

If you believe the claim has an error, contact Medicare on 132 150, selection option 2 and cite the Claim Reference.

Alternatively, some Medicare Patient Claims can be canceled via Tyro Health Online on the same day of original submission until 9pm AET. To cancel a submitted patient claim, select the original claim, select Cancel, then select a Cancellation reason. You can then submit an updated version of the claim without it being flagged as a duplicate.

There are many reasons that can cause this error to be returned, including incorrect patient details (e.g. Medicare card number, D.O.B, address), incorrect claim details (e.g. provider number, service type, service date), incorrect referral details, or incorrect service category and associated claim type. Check if the rejected claim contained the correct information for the above.
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For referred items on a plan such as Chronic Disease Management or Focused Psychological Strategies/Mental Health Plan items, this response code could also indicate that the maximum number of sessions for the period has been claimed.
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If there was something incorrect, you may try re-submitting the claim with updated information. If everything appears correct on the rejected claim or you re-submit with changes and get the same error, issue the patient/claimant an invoice receipt to claim through an alternative Medicare claiming channel such as MyGov, the Express Plus Medicare app or by phone.

These response errors show the patient's Medicare card details are expired, and a new card has been issued.
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You can verify a patient or claimant’s Medicare account online through Tyro Health Online and if an update has been found, the new Medicare card number may be returned. In Tyro Health Online, either create a new claim or select the patient/claimant from the patient list. Click Verify Details. If an update has been found, those details will be presented and can be used to submit a new claim. Verify these details with your patient.
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You can edit their patient record to reflect these new details and submit this claim again.

If an update has not been found, issue the patient/claimant an invoice receipt to claim through an alternative Medicare claiming channel. For online via MyGov, the Express Plus Medicare app or by phone.

This claim is not able to be processed as a patient claim as the item code is only to be bulk billed.

You can submit this claim again as a bulk billed claim.

This error codes means this claim is for a patient who has attended their 2nd or subsequent consultation and the date of that consultation was after the referral has expired for that patient.

Note the referral starts from the date the specialist first attends the patient, not the date issued. By default, and unless otherwise noted, referrals are valid for:

If the referral has expired, contact the referring provider about a new referral.

You can see more details about referral periods here.

Medicare needs the patient to update their address recorded with Medicare before any claims can be processed successfully.
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You may be able to correct this immediately by providing a temporary update of address from Tyro Health Online. Select and Duplicate the existing claim, then under Claimant/Patient details, select Edit details, then Show Advanced Options. Update the address by entering a full and valid address, including any unit numbers. Note that P.O. boxes are not accepted.

If after submission the claim remains declined, the patient must update their address with Medicare via MyGov, the Express Plus Medicare app or by phone. Alternatively you can issue the patient an invoice for them to manually claim a benefit.
For more details you can see this Medicare guide.
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Once the patient updates their details with Medicare this claim can be submitted again.
If the payment is already taken you can follow these steps to submit the Medicare claim.

A referral or request is required for this claim.

If the referral details were not submitted for this claim you'll need to submit this claim again with the referral details added.

To see how to add referral details to a Medicare claim you can click here.

This error means there is a problem with referral details. This is most likely due to:

Check referral details and update as required. If the problem is not obvious, contact the referring provider to ensure the correct referral details were issued.

This error means the claim has been sent to Medicare multiple times and was rejected as the first claim was processed and paid.
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Check the patient, item and date of service. It’s possible that incorrect details were submitted. If you are unsure of the duplicate claim, log into Medicare HPOS and search for prior claims from all origination channels.

If the claim is not a duplicate but the patient, item and date of service are the same, you may need to resubmit the claim with appropriate override settings on the duplicate item(s). In Tyro Health Online, create a new claim or Duplicate the existing errored claim. Select the duplicate item and under Advanced options, select Duplicate service override and set to Not duplicate and provide a brief explanation in Service text. You may also need to set Time of service to a specific time for each item if multiple attendances were provided to the same patient on the same date. For select items, you can use the MBS Items Online Checker in Medicare HPOS to check eligibility of duplicate services before you lodge the claim.
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If this claim is a new claim, confirm you've added the correct details and submit the claim again.

If the claim continues to be rejected it's best to speak to Medicare on 1800 700 199.

Typically, this error is related to a MBS rule or referral issue, such as:

If in doubt it's best to speak to Medicare's eBusiness team about this claim on 1800 700 199.

This response code means the patient is a minor. The patient and/or claimant is a minor and requires an adult (18+ years old) claimant. In most cases, any Medicare Patient Claim with a patient under 15 years old as at the earliest service date will require an adult claimant.
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For a claim where the patient is a minor you'll need to enter their parent or guardian's details for them to receive the benefit. See how to enter these details to a Medicare claim here.
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This claim can be submitted again with the claimants details entered in the claim.

This error relates to a restrictive condition between the patient and Medicare.
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Typically, this error is related to a referral or MBS rule issue, such as:

Check referral details and update as required in a re-submission. For clarification, contact Medicare on 132 150, selection option 2 and cite the Claim Reference.

Alternatively you can issue the patient an invoice for them to manually claim a benefit.
You can download the Medicare statement at the bottom of a claim and send this to the patient. The patient can use these details to claim back their benefit either through Medicare online (accessed in myGov) or through the Express Plus Medicare app.

More details regarding the patient claiming directly with Medicare can be found here.

This claim may have item codes for post-operative care and treatment after an operation.
These item codes need to include details such as the aftercare period or GP attendances.
You can see how to include aftercare details in Tyro Health Online here.
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If this transaction is not related to normal aftercare you may be able to re-submit the payment request. To be 'not normal aftercare', the treatment would need to be an unrelated condition or complications arising from the operation

If the service is applicable as-is, resubmit the claim with the appropriate override code. Select the item(s) and under Advanced options, set Aftercare override to Not normal aftercare and provide a brief explanation in Service text.
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You can see how to override the aftercare details in Tyro Health Online here.

This code is generated by Services Australia which indicates an error with Medicare or DVA systems. This error can be returned from:

According to Services Australia, 3004 errors are not uncommon. If this error is returned, it is likely this claim was submitted and a subsequent attempt may result in another error, such as '9632 Duplicate of service already paid.' If you experience multiple 3004 errors in a short period, contact Tyro Health Online support for investigation and escalation to Services Australia.

This is an automatic rejection received from Medicare or DVA when a provider's provider number is not registered with Services Australia for online bulk billing or DVA claiming using Tyro Health Online. In general, it is caused by one of the following:

To resolve this, please call Medicare eBusiness on 1800 700 199 and ask them to link your Tyro Health Online Location ID/s with your provider numbers. Your Tyro Health Online location ID/s can be found in your Tyro Health Online portal by clicking "Locations" and selecting the relevant location (the ID is named "Medicare location ID"). This process is used for both Medicare and DVA claims.

Note that Medicare patient verifications and patient claims may work prior to Medicare activation and linking a provider number to a location but Bulk Bill and DVA claims will not work until fully activated and linked.

This is an automatic rejection from Medicare or DVA which indicates that the provider number is registered with Services Australia but the location is not linked with that provider number.

In general, it is caused by one of the following:

To resolve this, please call Medicare eBusiness on 1800 700 199 and ask them to link your Tyro Health Online Location ID/s with your provider numbers. Importantly, each provider number can only be linked with a single location ID. Your Tyro Health Online location ID/s can be found in your Tyro Health Online portal by clicking "Locations" and selecting the relevant location (the ID is named "Medicare location ID"). If Medicare indicates that the location ID has been linked and activated, contact Tyro Health Online support and request a review and update of the location ID in PRODA.
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Note that Medicare patient verifications and patient claims may work prior to Medicare activation and linking a provider number to a location but Bulk Bill and DVA claims will not work until fully activated and linked.

There is no benefit payable for the claimed service. For allied/specialist services, this could be related to a missing or expired referral.

For clarification, contact Medicare on 132 150, selection option 2 and cite the Claim Reference.

The service has age related restrictions and the submitted patient age is ineligible. For Optometry, different consultations codes may be applicable for those aged under 65 and those at or over 65.

Check the patient date of birth and ensure that the correct date was submitted in the claim.

This response code means the referral details weren't added to the claim.
You can submit this claim again and enter the referral details.
To see how to add referral details in Tyro Health Online you can click here.

The provider may not be eligible to claim this item based on the registered profession. Contact Medicare/DVA to clarify if the item can be claimed by the provider.

For clarification, contact Medicare on 132 150, selection option 2 and cite the Claim Reference.

For MBS rule clarification, contact Medicare on 132 150, selection option 3.

The service is usually only payable if claimed in conjunction with an associated service on the same claim. If the service is applicable as-is, you may need to set an appropriate override and explanation for the item.

Review the service claimed and determine if the associated service should also be claimed. You can use the MBS Items Online Checker in Medicare HPOS to check eligibility before you lodge the claim.

If the service is applicable as-is, resubmit the claim but set the appropriate override code. Select the item and under Advanced options, select appropriate override, Service duration or Time of Service and provide a brief explanation in Service text.

The item has exceeded claimable limits due to care plan allocations or claiming period. For example:

These limits apply in aggregate across all providers who may deliver services under those plans. Some claiming limits may also require a plan extension or review by the referring GP or specialist, whilst other plans may reset allocations by calendar year.

You can confirm the number of claimed and remaining sessions by calling Medicare provider support or by logging into Medicare HPOS, select View Patient Care Plan History then Find Patient Record, confirm patient consent to view the record. On the patient record, you should then see a patient's care plan, including date of creation if they have it, plan type and number of sessions remaining. This includes a range of plan types including:

We recommend speaking to your patient, and let them know they've exceeded their allocated Medicare sessions for this calendar year. This means any additional sessions this year won't be eligible for Medicare claiming. If the plan allocation has been exhausted, speak to your patient about options for claiming under private health insurance or direct private billing.

If the plan requires an extension or review by the referring GP or specialist, you may need to send a report and request an extension to that referring provider. The patient may also be asked to attend a review session with that referring provider.

This error means the claim has been sent to Medicare multiple times and was rejected as the first claim was processed and paid.
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Check the patient, item and date of service. It’s possible that incorrect details were submitted.

If you are unsure of the duplicate item and claim, log into Medicare HPOS and search for prior claims from all origination channels.

If the claim is not a duplicate but the patient, item and date of service are the same, you may need to resubmit the claim with appropriate override settings on the duplicate item(s). In Tyro Health Online, create a new claim or Duplicate the existing errored claim. Select the duplicate item and under Advanced options, select Duplicate service override and set to Not duplicate and provide a brief explanation in Service text. You may also need to set Time of service to a specific time for each item if multiple attendances were provided to the same patient on the same date.
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For select items, you can also use the MBS Items Online Checker in Medicare HPOS to check eligibility of duplicate services before you lodge the claim.

This is usually triggered where multiple eligible items are claimed, such as 2 skin biopsies or 2 x-rays but without required information supporting each service. If the service is eligible for a Medicare benefit such as biopsies taken at 2 different physical locations or x-rays of separate limbs and not for comparison purposes, then appropriate override codes may be required.

If the service is applicable as-is, you may need to resubmit the claim with the appropriate override code. Select the items and under Advanced options, select appropriate overrides, such as:

For MBS rule clarification, contact Medicare on 132 150, selection option 3.

For select items, you can use the MBS Items Online Checker in Medicare HPOS to check eligibility of multiple items.

The claim has not been approved or the benefit amount has been adjusted. The explanation will be provided separately to the provider and will not be included in the related claim processing report.

For clarification, contact Medicare on 132 150, selection option 2 and cite the Claim Reference.

This claim may have item codes for post-operative care and treatment after an operation.
These item codes need to include details such as the aftercare period or GP attendances.
You can see how to include aftercare details in Tyro Health Online here.
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If this transaction is not related to normal aftercare you may be able to re-submit the payment request. Resubmit the claim with the appropriate override code. Select the item(s) and under Advanced options, set Aftercare override to Not normal aftercare and provide a brief explanation in Service text.

To resubmit the payment request in these cases using Tyro Health Online, you will need to use the "Aftercare Override" indicator in the advanced Options.
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You can see how to override the aftercare details in Tyro Health Online here.

If an item code was submitted below the Medicare scheduled benefit Medicare will automatically adjust the benefit paid to the business to reflect the current benefit fee.
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For reconciliation purposes, you may want to review the charge amount in your practice management or accounting system to ensure that rates reflect the current benefit amount.
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Medicare have not paid this service. This can be due to the associated service not being included on this claim.
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Review the claim against MBS lodgement rules and ensure the associated service is included in the re-submission.

If the service is applicable as-is, you may need to resubmit the claim with the appropriate override code. Select the item and under Advanced options, select appropriate override, Service duration or Time of Service and provide a brief explanation in Service text.

Provider not registered to claim benefit at date of service.

Review the item service date and servicing provider. If the service was performed by the same provider at the submitted service date but at a different location, re-submit the claim under the provider number for the other location.

For clarification, contact Medicare on 132 150, selection option 2 and cite the Claim Reference.
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Provider cannot refer or request service at date of request.
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This could be caused by:

Contact the referring provider to ensure the correct referring provider number was listed and that any prerequisite items and services have been submitted.

This error is usually triggered when a bulk bill incentive applicable only for concession holders is claimed without valid concession patient details.

If the unreferred Medicare service and related bulk bill additional item are eligible for a Medicare benefit, make sure you lodge both items together in the same claim for the patient. Use the correct bulk bill incentive item that applies to the unreferred Medicare service.

Concession eligibility can be verified in Tyro Health Online prior to submission, under Patient details, set Concession holder to Yes, then Verify details.

Another service is required to claim this item.

Review the claim against MBS lodgement rules and ensure the associated service is included in the re-submission or was submitted in a prior claim.

For clarification on the errored claim, contact Medicare on 132 150, selection option 2 and cite the Claim Reference.

For MBS rule clarification, contact Medicare on 132 150, selection option 3.

If the service is applicable as-is, you may need to resubmit the claim with the appropriate override code. Select the item and under Advanced options, select appropriate override, Service duration or Time of Service and provide a brief explanation in Service text.

Bulk bill additional item claimed incorrectly

DVA requires the provider to state the condition treated. Typically, this is because the patient is a white card holder where only approved conditions are claimable.

You can re-submit the claim listing the condition treated. Duplicate the existing claim but in the patient details section, set Accepted disability indicator to Yes, then in the Condition treated field, list the condition.

The condition treated is not related to the one registered with DVA or under referred services. This typically is only applicable for white card holders for which only services directly related to registered Accepted Disabilities/Conditions can be claimed.
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Check with the patient on which conditions have been registered. Contact DVA on 1800 550 457 or the referring provider to clarify the patient’s Accepted Disability.

You can re-submit the claim listing the clarified condition treated. Duplicate the existing claim and in the patient details section, set Accepted disability indicator to Yes, then in the Condition treated field, list the condition.

The referral expired prior to delivery of a subsequent date of service. The referral starts from the date the specialist first attends the patient, not the date issued. By default, and unless otherwise noted, referrals are valid for:

If the referral has expired, contact the referring provider about a new referral.

This error often means the referral provider number was not registered with Medicare when this referral was issued.
It's best to speak with the referring doctor to confirm the provider number, or the correct provider number to use for this referral.
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You can then submit this claim again with the correct provider number for the referral.

The claim has been canceled by Medicare at provider request - usually through manual contact with the Medicare provider support team.
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If you believe this response is in error, contact Medicare on 132 150, selection option 2 and cite the Claim Reference.

This can be caused by:

Contact the referring provider to ensure the correct referring provider number was listed and that any prerequisite items and services have been submitted.

Review the service date and ensure the servicing provider number was active for the given location.
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Servicing provider number not open at date of service. The servicing provider number was not valid or enabled as at the date of service.

Review the item service date and servicing provider. If the service was performed by the same provider at the submitted service date but at a different location, re-submit the claim under the provider number for the other location.

For clarification, contact Medicare on 132 150, selection option 2 and cite the Claim Reference.

There was an overpayment for the service. This service benefit was payable under an associated/derived service claimed base fee.

For MBS rule clarification, contact Medicare on 132 150, selection option 3.