Add child claim for Child Care Subsidy (CCS) 007-17103127

CCS activities are allocated to via Work Optimiser.

• Open the work item in Process Direct
• Go to the Transaction Summary (TS) screen
• Select to open Claim Overview information

The activity will contain:

• only information about the child to be added, and
• the customers declaration

The claim does not include:

• income estimate
• activity test details

The activity will include the keyword ADDCH.

Is the activity an Add child to CCS claim?

• Yes, see Table 2, Step 1
• No, the claim is identified as a full claim for CCS, see Processing Child Care Subsidy (CCS) claims

Before submitting a shortened claim, all required documents must be uploaded.

The only evidence that may be requested is a:

• Commonwealth statutory declaration:
• explaining why the child cannot be left
• confirming there is no suitable adult over the age of 18, (this includes all other support networks, not just the parent/s or carers) is available to supervise the child
• National Disability Insurance Scheme (NDIS) participant number, or
• Evidence to support children with permanent or non-permanent conditions or undergoing assessment (non-NDIS participant). The child has, or is undergoing an assessment for, one or more conditions:
• listed in Schedule 1 of the Minister’s Rules, as diagnosed by a medical practitioner
• listed in Schedule 2 of the Minister’s Rules, as diagnosed by a psychologist
• referred to in Part 2 of Schedule 3 to the Disability Care Load Assessment (Child) Determination 2010 by a medical practitioner

Check for any scanned documents lodged to support the CCS claim. To do this, select any of the following:

• the relevant document icons at the bottom of the expanded Claim Summary
• from the bottom of the open Process Direct window
• the Documents icon

Service centre staff

If the customer is lodging evidence for a submitted claim:

• Scan the document onto the customer’s record
• Access the customer’s record in Process Direct
• Select Transactions
• Select the Claim ID hyperlink. The Transaction Summary (TS) screen displays
• Select Tasks
• Update the status of documents required to Accepted
• Select Save
• Select the Status icon. If all required documents have been provided and the Claim Status is On hold, change Status to In Process. Select Save
  Note: if the Service Officer changes the claim status, the work item will be assigned to them. Return the claim to the pool if not trained to process the claim.
• Go to the work items list
• Select
• Check the box for the relevant work item
• Select Unassign to return the claim to the pool
• Check the Tasks status within the claim if the customer:
• gets advice that documents are missing, and
• states they have already been sent
• If the document is still showing as Required, select Documents icon to view documents:
• scanned at a service centre, or
• uploaded by the customer
• If the documents have been lodged, update the status to Accepted as above
• If not displaying via Documents, request the customer upload the documents again

Take a verbal claim using Assisted Customer Claim (ACC) if a customer:

• contacts to add a child to their CCS, and
• is unable to lodge using the digital channels

If an open FAO DOC with notes Plse action CCS claim in PD is allocated, complete the DOC in Customer First. Any relevant keywords will be added directly to the claim.

Locate work item in Process Direct.

Assign the claim to self via the Assign to me button in Work Optimiser.

Select the work item to go to the TS screen.

When a claim is submitted online or via the Assisted Customer Claim (ACC), a CCS new claim work item is generated on the customer’s record. The work item contains all the claim information provided by the customer online or entered into the ACC.

Note: check if the customer has submitted more than one CCS claim:

• Go to the TS screen
• Select Transactions icon

If more than one claim is made, process them in the order they were submitted. This ensures the latest data is applied. Each claim triggers a notice to the customer if there is a change to eligibility or entitlement. A notice is not issued if there is no change between claims.

Select the work item to go to the Customer and Activity Information table on the Transaction Summary (TS) screen.

The icons at the top of the screen display the customer's information currently held on the record in detail.

Review the information provided by the customer.

Select and to view the Claim Summary in a new window. If it is blank, use [F5] to refresh the page. If the claim remains blank, check the Keywords icon:

• Refer to Processing Child Care Subsidy (CCS) claims if these keywords are present:
• MANSOA, this indicates a manual Social Online Application (SOA) has been indexed
• FA084, this indicates a paper claim has been lodged
• If the keyword ADDCH is present, go to Step 4

Select the Notes icon or go to the Document List (DL) screen. Thoroughly review the customer’s record and review relevant documents, such as:

• Display on Access (DOA) DOCs
• previous claim DOCs or Notes
• requests for information issued
• notes that may help in assessing the claim
• outcomes of previous claims lodged

For more details about progress DOC/Notes and details of information to be recorded, see Families and Child Care (FCC) processing principles.

Has the customer indicated they want to withdraw their CCS claim?

• Yes, go to Step 11
• No, go to Step 5

Customers must advise when their child starts attending primary school. They may be prompted to advise the future school start date for children when claiming CCS.

To be eligible for CCS, a child must be aged 13 years or under, and not attending secondary school, or have an exemption.

Review child school status within the claim and information held on the customer’s record to determine child school status:

• select then select the relevant child(ren)
• go to the Child Education Details (CED) screen

Note: existing information may not be previously recorded on the CED screen. Use the information provided within the claim.

Are all children claimed for aged 13 years or under and are not attending secondary school?

• Yes, see Table 3, Step 1
• No, go to Step 6

Customers can request an exemption to the school status or age and school status rule if the child cannot be left unsupervised and there is no suitable adult over the age of 18 available to care for them. The child must also be either:

• 13 years or under attending secondary school
• 14-18 years with a disability attending secondary school (16, 17 or 18 years only approved in exceptional circumstances)

Review evidence requirements for the relevant exemption request, see Updating school status, and assessing age exemptions for CCS.

Has the customer requested a school status or age and school status exemption?

• Yes, and:
• evidence requirements have not been met, go to Step 7
• evidence requirements are sufficient, a referral must be sent to Level 2 Policy Helpdesk. See Updating school status, and assessing age exemptions for CCS. Procedure ends here
• the Level 2 Policy Help Desk has provided an outcome on the exemption, go to Step 7
• No, go to Step 7

If more information is required to assess the claim, request documents from the customer. For example, evidence to support an age/school status exemption. See Requesting information (CLK).

The claim is Not Effective if:

• a CCS claim has come off hold after a request for information has already been sent, and
• the required documents have not been provided

Is the claim Not Effective?

• Yes, go to Step 10
• No, go to Step 8

Can the claim be processed without further documentation/evidence?

• Yes, see Table 3, Step 1
• No, go to Step 9

Requests for information that require documentation must be by written notice. If the matter is urgent, call the customer and also send a written request.

Before calling, use Desktop Electronic Messaging Capability (DEMC) to tell the customer they will be receiving a phone call.

To request documents, issue a Q888 - Request for information - CCS and Additional CCS letter

• Put the claim on hold for 22 days (14 days plus 8 days postage)
• If the claim was originally allocated via an open FAO Note/DOC with notes Plse action CCS claim in PD, and shared/hierarchy handoff is not required:
• Ensure the Note/DOC is completed
• On the TS screen select Keyword
• Select Add, and search for and select OPSPLAN84. The keyword will now appear in the claim
• Annotate the existing CCS Progress Note/DOC advising the additional keyword has been added and claim was placed back on hold, awaiting further information

Procedure ends here.

Where other requested documents have not been returned within the correct timeframe, make the claim Not Effective:

• Select the Status icon
• Select Edit
• Change Status to Not Effective

For standalone claims, check the Activity List (AL) screen in Customer First for an open FAO DOC with notes Plse action CCS claim in PD. Cancel this off the AL screen if this is still open.

Where the claim has a rejected outcome, make a genuine attempt to contact the customer and tell them about the adverse decision (where the customer has not been previously contacted and advised). Details of attempts and/or customer discussion should be clearly recorded in the rejection Note/DOC.

Document the outcome in Notes with the following:

• CCS/ACCS NEF: s85AA to 85GB FA Act 1999
• Claim ID:
• Claim date: [insert date Claim completed by the customer]
• Children: [insert names of child/ren for which claim is made NEF]
• Reason: required documents/information has not been provided therefore no decision can be made about the customer's entitlement and so it is not possible for a customer to ask for a review of a decision about their entitlement. The claim is taken not to have been made. The customer can ask for a review of the decision that made the claim not effective. If the claim is still found to be not effective, a new claim will need to be lodged. A new claim is made not effective if requested documents were lodged late and this decision cannot be reviewed

Procedure ends here.

Customers may withdraw an effective claim for CCS at any time before their payment status is CURrent for that child.

A customer can withdraw their claim in writing, verbally, or online.

When a customer chooses to withdraw a claim, the claim is taken never to have been made.

To withdraw a claim:

• Select the Status icon
• Select Edit
• Change Status to Withdrawn

For standalone claims, check the Activity List (AL) screen in Customer First for an open FAO DOC with notes Plse action CCS claim in PD. Cancel this off the AL screen if this is still open.

Document the outcome in Notes with the following:

• CCS Withdrawn: s85AA to 85GB FA Act 1999
• Claim ID:
• Date of claim: [insert date claim submitted]
• Reason: [insert reason discussed with customer]
• A withdrawn claim is not appealable. The customer will need to lodge a new CCS claim if they wish to be assessed again for this payment

Procedure ends here.

Generally, partner and child relationships must be reviewed/updated before starting to process a CCS claim.

However, as an Add child claim can only be lodged where a customer is already Family Tax Benefit (FTB) current for the child, the child will already be linked to the customer.

The following changes cannot be done with these claims:

• change of circumstance updates
• relationships updates

From the Transaction Summary (TS) screen, select Process.

The claim will display the Message Log and Task Selector tables on the Errors (SWE) screen.

Message Log:

• This section displays any errors with existing coding. These must be fixed before the claim can be assessed
• Select messages to view/update the relevant details. An error or warning will display if information has not loaded correctly from the online claim or Assisted Customer Claim (ACC)

Task Selector/s:

• A flag displays against listed screens containing data uploaded from the online claim, or added by a previous staff member
• As an Add child claim is an abridged claim, the only mandatory screens within the customer’s Task Selector will be the Child in CCS Claim (CCC) and Aboriginal and Torres Strait Islander Heritage (HERITAGE) screens
• Regenerating the claim will clear any previous data coded
• Staff do not need to select any additional screens, however they can select screen to be checked/updated, if required

Select Next to go to the selected screens.

When progressing through the screens staff will see information with a status of:

• Confirmed: information previously verified about the customer
• Provisional: new information updated in the claim transaction
• Changed: existing information which has been changed by claim data

Information can be added, deleted or edited, as needed. Where the information is already accurately recorded, no updates are required.

Note: staff do not have the access to delete provisional information. If Service Officers have added the line incorrectly, it can be removed by regenerating the claim. If the incorrect child was added by the claim, contact a CCS SSO via the local escalations processes to have it deleted.

If the customer is partnered:

• Use to switch between the customer and partner records if having to correct or update information
• When the partner’s record is selected, the switch should occur on the same screen, e.g. if within the Activity Test Details (ATD) screen on the customer record, it will switch over to the ATD screen on the partner record. Once partner updates are completed, select the customer to switch back

CCS current children will have a Confirmed Record Status line already coded. Confirmed Record Status lines will rarely require updating/editing.

Where the customer claims for a non-current child, a Provisional line will be recorded. The system will calculate the Deemed Date of Receipt (DDOR) and will apply the correct Start Date.

Check/record relevant fields on the Child in CCS Claim (CCC) screen:

• Status
• Start Date:
• The Start Date can only be backdated a maximum of 28 days, however the start date must be the Monday of a CCS fortnight. This is the DDOR
• The system will calculate the DDOR and will apply the correct date. If staff suspect the DDOR is incorrect, manually regenerate the claim. This is because Calculate DDOR functionality may have altered this date
• The DDOR is displayed at the top of the screen under Receipt Date
• End Date defaults to 31/12/9999
• Child Customer Reference Number (CRN): - the CRN should match the child being assessed for

For claims submitted before 8 July 2024, the Add Child claim will not ask the Aboriginal and Torres Strait Islander Heritage question within the claim. There is no requirement to review the data provided, including confirmed lines. Go to Step 5.

For claims submitted after 8 July 2024, customers will be presented with the Aboriginal and Torres Strait Islander Heritage question within the claim and a Provisional line may be recorded with the customer response.

Evidence to verify the response is not required and not to be requested under any circumstance.

HERITAGE details are to be recorded in the CCS customer’s record, not the child’s record. Ensure Process Direct displays the customer's details at the top of the screen.

Check/update relevant fields on the Aboriginal and Torres Strait Islander Heritage (HERITAGE) screen for each child:

Note: to ensure debts are not raised, new or updated responses are recorded in a new line within the table. The system will automatically end date previously confirmed lines, as necessary, i.e. there is limited need to edit previously confirmed lines.

• Benefit: CCP
• Start Date: If the customer has provided a:
• new response, confirm the claims Deemed Date of Receipt (DDOR) has populated. The date of effect will be the earliest CCS Monday within 28 days of the date of receipt recorded in the HERITAGE screen
• response that differs to a previously confirmed response (that will result in the base 36 hours ceasing), change the start date to today’s date to ensure debts are not raised
  (e.g. Aboriginal or Torres Strait Islander heritage changed to either ‘Do Not Wish to Answer or Not Aboriginal or Torres Strait Islander)
• End Date: new entries will pre-populate to 31/12/9999. (Note: no manual coding/editing of confirmed lines is required, the system will end date as necessary)
• Date of Receipt: the system will pre-populate the claim submission date
• Heritage: select customer’s response/s from the dropdown box
• Reason: this field will only display for the response of ‘Do Not Wish to Answer’
• Heritage of: select relevant child from the dropdown box

See Coding Activity Test details for Child Care Subsidy (CCS) if further details on how to record updates to the HERITAGE screen is required.

Use :

• select the child the customer is claiming CCS for
• go to the SWE screen to populate the Child Task Selector

Make sure the following screens from the Task Selector are selected:

• CED - Child Education Details
• CIM - Immunisation

Select Next to go to the selected screens.

When progressing through the screens staff will see information with a status of:

• Confirmed: information previously verified about the customer
• Provisional: new information updated in the claim transaction
• Changed: existing information which has been changed by claim data

Check/update relevant fields on the Child Education Details (CED) screen:

• Child has not started school:
• Start date: the child's date of birth
• Education level: select Has not started studies
• This can be coded from when the child turns 3 years old
• No further details are required/enterable
• If a provisional line has not been recorded, there is no requirement to add one
• Primary school:
• Start date: the date the child did or is expected to start primary school. Note: this is not the start of the calendar year. See the Resources page for a link to Term Dates for public schools for a guide to help customers with the correct start date
• If the customer has advised they are delaying the child’s entry into primary school, start a new line with the new primary start date. This lets the customer access additional pre-school hours (if applicable) when the child is repeating preschool
• Education level: select Primary education
• No further details are required/enterable
• Secondary school:
• Start date: the date the child did or is expected to start secondary school. Note: this is not the start of the calendar year. See the Resources page for a link to Term Dates for public schools for a guide to help customers with the correct start date
• Education level: select Secondary education
• Disabled child: select Yes or No (leave blank if not known)
• Adult available to care: select Yes or No (leave blank if not known)
• Unable to be left alone: select Yes or No (leave blank if not known)
  Note: Yes confirms the child cannot be left unsupervised, if it is changing to a Yes, check that a referral to Level 2 Policy Helpdesk for approval has been done, see Table 2 in Updating school status, and assessing age exemptions for Child Care Subsidy (CCS)

See Updating school status, and assessing age exemptions for Child Care Subsidy (CCS) for more details.

CCS will reject for children who do not meet the immunisation requirements at the time of claim determination, unless an immunisation exemption is approved or the child is under 3 months. Claims should not be rejected where the immunisation status is unknown because a link with the Australian Immunisation Register (AIR) has not been established. Where a 'W' (wait) response is received from AIR, place the claim on hold while the link is established, regardless of the age of the child.

Check the CCS AIR link has been successfully established for the child on the Child Immunisation Details (CIM) screen:

• If the child record is linked with the AIR, the following will display:
• Status: Yes or No
• Reason Code: 5 digits, starting with 10
• AIR Response: A (Accept)
• If the child record has not linked with the AIR, the following will display:
• Status: no information will exist
• Reason Code: 5 digits, starting with a 9, 8 or 7
• AIR Response: R (Reject) or W (Wait)

To establish the link, including where Medicare details have not been provided, see the Table 1 in Immunisation requirements for Child Care Subsidy (CCS).

Go to Step 8.

The Child Task Selector will return to the SWE screen once the user has progressed through all the previously selected screens.

If the customer is claiming CCS for another child, repeat steps 5 to 7 to check/update the information recorded.

Return to the customer’s SWE screen to view errors, warnings and messages in the Message Log. These messages advise the items that need to be addressed to prepare to finalise the claim.

Select at top right to launch the Digital Assistant Roxy. Key the error message into the Digital Assistant Roxy for help. See Using Digital Assistant Roxy in Process Direct and Process Direct navigation, common screens and functions for more information.

Where claims are to be held pending issue resolution, update information in relevant progress Notes/DOCs.

Check Process Direct - Current Issues for known errors and approved workarounds.

Mainframe errors

For any mainframe errors that have been resolved, the error will continue to display until the user navigates back to the SWE screen and selects Assess again.

Immunisation related warnings

For immunisation related warnings, go to Step 10.

Once all errors have been addressed, select Assess and go to Step 11.

Follow Digital Assistant Roxy help text instructions if any of the following messages appear:

• SR210 MY CHILD CARE: Child DOB mismatch between CLK and AIR
• SR212: MY CHILD CARE: WAIT for AIR manual matching to complete
• SR215:MY CHILD CARE: Immunisation status not received: Eligibility for (Child Name) may cease, (see specific instructions if child is under 3 months of age)

For more detail, see Immunisation requirements for Child Care Subsidy (CCS).

After addressing the data validations, select Assess to display any errors, warnings or messages that need to be addressed. If there are no errors, the Assessment Results screen will display.

The Assessment Results screen displays the Customer tab (see screenshot).

Note: this is not the final outcome as the Assessment Results take a moment to load.

Do not take any action until information displays in the Eligibility and Entitlements tables on the SSP tab. These display automatically (see screenshot).

When the Eligibility table has loaded the data:

• Check the date of grant is correct and that backdating provisions have been applied correctly
• Check that all children claimed have been included in the assessment
• If the assessment result displays a CCS status of 'not eligible' and a reason of 'immunisation not met' check that a successful AIR link has been established. See Immunisation requirements for Child Care Subsidy (CCS)

On the Entitlements table:

• Check the CCS percentages and Activity Test Fortnight Hours have applied correctly
• Determine whether the claim is reassessing any past periods of CCS:
• Reassessments will display under the Planned Payments table. If the table is blank, the claim is not reassessing past periods of CCS
• See Reviewing assessment outcomes for Child Care Subsidy (CCS) for more detail

Select the Customer tab and Partner tab to check the effects of the CCS claim on other payments before finalising the activity.

If an incorrect update within the CCS claim has affected eligibility to previous payments, a negative adjustment displays (see screenshot example where an incorrect residency update is causing partner DAP debt).

• Check details provided in the CCS claim. If the:
• claim residence details differ from those previously recorded on the residency screens, correct to align with previous coding
• new information is correct, contact the customer to confirm before accepting the new information, and advise the customer the impact this will have on their other payments

With outcomes confirmed and necessary corrections done, return to the SSP tab to finalise the activity.

Claim outcomes must be recorded in a Note.

Select Finish to present the Notes.

If the claim is not being finalised, record relevant information in Notes.

Claim ID, Child Name and Reason for adverse decision are considered minimum requirements for claim notes, which should auto populate:

• If CCS has been granted for all or any child/ren, include in the claim Notes:
• CCS granted: s85AA to 85GB FA Act 1999
• Claim ID:
• Date of claim: [insert date claim submitted]
• Date of grant: [insert start date of CCS as determined by the system on the Assessment Results screen]
• Child/ren granted: If assessing a claim where the customer is already CCS current for all children listed in the subsequent claim, use the above grant details and note that the claim is a duplicate/multiple. List details of any circumstances updated within the claim
• If CCS has been rejected for all or any child/ren, include in the claim Notes:
• CCS rejected: s85AA to 85GB FA Act 1999
• Claim ID:
• Date of claim: [insert date claim submitted]
• Child/ren rejected:
• Reason: [insert reason, e.g. Child over age]

Note: where the claim has a rejected outcome, make a genuine attempt to contact the customer and tell them about the adverse decision (where the customer has not been previously contacted and advised). Details of attempts and/or customer discussion should be clearly recorded in the rejection Note/DOC.

Record details of contact attempts and/or customer discussion in the rejection DOC.

For more information on additional information to be recorded, see:

• Online Document Recording, Resources page
• Creating, viewing and deleting documents (including Fast Notes and DOA DOCs)

Select Finalise (or Not Finalise if appropriate) to complete the activity.

Check Notes to ensure a sufficient claim assessment DOC has been recorded. Create a new claim assessment DOC by copying and pasting the relevant claim notes above if the DOC has not recorded correctly.