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My Health Record (Provider) quality checking processing 111-22120010

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This page contains detailed information on the Quality Checking process.

On this page:

Pre-check - notification letters automated by the Provider Participation Register (PPR) for My Health Record - Provider - quality checking

Targeted check - closed registrations for My Health Record - Provider - quality checking

Targeted check - uncompleted registrations for My Health Record - Provider - quality checking

Full application check for My Health Record - Provider - quality checking

Post-check reporting on the My Health Record Checking Results spreadsheet

Pre-check - notification letters automated by the Provider Participation Register (PPR) for My Health Record - Provider - quality checking

Table 1: This table outlines the pre-check process for daily 'pending' notification letters automated by PPR. This check must be completed before close of business on a daily basis.

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Step

Action

1

Initial steps

Open the Provider Participation Register (PPR), accessed through the Medicare Portal.

Under Navigation select the Letters tab.

Pending Auto Letters will be displayed

2

Search for application

Search for the application to match each of the letters in the shared directory

In the Search field type in the name of application displayed in the PPR Pending Auto letters

Note: if the Authorisation Links letter is for changes to the established authorisation link list, it may have been actioned via telephone. To check this Service Officers will need to see the Healthcare Provider Identifier - Organisation's (HPI-O) Customer Relationship Management (CRM) entry to confirm.

3

Checking the application

The Application Part B and the Participation Agreement must be checked in full to ensure the documentation is correct according to policy

The Quality Checker must ensure that the person who completed Part B matches the person selected on PPR.

See also Create Healthcare Provider Identifier - Organisation (HPI-O) record for seed organisation in Healthcare Identifiers (HI) Service

4

Error check

Is the application complete?

5

Critical errors

If a critical error has been identified, the letter must be stopped before the letters are automatically generated at 2:00am the following morning.

Notify the EL1, Team Coach or Authorised Officers using an established email template in the SME box.

An appropriate officer with administration permission in PPR will select Not Required button as a new letter will be manually issued by Local Peer Support (LPS) when the letter is re-registered by Service Officer.

6

Create new Service Request (SR)
  • Open CRM
  • Search for HPI-O
  • Create a new SR
  • Add a new task with the relevant details.

See the workflow management tool (My Health Record Tracking Database procedures)

Email details of SR to the eHealth Provider Operations Helpdesk (see Resources for a link), the eServices Assistant Director, the Service Officer's Team Leader and Local Peer Support (LPS).

Add to the eHealth issues register

7

Resolution within 24 hours

Provider Healthcare Identifiers (HI) Service and My Health Record Subject Matter Expert (SME) will suspend (not cancel) the organisation to prevent any access to the My Health Record System

Has the case been resolved within 24 hours?

8

No resolution within 24 hours

If the case is unresolved after 24 hours, send a second email to the Provider Healthcare Identifiers (HI) Service and My Health Record Subject Matter Expert (SME) requesting advice.

Action advice as appropriate.

Update the eHealth issues register

9

Finalisation

Update the quality checking spreadsheet with the steps taken.

For critical errors:

  • Update and close issue in the eHealth Issue register
  • notify eServices Assistant Director, the Service Officer's Team Leader and Local Peer Support (LPS)

10

Feedback

Provide feedback to the Service Officer. This may include positive feedback for transactions identified as error free.


Targeted check - closed registrations for My Health Record - Provider - quality checking

Table 2: This table details the weekly post checking process for the closed registrations, to be completed every Monday prior to submitting the quality checking spreadsheet.

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Step

Action

1

Email from Provider Healthcare Identifiers (HI) Service and My Health Record Subject Matter Expert (SME)

An email will be sent by the Provider HI Service and My Health Record SME every Monday with all Service Officer applications created in the previous week.

Note: Authorisation Links will not appear on this list.

2

Open workflow management tool

Open the workflow management tool (My Health Record Tracking Database)

The Service Officer should select their ‘P number' to launch.

To find all applications completed in the previous week:

  • Click New Search button
  • In Event Type: select 'My Health Record Application Processed'
  • In the Event From/To: field key in start date and end date for previous week
  • In My Health Record Status: field select 'Closed-completed'
  • Click Search button

Applications (Registrations and Authorisation Links) matching the search criteria will be displayed.

Because the search criteria includes event dates, the search may return multiple results for the same application. This is because there may be multiple events recorded for an application within the timeframe covered by the Event From/To dates. All events for an application are regarded as one single application for the purposes of quality checking.

3

Perform check

Compare the closed applications against the email from the Provider HI Service and My Health Record SME.

Do all applications match?

  • No
    • for applications missing from the Provider HI Service and My Health Record SME list, go to Step 4
    • for application included on the Provider HI Service and My Health Record SME list that are not on the database list, go to Step 5
  • Yes, go to Step 6

4

Applications missing from the Provider HI Service and My Health Record SME list

Check the application against the quality checking spreadsheet and the Provider Participation Register (PPR). If it is an auth link, it will not appear on the email and it has been processed, no further action required.

If it not an auth link investigation must be completed as to if it has been processed correctly and why it was not closed off the database.

Go to Step 6

5

Applications included on the Provider HI Service and My Health Record SME list but not on the database list

Was an error identified?

  • Yes:
    • Advise Service Officer's Team Leader
    • Advise the Service Officer to rectify the error to complete registration or authorisation linking.
    • Go to Step 6
  • No, go to Step 6

6

Finalisation

Reply to the Provider HI Service and My Health Record SME emails with the details of the check. This email needs to include any anomalies identified, or a confirmation that all applications have been accounted for.


Targeted check - uncompleted registrations for My Health Record - Provider - quality checking

Table 3: This table details the weekly post checking process for the uncompleted / open registrations, to be completed weekly. This is to be completed by Team Leader.

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Step

Action

1

Open workflow management tool

Open the workflow management tool (My Health Record Tracking Database):

The Service Officer should select their ‘P number' to launch.

To find all applications completed in the previous week:

  • Click New Search button
  • In Event Type: select 'My Health Record Application Processed'
  • In the Event From/To: field key in start date and end date for previous week
  • In My Health Record Status: field select the appropriate status as outlined in the following step
  • Click Search button

Applications (Registrations and Authorisation Links) matching the search criteria will be displayed.

2

Perform check

The types of checks performed should include the following:

  • HI Status = 'Open'
  • HI Status = 'Sent to QC'
  • HI Status = 'Closed-completed' and My Health Record Status = 'Not assessed'
  • HI Status = 'Closed-completed' and My Health Record Status = 'Incomplete - No HPI-O'
  • HI Status = 'Closed-completed' and My Health Record Status = 'Ready to Register'
  • HI Status = 'Closed-completed' and My Health Record Status = 'Sent to QC'

3

Finalisation

Investigate any applications displayed by the above searches to ensure they are actioned appropriately. Any issues must be addressed with the Team Leader of the processing team.


Full application check for My Health Record - Provider - quality checking

Table 4: This table outlines the full application check. This checking process applies for the

  • Post check
  • Pre-check for new Service Officers proficiency
  • Targeted check for Service Officers with quality issues for proficiency
Expand table

Step

Action

1

Initial steps

Open the workflow management tool (My Health Record Tracking Database)

The Service Officer should select their ‘P number' to launch.

Note: Auth links applications that are processed form telephony transactions should be fully checked as soon as the email is sent to Local Peer Support (LPS), and the results included in the quality checking spreadsheet. These are not listed on the database.

2

Run reports

Run reports in the workflow management tool to conduct checks on applications completed in the previous week from the folder located in the directory for the applications registered:

Post Check: randomly select the sample from the past week

  • Click New Search button
  • In Event Type: select 'My Health Record Application Processed'
  • In the Event From/To: field key in start date and end date for previous week
  • In My Health Record Status: field select 'Closed-completed'
  • Click Search button

All applications processed in nominated period are displayed

Pre-check for new Service Officers:

  • As described above plus:
    • In Allocated to: field, select the appropriate Service Officer's user ID and name from the drop-down box
    • All applications processed by Service Officer are displayed

Targeted check for Service Officers with quality issues

  • As described in above points.

3

Search for application

Search for the application to match each of the letters in the shared drive G:/Business Outreach Services/HI eHealth

In the search field type in the name of application displayed in the PPR Pending Auto letters

Ensure the application documentation is complete and correct according to policy.

See also Create Healthcare Provider Identifier - Organisation (HPI-O) record for seed organisation in Healthcare Identifiers (HI) Service

4

Provider Participation Register (PPR)

Search for an Organisation using the Healthcare Provider Identifier - Organisation (HPI-O) in the PPR

Check under ‘Reg Indicator’ heading to identify status of registration

5

Database

Search for the application entry in the My Health Record Tracking Database

Ensure the following information has been updated by the Service Officer:

  • My Health Record Status field: 'Closed-completed'
  • Check Event tab:
    • All processing details have been recorded
    • Event type 'My Health Record Full Paperwork Received' has been recorded
    • Event type 'My Health Record Application Processed' has been recorded
    • My Health Record CRM ref: field - where applicant contact has been required, a CRM reference ID must be populated. Customer contact can be determined by reading event types

See: My Health Record Applications Tracker Procedure - found in the shared directory.

6

Customer Relationship Management (CRM)

If the applicant was contacted there must be an entry in CRM

  • Open and logon to CRM
  • Search via HPI-O
  • Select related SR
  • Ensure information keyed in task descriptions match mandatory information
    • New Rego received date
    • Cleared HI date
    • Application Assessment
    • Provider Contact
    • Registration date

Note: the HPI-I number must not be shown in CRM for Authorised links.

7

Finalisation

Update the quality checking spreadsheet with the results.

Provide feedback to the service Officers. This includes positive feedback for transactions identified as error free.

All errors must be rectified immediately.


Post-check reporting on the My Health Record Checking Results spreadsheet

Table 5: This table outlines how to enter post-check data in the My Health Record Checking Results spreadsheet.

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Step

Action

1

Perform checks

Check each transaction as per the processes outlined in this procedure.

2

Open spreadsheet

Open the My Health Record Checking Results spreadsheet located in the shared directory

Select the tab for the relevant month.

3

Enter results

Complete the month result

  • Type of check - select from the drop down list the type of check completed
  • Registration Date - date the work type registered
  • Service Officer - logon ID of processing Service Officer
  • HPI-O name - name of the organisation
  • Auth Link received by - For Auth Links Only - indicate how the request was received
  • Quality Checker - the log on ID of the person who checked the work item
  • Date of check - the date the work item was checked
  • Items checked - the number of items checked within that work item
  • Items with critical errors - how many of those work items were in error with critical errors
  • Error 1 Found to Error 4 Found - select the appropriate error code from the drop down list for the errors identified. Note: record all errors even if they are non-critical

4

Detection of errors

Has an error been identified?

5

Error reporting

Complete the error register tab for error/s identified:

  • Copy columns B to F in the month tab to the Error Register. Note: ensure there is one line populated for every error found
  • Error Code - select the error code from the drop down list
  • Underlying Factors - in conjunction with the Service Officer, determine the underlying factors of why the error occurred
  • Feedback supplied - enter information as to whether feedback has been supplied
  • Systemic? - enter yes if the issue has been identified as systemic
  • Root cause analysis - complete the analysis when the issue is identified as systemic, or if the key performance measure (KPM) has not been achieved

6

Finalisation

At the end of the first working day of the new month the spreadsheet is to be sent to the eHealth Provider Operations helpdesk using the email address on the eHealth Branch page and the Quality Management Section using the applicable Quality Checking contact on the Quality Processes page. See Resources for links to these pages.

Note: results will be included in the Medicare Provider Executive report.