Quality Management Application (QMA) quality checking in emergency claims 111-23103055

Emergency claims are selected for quality checking using QMA. These include:

• Australian Government Disaster Recovery Payment (AGDRP)
• New Zealand Disaster Recovery Payment (NZ DRP)
• Disaster Recovery Allowance (DRA)

QMOs are allocated these work items for quality checking through Workload Management (WLM). They receive allocations aligned to their:

• skillset (the type of work they are skilled to do), and
• business and technical knowledge in the work type

Emergency claims are quality checked using Integrated QMA. When completing a check, this means that QMOs will:

• have the QMA Processing button greyed-out under the More Options button
• complete the quality check by:
• selecting Next
• moving through screens and/or the workflow with provisional data that has been updated by staff
• using the Task Selector

Emergency claims are checked using 3 different processes depending on the claim type:

Australian Government Disaster Recovery Payment (AGDRP) full claim

AGDRP claims use a question-based workflow to capture the online claim responses. These screens will display as Form on the Super Key.

• AGDRP full claim quality checks contain:
• No Error/Error buttons in the question-based workflow
• no automated processing
• QMOs must:
• assess if all coding is completed correctly
• determine if the claim outcome is correct

Partial Claim Automation (PCA)

PCA is a rules-based automation capability that:

• allows Service Officers to process specific PCA manual actions in a claim
• automates other parts of the claim

A manual action is a decision or update that cannot be made by automation. The automated process needs intervention by a Service Officer to support an outcome.

• PCA quality checks contain manual actions with No Error/Error buttons
• QMOs must:
• assess if the manual action decision is correct
• determine if the claim outcome is correct

New Zealand Disaster Recovery Payment (NZDRP) workflow and Disaster Recovery Allowance (DRA)

NZ DRP and DRA Emergency claims use a question-based workflow to capture the online claim responses. These screens will display as Form on the Super Key.

The question-based workflow within these claim types does not include Integrated QMA checking.

• NZ DRP and DRA workflow quality checks do not contain:
• QMA Action column
• No Error/Error buttons
• automated processing
• QMOs must:
• assess all coding has been completed correctly, and
• determine if the claim outcome is correct
• ensure all errors identified in the NZ DRP and DRA workflows are recorded on the QMA Summary screen.