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Low Income Health Care Card (LIC) renewals 101-06040020

This document explains how customers complete their LIC renewal claims and how staff process LIC renewals. It also includes details on supporting documents, dates of event and qualification for the LIC renewal.

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Renewal claim lodgement

Renewal pre-claim processing

Processing online LIC renewal

Renewal claim lodgement

Table 1

Step	Action
1	LIC renewal The preferred method of renewing a LIC is online. If the customer is deemed unable or unsuitable to complete an online claim, staff should offer to complete an Assisted Customer Claim (ACC) with the customer. If a processing officer receives a LIC renewal work item, including a reassessment of a rejected LIC renewal, see Table 2 > Step 1. If the customer query is about: being unable to claim or renew LIC as their expired LIC is still displaying as current, see Table 4 in Processing Low Income Health Care Card (LIC) claims timeframes relating to completing the renewal, see Important dates and periods for assessing eligibility for LIC renewals help to complete their online renewal, go to Step 2 a replacement form, go to Step 3 lodging a LIC renewal form, go to Step 4 a rejected LIC renewal, see Request to reassess a rejected claim urgent processing, go to Step 5
2	Online Health Care Card Renewal An outstanding task will display on the customers homepage when they select Centrelink services from their myGov account. Services officers can assist the customer with their renewal task by using Customer Online View. This allows Service Officers to see what the customer can see when they are using their online account. Is the Health Care Card renewal Task displaying? Yes, advise the customer to: Select My Tasks Select Health Care Card Renewal Select Start Complete the relevant steps in Renewing your Low Income Health Care Card Once all required tasks have been completed, the customer can submit their claim Select Submit Go to step 5 No, complete an Assisted Customer Claim (ACC), go to step 5
3	Customer requests a replacement form Service Officers must promote online claiming or offer Assisted Customer Claim (ACC) first. Customers can request a replacement form if: their LIC is still current, or it is within 13 weeks of the previous card expiry date Service Officers can create and print a LIC renewal form (SS054M) manually and issue it personally in the service centre or post it to the customer’s address. Service Officers must check the following details are correct before manually printing the form: customer's name address Customer Reference Number (CRN) renewal period, see Resources for an example of determining the start date for the renewal period return address and date of issue Go to step 5.
4	Lodging a renewal form Customers can lodge a Renewing your Health Care Card (SS054) form: at a service centre via Upload Documents in their online account by post by fax offsite Manually issue a FA012 if the customer has lodged a paper SS054 and advised they: have a new dependent, and are not receiving an Income Support Payment (ISP) or Family Tax Benefit (FTB) Has the SS054 been received and the customer’s LIC is still current or within 13 weeks of the previous card's expiry date? Yes, see Claim lodgement of Centrelink claims, then go to Step 5 No, customer is outside of the LIC renewal period, tell the customer they must submit a new claim for LIC. Procedure ends here.
5	Urgent processing If the customer is requesting the renewal to be processed urgently or immediately, see Immediate new claim and non-new claim priority processing. Does the customer meet the criteria for immediate processing? Yes, see Table 2 > Step 1 No: tell the customer the renewal will be allocated to processing staff to complete procedure ends here

Renewal pre-claim processing

Table 2

Step	Action
1	Locate claim Locate the work item in Process Direct. Select the work item to go to the Customer and Claim Information table on the Transaction Summary (TS) screen to review and process the customer's claim. Paper claims When a Claim for a Health Care card renewal (SS054) is scanned to the customer’s record, a Social Application (SOA) shell work item is generated on the customer’s record. This has no claim information apart from: the Customer Reference Number CRN) personal details, and receipt date Manually add claim details into the work item using information from the scanned claim and documents. For guidance on accessing claims for processing and creating a SOA shell, see Process Direct navigation, common screens and functions.
2	Claim status The claim status must be In Process before it can be processed. If the renewal has been previously rejected, claims may be reassessed within 13 weeks of the rejection notice. See Request to reassess a rejected claim Is the renewal claim status In Process? Yes, go to Step 3 No, for claim status definitions and actions to take, see Process Direct navigation, common screens and functions. Go to Step 3
3	Review claim summary Select to view the Claim Summary: select to expand the Claim Summary in a new window if desired Key details include: relationship status Australian residence dependent children income details To view supporting documents, select one of the following: links at the bottom of the expanded Claim Summary from the bottom of the open Process Direct window, or the Documents icon When reviewing supporting documents check: all the documents have been received the date the document was scanned Note: documents that have been requested in the claim must not be requested again, the claim must be rejected.
4	Relationship details These details must be reviewed/updated before selecting Process. On the TS screen: Link Summary (LS) table shows linked records, for example Partner Children Marital Status (MS) table shows the customer's relationship details, including any Relationship Qualifier codes. For coding help, see Table 4 in Process Direct navigation, common screens and functions Compare relationship details provided in the claim with the details already recorded in the Marital Status (MS) table. If the customer has advised a change in relationship status and they are now: Separated or single: Ensure their personal information is kept safe. See Separating safely – protecting personal details If the customer has separated in the last 6 months, this is a family and domestic violence interaction point. See Family and domestic violence If the customer is current on a payment or benefit, the relationship will need to be assessed based on their current payment or benefit prior to assessing the LIC renewal. See Change in relationship status from partnered to single. Once completed, go to Step 5 Only claiming LIC, go to Step 5 Partnered. If the customer has lodged a: Paper claim signed by the partner, go to Step 5 Paper claim not signed by the partner, see Confirming a partnered relationship to assess the relationship. Once confirmed, go to Step 5 Online claim advising they are partnered, do not issue a MOD P or a Temporary Access Code (TAC). See Table 1 > Step 5 in Confirming a partnered relationship to assess the relationship. Once confirmed, go to Step 5 Note: a Member of a couple (MoC) assessment is not required for a customer and sharer/other person who are claiming or have a current Low Income Health Care Card (LIC) only. When any updates have been made to relationship details, the claim will need to be regenerated, select > Regenerate claim to regenerate the claim. Go to Step 5.
5	Eligibility for LIC Check if the customer has met the basic eligibility for LIC. Does the customer qualify for LIC? Yes, go to Step 6 No, reject the LIC claim. Procedure ends here
6	Identity Confirmation Customers are not required to prove their identity as part of a LIC renewal. Service Officers can check the status of the customers, and if relevant partner’s, identity status on the Transaction Summary (TS) screen. This will display either: confirmed identity, or they have established their identity via Alternative Identity provisions If the customers identity status is not confirmed and identity documents have been provided, Service Officers must code identity documents using the Identity Confirmation Dashboard. See Identity Confirmation LIC customer becomes partnered When a LIC customer becomes partnered and their partner has an identity status of not confirmed, they are required to provide identity documents for the customers LIC renewal. If the partner is: confirmed or has a no linkage identity status: identity requirements have been met for partner, no documents are required go to step 7 receiving an Income Support Pension (ISP), Department of Veterans Affairs (DVA), Low Income Health Care Card (LIC) or Commonwealth Seniors Health Care Card (CSHC): no documents are required Service Officers must apply an identity review on the partner's record. The review will auto complete when the linked claim is processed. For the process when the partner is an ISP, DVA, LIC or CSHC recipient, see Alternative Identity none of the above: the partner is required to establish their identity by providing 3 approved documents to achieve a no linkage identity status on the dashboard, Service Officers are required to select NP – No Linkage required, see Coding identity documents Do not update Proof of Identity (POI) screens
7	Documents Check the claim to make sure all required documents have been provided. Have all relevant documents been provided? Yes, go to step 9 No if: additional documents are required, go to step 8 documents have been requested at the time of claim, or after, and not returned, reject the claim. Procedure ends here
8	Request more documents or information If more details, clarification and/or submitted documents are needed to determine the customer’s eligibility, make genuine attempts to contact the customer. If contact was successful, record the details of the conversation in the Progress of claim note. Can the customer immediately upload the information or has verbally provided the required details: Yes, see Table 3 No: issue a request for any additional information by selecting > Request Documents do not re-request documents that have previously been requested at Next Step of the claim. This process is only relevant where more information or evidence is required to clarify the customer’s circumstances to assess the claim tell the customer the claim may be rejected if they do not provide the required evidence. the claim will be placed on hold to allow the customer to respond. Procedure ends here If the contact was unsuccessful or it is not appropriate for the customer to provide the information or evidence verbally: issue a request for information via > Request Documents Note: documents that have been requested at Next Step in the claim must not be requested again, the claim must be rejected record the details of the genuine attempts, including what information is needed in the Progress of Claim note Procedure ends here.
9	Further action required Are further actions required? Yes, a referral is: required, go to Step 10 still outstanding. Update the status with the relevant reason, hold the claim for a further 14 days and annotate the LIC Claim Progress Note. Procedure ends here No, there are no outstanding referrals and LIC renewal is ready to be processed, go to Table 3 > Step 1
10	Referral If a specialist assessment is required, select > Referral and complete the referral details. Note: if more than one referral is required, ensure that all referrals are completed. Complex Assessment Officer (CAO) referrals Unless it is clear the claim must be rejected due to not meeting basic eligibility criteria, claims needing a CAO referral should not be finalised until the assessment has been completed. If the customer’s financial circumstances are complex (for example, they include a trust or company), make a CAO referral to ensure the income and assets tests are met. Compensation Clearance request referrals See Coding Compensation and damages (MOD C) to request a clearance for referral instructions. Centrelink International Services Officer (CIS) referrals If necessary, check all foreign pension documents are scanned to the customer’s record as ‘INT’OG' ensuring that no work item is created (scan to store). Translation of foreign pension documents is not needed before referring to CIS. Referrals to CIS should not be made for a non-government payment or a payment made by a private organisation, as this is not a foreign pension. Assessment of Care Arrangement referral A completed FA012 form must be lodged as part of a LIC claim if: there is a change to care arrangements for an existing child, or a new child has entered the customer's care An Assessment of Care Arrangements referral must be created when a Details of your child’s care arrangements (FA012) form has been requested and returned as part of a LIC claim or renewal. If an Assessment of Care Arrangement FA012 form has been returned and a referral is required, see Table 2 in the Process Direct tab of Processing Low Income Health Care Claims. Once actioned go to Table 3 > Step 1 After a referral is made: the claim remains on hold until the assessment has been completed annotate the Progress of Claim Note with details of the request procedure ends here until referral is completed

Processing online LIC renewal

Table 3

Step	Action
1	Process the claim Before selecting Process, ensure all outstanding referrals have been completed. If not, place the claim back on Hold for a further 14 days and annotate the LIC Claim Progress Note. If the relationship details are updated after processing has been started, the claim will need to be regenerated by selecting > Regenerate claim. Do not start coding before selecting Process as this will result in errors. Select Process at bottom right of the claim to start coding and assess the claim. The Errors (SWE) screen will display. Before coding any screens: select Assess to send the claim details to ISIS. The Entitlement (ELD) screen will display return to the SWE screen to complete the claim coding by selecting Back or keying SWE in Super Key Message Log This section displays any errors with existing coding. These must be fixed before the claim can be assessed. For help, see Using Digital Assistant Roxy in Process Direct. Task Selectors These list common screens. Task selectors that have mandatory screens are pre-selected. Task selectors may not list all screens that must be checked or coded. Check screens to compare historical details with the claim details: a flag will display against all screens that have provisional claim data. These may not need to be accessed to process the claim select the screens to be checked or updated. There is an option to select all screens select Next or press [Enter] to go through the selected screens use Super Key to go to screens. Key 'screens' to view a full list Go to Step 2.
2	Assess and code the LIC claim Check information provided in the claim (provisional data) is accurate and in line with any evidence provided. See Income and financial investments for coding instructions. See the Resources page for help in determining the right Date of Event. Select all relevant Task Selectors and select Next: key/update required information for each relevant screen check information provided in the claim (provisional data) is accurate and in line with any evidence that has been provided. Update where necessary check nominee information has not been incorrectly ended, for example Public Trust nominees, see Adding or rejecting a nominee request check there is no historical coding of continuous income that needs to be ended, see Recording and correcting employment income details Review any DOCs/Notes to determine the assessment for child/ren in the LIC renewal. This includes information such as the child’s name, date of birth (DOB) and care percentage details.
3	Dependent children coding Has the customer advised they have new dependent enter their care in the previous 8 weeks, and a completed Care Assessment has been done? Yes, go to Step 4 No, go to Step 8
4	Care assessment finalised Review all related DOCs/Notes to determine the assessment for child/ren in the LIC renewal. This includes information such as the child’s name, date of birth (DOB) and care percentage details. If the assessment outcome is: a change to or confirmation of care arrangements for a child already in care or no change to existing care arrangements: select to complete a SAP refresh go to Step 7 a new child has entered the customer’s care, go to Step 5 the child is not in the customer’s care, go to Step 6
5	New child in customer’s care If a new child is in the customer’s care: Select > Regenerate Claim when the claim has been regenerated, the child should be listed under the Known Relationships select > Child check the Child in Care (CHC) screen has been coded go to Step 7
6	Child is not in customer’s care If the child is not in the customer’s care: select > Regenerate Claim go to Known Relationships check if the child showing under the Claim Relationships table, change the status to ‘Not Required’ go to step 8
7	Update information on the Child Override/Claim (CHOC) screen The CHOC screen must be recorded for each dependent child individually. Go to the CHOC screen via the Super Key: if the dependent child/ren do not display Service Reason LIC, select Add update Start Date to Date of Birth of Child Child Name, select each relevant child separately Service Reason, Low Income Health Care Card Reason, Claim select Save Go to Step 8
8	Finalise the claim After coding the claim and addressing the data validations: select Assess the Errors (SWE) screen will list any validation errors to address once the Message Log is clear, select Assess the ELD Entitlement screen displays the outcome. Ensure the outcome is correct for the customer (and partner if applicable) select Finish review the Claim Outcome DOC and ensure the Getting it Right (GIR) Minimum Standards are met select Finalise select Finish. A box will confirm the claim has been successfully completed Procedure ends here.