The correct way to determine a referral expiry is by adding X months (typically 3 or 12) to the first service date where the referral is used (i.e. the specialist servicing provider initial consult). See details further below.

Historically Medilink has only had a field for the referring provider's letter date, so it's just used X months from that date. That was a fairly good approximate in most cases but not necessarily correct.

To tackle this problem a few years ago we did add a setting that would automatically try and calculate the first service date on the fly, but this had mixed results for practices (especially with multiple servicing providers).

However, now with the 2022 update we have a field for the first service and expiry in the referral itself. Typically you would simply leave these blank when you enter them, and the first service will be automatically set when you first bill a patient with that referral (or if you have prior billings for that referral it will use the first one of those). You can always override this manually if you need to by editing the referral.

There is a tool here to mass update first service dates for all referrals:

That all said, we cannot always guarantee referral expiry is correct and/or will work. This is because we don't inherently know what Medicare has at their end in terms of referral details and we cannot tell them to 'override' whatever they have in their system. So you will sometimes need to deal with that scenario. As a rule of thumb if the referral is older than 12 months from the letter date you should take some caution.

The most typical scenario we see a referral rejected for is because you may have had the wrong period when it was first submitted (i.e. it was originally billed with a standard referral of 3 / 12 months but then later you realize it was indefinite - but Medicare would already have calculated the referral expiry based on the original submission).

When you get a referral rejection that you believe should have been correct you should contact Medicare and enquire. They may ask that you email a scan of the referral letter so that they can update their details and then ask you to resubmit after this is done (i.e. Bulk Bill Revert Batch and then Rebatch & Forward, or for Patient Claims: Invoice Copies -> Submit Claim).