Forward 9201 Error

Over the 14-15 June 2015 weekend Medicare changed their server logic and now when you submit/forward claims they are automatically rejecting names with punctuation in them (error code 9201).

(Update 19 June: This has been disabled by Medicare.)

(Update 29 August: This has been re-enabled by Medicare.)

This causes a problem for practices who in the past have put preferred names/nicknames in the firstname field surrounded by brackets or double quotes (there was a time when we didn't have a KNOWN AS field). Hyphens and apostrophes are ok though.

All versions of Medilink 2014 and older are potentially affected.

To fix you should:

  1. Go to the Medicare Online Control Centre
  2. Click the STORED button on the right to see which batches are waiting to be forwarded.
  3. Type in one of the batches in the UTILITY BATCH REPORTS.
  5. Review the batch statement, look for any names with punctuation in them.
  6. If you find one, open the patient up and fix their name, it should be the name on their Medicare card, (use KNOWN AS for nicknames etc).
  7. If you have changed any patient names in that batch you will have to unbatch (BATCH REVERSAL button), then re-batch (you shouldn't need to rebill).
  8. Repeat for each batch in the STORED FOLDER.
  9. Patient claims may also be affected, in that case you need to correct and rebill those.
  10. Once all finished, click FORWARD.
  11. We are working on a more permanent fix which will automatically strip these out before sending to Medicare - but that will be in a future update. (Update: this is available in version 2015 onwards.)

Until we have that fix you should check the names when billing and batching; remove punctuation where you find it.

Note, error 9201 is a pretty generic error. The above advice relates to this specific issue, but you might get 9201 for other things. Basically if you get 9201 errors but don't find any patient names with punctuation then something else must be wrong - if you can't find it please let us know.

Update 29 August 2015

Medicare have now re-enabled this logic. Anyone who is on a version of Medilink pre-2015, and who leaves punctuation in patient names, will have this 9201 error occur.

Update 19 June 2015

Here is Medicare's updated advice on the matter:

The Department of Human Services advises that due to feedback from the software vendor community we have decided to back out the change that has resulted in an increase in the 9201 return codes (patient validation names). As of 6.00pm, today (Friday, 19th June 2015) the system will be returned to the previous state until future notice.

We will provide time frames and more advice as soon as possible on when this change will be re deployed.

The department apologises for any inconvenience this may have caused.

Update 18 June 2015

Here is Medicare's advice on the matter:

The Australian Government Department of Human Services (the department) wishes to confirm that as a result of the Medicare Online June 2015 release, the following transmissions have had the validation rules updated:

Bulk Bill (DBS),

Patient Claims Interactive (PCI),

Patient Claim Store and Forward (PCS),

Same Day Delete (SDD).

For these claims, patient/claimant first names and surname fields have been updated. Characters accepted are alpha-numeric characters, apostrophes, hyphens and spaces, however spaces must not appear immediately before or after the apostrophes and hyphens.

Prior to this change, these claim types were being pended in our system for up to 14 days and then rejected. Now, following the change; name validation errors are detected at the first entry point of the claim allowing practices to review the input and correct the information for re-submission immediately, thus avoiding any delay in payments.

For example:

O'Toole - Valid

O' Toole - Invalid (one or more spaces after apostrophe)

O 'Toole - Invalid (one or more spaces before apostrophe)

Anne-Marie - Valid

Anne -Marie - Invalid (one or more spaces before hyphen)

Anne- Marie - Invalid (one or more spaces after hyphen)

Anne - Marie - Invalid (one or more spaces before and after hyphen)

Robert AKA Bob - Valid

Robert (Bob) - Invalid ( '(' and ')' are not one of the allowed characters)

If you have received a 9201 return code (invalid format for data item) please do not resubmit the transmission to the department until you have checked and updated names fields according to the rules listed above.

Please ensure that the name used in these fields matches the name displayed on the Medicare card. For example, where William is on the Medicare card however the preferred name is Bill, please transmit William.

The department apologises for any inconvenience this may have caused.