Bulk Bill quality checking processing 111-22090010

Key 'QBBI' and press [Enter].

The QBBI screen displays details of selected transactions from the previous day's processing plus any outstanding transactions not previously actioned.

Note: for more information on how to interpret information on the QBBI screen, see The Quality Control System (QCS) for Medicare on the Resources page.

The details returned on the QBBI screen format for bulk bill transactions include:

• PRCDT - processing date
• TIME - time of processing
• OPER - operator number of the Service Officer who processed the voucher
• TY - transaction type - values are:
• BM - bulk bill manual system paid
• BN - bulk bill manual Service Officer paid
• BI - bulk bill HIC online Service Officer paid
• TRAN - transaction that was updated (DAPI/C/U)
• REFERENCE DETAILS:
• card number or provider number for the voucher selected
• claim id of the claim in which the voucher will be found

Note: a transaction is selected based on the time the bulk bill claim was processed and the voucher number. The voucher number on QBBI will not always match the voucher number on the patient's history screen.

The voucher number on QBBI is the 'index' number of where the voucher is positioned within the claim by the overnight file.

Select the voucher to be checked by positioning the cursor in the 'S' (select) field then pressing [Enter].

Medicare patient history screen displays the claims history of the voucher selected.

For:

• vouchers of bulk bill claims, go to Step 3
• online transactions, go to Step 4

For vouchers of bulk bill claims:

• examine the batch of the Service Officer who finalised the claim and locate the source documents
• compare the source documents with the claims history displayed and determine if the voucher had been processed correctly

Note: it is necessary to check that the claim header (DB1) and vouchers for the claim have been completed correctly.

Go to Step 5

For online transactions:

• key DQRI,provider number,Claim ID
• key 'F' against the claim to be selected
• check the raw data to see if the information transmitted is the same as the patient history
• read text, (indicated by a 'T' in the service line on the history screen), in conjunction with processing indicators and reason codes on the history to determine if the claim has been assessed appropriately

Note: if the Service Officer is unable to determine if the claim has been assessed appropriately, they should check with the relevant Support team/SME.

See also the Explanation of DQRI online formatted data for bulk bill claims attachment on the Resources page.

Press [F3] to exit from history and return to the QBBI screen.

Key the appropriate status codes in the Status fields for the selected voucher and press [Enter].

Note:

• only one status code must be keyed - the error with the greatest impact
• where no errors are detected, the appropriate status code is 001

The system returns a 'u' in the S (select) field to indicate that the selection has been updated.

Note: if no status codes have been keyed, the system returns a 'b' to indicate that the selection has been browsed, but not finalised.

When all the vouchers or online transmissions have been actioned press [F3] to exit the QBBI screen.

For errors identified:

• Send to the relevant area with a copy of the source documents for adjustment
• Submit the online quality checking Error Explanation Sheet (EES) ensuring all errors identified in the checks are recorded

See the Resources page for links to the online EES, the Guide to completing the online EES and The Quality Control System (QCS) for Medicare.