eBusiness quality checking in QST 111-20080652

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See Service Delivery Quality and Evaluation for Quality Frameworks and Standards

Health Provider Support and Education Section

Forms

Banking details online claiming form (HW052)

Online claiming provider agreement form (HW027)

Provider registration for Electronic Funds Transfer payments form (HW029)

Manual identity verification for Provider Digital Access form (HW080)

Contact details

Quality and Skill Tags

eBusiness generic - error codes

Table 1

Error group	Error code	Error definition	It is an error when
N/A	ED00	No errors.	No errors identified by the quality checker. The quality checker may provide written feedback, with suggestions/improvements.
PaNDA	ED01 Non-critical	Incorrect naming convention/s.	The naming convention does not reflect one of the relevant options below. The: Username field on the PaNDA work item does not match the relevant PRODA account username PaNDA work item naming convention does not include the provider number/stem (if applicable) and name of practice, or name of provider PaNDA work item Case ID field does not display the Source Work Item (WID) number
PaNDA	ED02 Non-critical	PaNDA notes not added, are incomplete or incorrect.	The notes on PaNDA do not reflect the action/s taken by the service officer. Notes on PaNDA must explain all action taken and anything that still needs to be completed.
PaNDA	ED03 Non-critical	Relevant PANDA enquiries not associated.	PRODA only The PaNDA work item has been marked as 'Complete' without first associating all relevant work items. This could (but not necessarily) include PRODA enquiries. Banking forms only All relevant work items that have been received within previous 3 months have not been associated. Refer to error code ED04 when PaNDA work items are associated incorrectly by the service officer.
PaNDA	ED04 Non-critical	PaNDA documents associated incorrectly to a work item.	Service officer incorrectly associated PaNDA documents not relating to a work item.
Email	ED05 Critical	All emails.	The email was not sent or does not contain the correct information, for example: PRODA: RA number, account holder name, PaNDA work item ID not listed Email sent to account holder requested incorrect documents Banking forms: Provider name, provider number, PaNDA work item ID not listed Rejection email sent to provider did not state the relevant reason/s for rejection Both programs: Email sent to incorrect/invalid email address Email not sent when it was required as part of Operational Blueprint process
Email	ED06 Non-critical		Email has not been uploaded in the PaNDA work item. Email not sent on behalf of correct positional mailbox.

PRODA applications - error codes

Table 2

Error group	Error code	Error definition	It is an error when
Form related	EB02 Critical	Form incorrectly rejected as sufficient information is provided on the form.	HW080 form has been incorrectly rejected as it can be accepted with minimal or missing details listed, if it contains enough information to process the form without: any additional effort to locate the user account, and/or having to refer to another system such as CDMS to obtain further information
Form related	EB03 Critical	Mandatory declaration tick box not ticked.	Accepting and processing a form in which the mandatory declaration tick box has not been selected.
PRODA	EB08 Critical	Account on non-verified name set after account made KNOWN.	The PRODA account has been made KNOWN, however 'Manage Names' has not been checked to confirm the account has been set to a 'Verified’ nameset.
PRODA	EB09 Critical	Gender on account is incorrect.	The gender on the PRODA account does not match the supplied Evidence of Identity (EOI) and the service officer coded it to the account.
PRODA	EB10 Non-critical	Notes not added, are incomplete or incorrect.	The notes on PRODA do not reflect the action taken by the service officer. Notes on PRODA must explain all action taken and anything that still needs to be completed.
PRODA	EB11 Critical	Documents coded in error - account made KNOWN as a result.	A document has been coded to the PRODA account in error, in doing so this has made the PRODA account KNOWN incorrectly.
PRODA	EB12 Non-critical	Documents coded in error - account status unaffected.	A document has been coded to the PRODA account in error, coding the document has not affected the account however, the document was not required.
PRODA	EB13 Critical	Documents have been provided and are necessary but not coded.	A document was provided that was necessary for the PRODA account, however it was not added to the account. A document was provided that was necessary for the PRODA account, however it was not escalated to Tier 3/PRODA Support for assessment.
PRODA	EB14 Critical	Documents coded incorrectly/with errors.	A document has been coded to the PRODA account contrary to Operational Blueprint, or Local Peer Support (LPS) advice.
PRODA	EB15 Non-critical	HPOS Provider details not linked despite being provided.	The account holder has provided an identifier, for example, a Medicare provider number in order to link the PRODA account to HPOS. Notes: This can only be marked as an error if the customer had provided the identifier on the form. For quality checking purposes, there is no requirement to perform a PDS search if the quality checker identifies that the customer is a provider they should perform a PDS search, link the identifier and provide written feedback only to the service officer (this will not count as an error)
Email	EB16 Critical	Information incorrect/incomplete in email.	The email sent to the account holder does not contain the correct identifying information RA, account holder name, Source Work item number.
Email	EB17 Critical	Incorrect email template used.	The email sent to the account holder was sent using the wrong template for the situation.
Email	EB18 Critical	Customer contact not made.	No evidence of customer contact via phone and/or email.
Email	EB19 Non-critical	Formatting of email is incorrect.	Unapproved changes have been made to an email template that has then been sent to the account holder. Example, unapproved bold or highlighting.
Form related	EB27 Critical	IMG/OTD - Question 9 ticked.	Q9 has been ticked and the application has been rejected/escalated incorrectly.

Provider banking details - error codes

Table 3

Error group	Error code	Error definition	It is an error when
Form related	ES03 Critical	The incorrect provider number is updated that is not stipulated on the form.	Banking forms have been accepted and processed to the incorrect provider number profile in PDS.
Form related	ES05 Critical	Form incorrectly rejected.	Banking forms have been rejected incorrectly.
Form related	ES06 Critical	The signature details are invalid.	Banking forms have been accepted and processed despite signature discrepancies, including: missing applicant signature absence of a handwritten signature (digital, copied, or non-original signatures not accepted) date of signature exceeds 30 days from the date of lodgement Note: future signature dates are not accepted. This excludes effective start dates for banking details and/or Minor ID's.
Form related	ES09 Critical	The additional document to authorise the update provided with the bank details form has not been signed by the provider but has been actioned.	Additional correspondence was attached requesting to update multiple providers but the attachment was not signed by the applicant. Banking forms have been accepted and processed.
Form related	ES10 Critical	The additional document with the form signed by the provider has not been actioned and no contact was made to the provider.	In the instance of requests to update multiple providers the documents have been signed by the applicant but was not processed. Provider was not contacted to confirm date of effect.
PDS	ES11 Critical	The provider number is closed and bank details/Minor ID have been updated.	Banking forms have been accepted and processed where the provider location is closed (end dated) in PDS and banking details and/or Minor ID have been updated.
PDS	ES12 Critical	Minor ID PDS.	Banking forms have been accepted and processed but the Minor ID has not been updated in PDS for the provider's bank details. Banking forms have been accepted and processed without creating the new Minor ID in PDS. Minor ID registration details in PDS have been created incorrectly, but bank details have been accepted and processed. Banking forms have been accepted and processed with the incorrect Minor ID updated to Provider Number in PDS.
PDS	ES13 Critical	Minor ID and/or banking details are recorded before effective date on form.	Banking forms have been accepted and processed with bank details and/or Minor ID but with incorrect effective start date.
PDS	ES14 Critical	Bank account number details.	The bank account number and/or BSB entered in PDS does not match the form. The bank account number start/end date is incorrect. The bank account details have not been recorded at all.
PDS	ES16 Non-critical	Bank account name is not recorded correctly	Banking forms have been accepted and processed where the bank account name is not entered correctly, excluding abbreviations. Note: this would include a change from an individual to another type of legal entity, or one type of legal entity to another.
Email	ES20 Critical	Australian Immunisation Register (AIR) box is ticked but not forwarded to AIR.	Banking forms have been accepted and AIR is selected on the form however no evidence of work item created for AIR for actioning.
Form related	ES26 Critical	Application(s) received but not actioned.	Application(s) received but not rejected/actioned accordingly.
Form related	ES28 Critical	The provider number does not match the name or practice address listed on the form.	Banking forms have been accepted and processed when the details in PDS do not match the provider name/practice address listed on the form. This also includes the absence of a provider number and details have been updated in PDS.
Form related	ES29 Critical	Completed forms/type/version.	A HW027 or HW052 form has been provided, are missing any page and the banking details have been accepted and processed. A HW029 has been provided but is missing page 1,2 or 6, and the banking details have been accepted and processed. The application received is not the current version/incorrect form and the bank details/Minor ID have been updated.

Bulk banking details update for National Health Service - error codes

Table 4

Error group	Error code	Error definition	It is an error when
Form related	BU02 Critical	The provider number does not match the name or practice address listed on the form	Banking forms have been accepted and processed when the details in PDS do not match the provider name/practice address listed on the form. This also includes the absence of a provider number and details have been updated in PDS.
Form related	BU03 Critical	The incorrect provider number is updated that is not stipulated on the form.	Banking forms have been accepted and processed to the incorrect provider number record in PDS.
Form related	BU05 Critical	Form incorrectly rejected.	Banking forms have been rejected incorrectly.
Form related	BU06 Critical	The declaration/form has not been signed by the provider.	Banking forms have been accepted and processed without the providers signature.
Form related	BU07 Critical	Incorrectly rejected digital signature/signature date.	National Health Service process allows for digital signatures and should not be rejected for this reason. There is no time frame required for signatures for the National Health Service process, all dates are accepted.
Form related	BU08 Critical	Pages 1,2 and 6 of the HW029 form have not been received and details have been recorded.	Banking forms have been accepted and processed where all or part of the banking form is absent.
Form related	BU10 Critical	Application(s) received but not actioned.	Application(s) received with required details but not actioned accordingly.
PDS	BU11 Critical	The provider number is closed, and bank details have been updated.	Banking forms have been accepted and processed where the provider number is closed (end dated) in PDS.
PDS	BU12 Critical	Minor ID has been updated in error.	The Minor ID has been updated when not required.
PDS	BU13 Critical	Date of banking details are recorded incorrectly.	Banking forms have been accepted and processed with incorrect start/end date.
PDS	BU14 Critical	Bank Account number details.	Banking forms have been accepted and processed with incorrect details.
PDS	BU15 Non-critical	Bank account name is not recorded correctly.	Banking forms have been accepted and processed where the account name is not entered correctly, excluding abbreviations. Note: this would include a change from an individual to another type of legal entity, or one type of legal entity to another.
PaNDA	BU16 Non-critical	PaNDA WID processing notes/pend status/association/naming convention.	Processing notes on a PaNDA work item should clearly explain all action taken to complete that WID as well as identifying what is required. Work item was pended when it should have been unassigned to the queue. PaNDA WID associated in error. The PaNDA work item Case ID field does not display the Source Work Item number.
Email	BU20 Critical	Email notification for Rejected EFT registration incomplete.	Email notification sent to DCM did not state the relevant reason/s for rejection. The Minor ID spreadsheet is not included or is incorrect/incomplete.
Email	BU21 Critical	Email sent to provider.	Details have been accepted and processed and one of the below apply: Email was sent to the provider when it should have been sent to Digital Channel Management Bulk banking for National Health Service Email sent to incorrect email address Email sent to invalid email address
Email	BU22 Non-critical	All emails.	Email sent and one of the below apply: Email not sent on behalf of Provider forms Email has not been uploaded in the PaNDA WID Email notification sent to Digital Channel Management Bulk banking for National Health Service did not state the relevant reasons/action required Email notification sent to provider and not to Digital Channel Management Bulk banking for National Health Service Email not moved to Provider forms sent folder The email template is missing information. For example, Name/Date of lodgement/Work ID
PaNDA	BU23 Non-critical	Minor ID spreadsheet.	The Minor ID spreadsheet has been updated incorrectly or is incomplete. The Minor ID spreadsheet has not been uploaded to PaNDA.

Operational Information

eBusiness quality checking in QST 111-20080652