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Process claims in the Australian Immunisation Register (AIR) 011-10100000



View PF in Definitions for more information on using these functions.

On this page:

Check received source location of encounter (IM018) and history (IM013) forms

Process notification of a hepatitis B (Hep B) birth dose

Register and process immunisation encounter/s from IM018 form

Add an encounter to an immunisation encounter claim

Amend manually created header details

Get provider number where details not supplied

Abandon/delete a claim for the AIR

Reject or accept an episode from an individual's immunisation history

Check received source location of encounter (IM018) and history (IM013) forms

Table 1

Step

Action

1

Check received source location on PaNDA + Read more ...

Check the Source Location for the form on the PaNDA work item.

If received via:

2

Check source of form received via HPOS + Read more ...

PaNDA work types configured to receive items from HPOS will display an Open in HPOS button in the top right-hand corner of the Work Item and Document Details screen.

In the PaNDA work item:

  • Select Open in HPOS in top right corner of work item
  • Check Sent for details in Text to see who sent the form:
    • Provider/Doctor - provider's name shows in Sent by
    • Delegate - shows as Sent for provider's name, by delegate's name
    • Organisation - shows as Sent for organisation's name, by delegate's name
    • Unidentified - name in From/Sent by matches patient's name on form or another HPOS user (check this by opening the attachment under File Name)

If the form was sent by:

3

HPOS form sent by unidentified source + Read more ...

Service Officers must:

  • not process AIR Forms submitted by:
    • an individual other than the provider/doctor, or
    • a delegate on behalf of the provider/organisation
  • make one attempt to contact the practice

If contact with the practice was:

4

Contact successful + Read more ...

Do not process the form.

For outbound calls, Service Officers must use the script in Table 2, Step 4 in the Authentication and release of information for Australian Immunisation Register (AIR).

Tell the practice:

  • the form submitted via HPOS by <Sender Name in HPOS> cannot be processed
  • AIR forms lodged via HPOS can only be accepted if submitted by:
    • the provider that signed the form
    • a nominated HPOS delegate, acting on behalf of the provider who signed the form, or
    • an individual acting on behalf of a PRODA organisation
  • to resubmit via Provider/Delegate/Organisation

After successfully contacting the practice, go to Step 6.

5

Contact unsuccessful + Read more ...

Do not process the form:

6

Reply to the individual via HPOS message + Read more ...

To reply to the individual:

  • Select Open in HPOS in top right corner of PaNDA work item
  • Select Reply
  • Open the Z2924 HPOS text template (Notepad document)
  • Copy the message into the Text field
  • Add the individual's (sender’s) name and relevant form number

Attach infographic (see the Resources page for the AIR form upload infographic)

  • Save the infographic to a file of choice
  • Select Choose File and go to where the infographic was saved
  • Select Open - file can be seen next to 'Choose File'
  • Select Add File - make sure the correct file is attached, if not, select Remove and search again

Finalise Message

Double check the attachment, message and names are correct:

  • If not correct:
    • Select Cancel
    • Confirm cancellation
    • Start again
  • If correct - Select Send

Add comments in PaNDA:

‘IM081 form submitted by <person name> has been returned as not sent via correct delegation channel.

Called practice and spoke to <name> and advised to resubmit using correct HPOS delegation.’

‘Attempted to contact practice/provider on <date/time> no answer. Returned form via HPOS messages ref <HPOS reference number from PaNDA (for example, 123456789-1)’

Mark the work as complete in PaNDA.

Procedure ends here.

7

HPOS form sent by patient, other or unable to contact practice + Read more ...

Do not process the form.

  • Send the form back to the patient with Z2334 standard letter
  • Add comments in PaNDA and mainframe. 'Form submitted by (patient/unknown person), returned with letter'
  • Check the correct Medicare number and provider number have been saved on the PaNDA work item
  • Upload/Add letter to PaNDA work item
  • Complete the work item in PaNDA

Procedure ends here.

8

Form received via email or SOC + Read more ...

Service Officers must:

  • Make one attempt to contact the practice
  • For outbound calls, use the script in Table 2, Step 4 in the Authentication and release of information for Australian Immunisation Register (AIR)

If contact is:

9

Confirm if the practice sent the form + Read more ...

Advise the practice contact person, when manual forms are received, Services Australia contact them to confirm if they sent the form.

Use this time to promote digital options.

If the Service officer is:

  • internet trained:
    • promote the AIR digital options available
    • if the contact person is not available, arrange another time to call back
  • not internet trained:
    • offer to transfer them to the AIR Internet helpdesk, or
    • give the practice the phone number

If the promotion of digital options generates a negative response, complete a Local Peer Support (LPS) referral form and request that an AIR Business Development Officer (BDO) contacts the practice.

Attach a copy of the form that prompted the call and include in referral form:

  • It is a manual lodgement of form, (email/SOC)
  • Provider number
  • Name of practice
  • Name of the contact person the Service Officer spoke to
  • Initial conversation/outcome
  • Reason for not submitting digitally

Did the practice contact confirm that they sent the form?

10

Provider signed the form + Read more ...

Has the provider signed the form or completed the declaration section in full?

  • Yes:
    • Add comments in PaNDA and mainframe - 'Confirmed with <name> (doctor/nurse/receptionist) form sent by practice'
    • Process the form, see Table 3
  • No:
    • Confirm it was completed by a provider and sent manually
    • Add comments in PaNDA and mainframe - 'Spoke to <name> (doctor/nurse/receptionist) and confirmed form completed and sent by practice'
    • Process the form, see Table 3

Note: if the form is:

  • received via email and it is clear the practice sent it, see Table 3
  • only for notifying of hepatitis B birth dose, see Table 2

11

Unable to contact practice or confirm sender + Read more ...

If the Service Officer is unable to determine if the practice sent the form:

  • return the form to the patient with Z2334 standard letter
  • add comment in PaNDA and mainframe - Unable to confirm who sent the form, returned with letter to patient
  • check the correct Medicare number and provider number have been saved on the work item
  • complete work item in PaNDA. See Work Optimiser for staff

Process notification of a hepatitis B (Hep B) birth dose

Table 2

Step

Action

1

Notification by individual or form type + Read more ...

If the notification of a Hep B birth dose is:

2

Pre-processing checks + Read more ...

If an individual requests that the vaccination be shown on an immunisation history statement and the Hep B birth dose flag on AIR mainframe is:

  • already recorded, Service Officers can use the information shown in the flag (date given and notifying provider) to enter the Hep B birth dose as an encounter. See Table 3
  • not recorded, refer the individual to their vaccination provider to add the vaccine to the AIR. Procedure ends here

3

Determine form type + Read more ...

For the:

4

Process the Hep B encounter from the IM018 form + Read more ...

The Hep B birth dose can show on the AIR immunisation encounter form (IM018) form in 2 ways, by completing:

In AIR mainframe:

  • Key YIAM - the Create/Amend Header Register Manual Claim screen displays
  • Key the following:
    • Information provider number
    • Claim ID (add 'X9' in front of 5 digit 'P' number) (for example, for P number P22221 the Claim ID will be X922221)
    • 1 in the Quoted Number field
    • Receipt date (date form signed)
    • Immunisation date (date noted at question 8)
  • Press [Enter] - the message PF9 TO UPDATE displays
  • Press [PF9 - UPDATE]. The YXCB - Individual Selection screen displays
  • Key the individual’s details by using the Medicare number or the individual’s details on the form
  • Press [Enter] - the YXCB - Individual Selection screen displays
  • Key (/) to select the individual
  • Press [Enter] - the YIAE - Encounter Details screen displays
  • Press [Enter] - the message PF9 TO UPDATE displays
  • Press [PF9 – UPDATE]. The YIAN - Antigen Details screen displays
  • Antenatal field – leave blank
  • Key the vaccine code in the Vaccine Code field
  • Key B in the Dose field if given in first 7 days after birth
  • key the batch number
  • key the vaccine type code (NIP or OTH)
  • key the route of administration code in the relevant field (if supplied):
    • PO – Oral
    • SC – Subcutaneous
    • ID – Intradermal
    • IM - Intramuscular
  • Press [Enter] and [PF9] to update

Register and process immunisation encounter/s from IM018 form

Table 3

Step

Action

1

Check immunisation history + Read more ...

Display immunisation history.

To display any recorded vaccinations, log on to AIR mainframe then:

  • Key YCUI anywhere on a blank screen
  • Press [Enter] - the Registration Amendment Search screen displays
  • Key Medicare number or individual's details from form
  • Press [Enter] - the Amendment Registration screen displays
  • Press [PF14] - (shift + [F2] to go to the YIRD - Episode History-Basic screen

2

Check for any duplicate encounter/s + Read more ...

Check the immunisation history.

Has the immunisation information already been recorded?

  • Yes, and it is for:
    • the same claim ID or immunising provider number as the one already recorded, do not process
      Record a comment in PaNDA notes - 'Duplicate encounter - not processed' Finalise the document as per Workload Management (WLM) processing guidelines. See Work Optimiser for staff
      Procedure ends here
    • a different claim ID or immunising provider number, see Process pended claims in AIR
  • No, go to Step 3

3

Create and record an immunisation encounter + Read more ...

In AIR mainframe:

  • Key YIAM
  • Press [Enter] - the Create/Amend Header Register Manual Claim screen displays
  • Key the following:
    • Information provider number
    • Claim ID (add 'X9' in front of 5 digit 'P' number) (for example, for P number P22221 the claim ID will be X922221)
    • 1 in the Quoted Number field
    • Receipt date (date form signed)
    • Immunisation date (date noted at question 8)
  • Press [Enter] - the message PF9 TO UPDATE displays
  • Press [PF9 - UPDATE]. The YXCB - Individual Selection screen displays
  • Search for the individual by using the Medicare number or the individual's details on the form
  • Press [Enter] - the YXCB - Individual Selection screen displays
  • Key (/) to select the individual
  • Press [Enter]. The Encounter Details screen displays
  • Press [Enter] - the message PF9 TO UPDATE displays
  • Press [PF9 - UPDATE]. The YIAN - Antigen Details screen displays
  • Key Y or N in the Antenatal field (if the individual is female aged 10-65 years)
  • Key the vaccine code in the vaccine Code field
  • Key dose number in the Dose field
  • Key the batch number in the batch number field:
    • some vaccines have a lot number instead of a batch number
    • if so, key the lot number in the batch number field
  • Key the vaccine type code in the Vaccine type field
  • Key the route of administration code in the relevant field (if supplied)
    • PO – Oral
    • SC – Subcutaneous
    • ID – Intradermal
    • IM - Intramuscular
  • Press [Enter] and [PF9] to update

Note: for all NIP, COVID-19, influenza, or Japanese Encephalitis virus (JEV) vaccines, Service Officer must attempt one outbound call to the provider if:

  • Question 8 on the IM018 form is not completed, and the individual is female aged 10-65 years inclusive
  • the batch number is not recorded
  • the vaccine type is not recorded
  • the route of administration is not recorded (for all JEV or the Jynneos brand smallpox vaccines only)

If contact is unsuccessful, return the form as incomplete with the Z2334 standard letter.

For multiple encounters, go to Step 4.

Note:

  • If error message is returned, see Table 5 on the Resources page
  • If amendments to header details are required, see Table 5

4

Multiple encounters + Read more ...

To locate individual:

  • Press [PF15] - the YXCB - Individual Selection screen will display
  • Key Medicare card number (if available), or
  • Personal details such as:
    • surname
    • given name
    • gender
    • date of birth
    • postcode (optional)
  • Press [Enter] - the YIAE - Encounter Details screen displays when a unique match or list of possible matches displays on the YXCB - Selection screen
  • Select (/) the match from the list to display the YIAE - Encounter Details screen

5

Determine if the individual is located + Read more ...

Is the individual's record located?

  • Yes, go to Step 7
  • No,
    • The message Amend search details or PF10 to add child displays, or
    • List of possible matches found. Scroll list to check for a match
    • Search Medicare CDMS for the individual. If the individual cannot be found, add the individual to the AIR by creating a SIN (Supplementary Identification Number) record
    • go to Step 6

6

Add new individual + Read more ...

To add the individual:

  • go to the YXCB - Selection screen, remove Medicare number if present
  • press [PF10] - new child or individual to the AIR as a SIN record

When adding an individual, key:

  • a Medicare address, or
  • an address supplied by the provider, and
  • the individual’s gender

7

Update and record vaccines + Read more ...

To record vaccination details:

  • Key the date the immunisation was given in the Date field
  • Press [PF9] to update
  • Key antenatal status (if applicable), vaccine code, dose, batch number, vaccine type and route of administration codes in relevant fields on the YIAN - Antigen Details screen
  • Press [Enter]
  • Check that there are no pends by looking for an A in the ST field and 00 in the Pend Count field. If there are pends, action pended antigen with appropriate action code
  • If all vaccines have an A status, press [PF9 - UPDATE] - the YIAE - Encounter Details screen displays
  • Finalise the document as per processing guidelines

Note: if recording a hepatitis B birth dose from the immunisation encounter form, key B in the Dose field if given to a child up to 7 days of age.

See AIR system for a list of vaccine code names or place cursor on VACC field and select [PF1-HELP] to display a list of vaccine codes.

8

Update indigenous details + Read more ...

Check the Medicare CDMS personal tab

Are the details listed on Medicare CDMS?

  • Yes, do not update the record
  • No:
    • Key YCUI anywhere on a blank screen - the YCUI - Registration Amendment Search screen displays
    • Key Medicare number or individual's details
    • Press [Enter] - the YCUA - Amendment Registration screen displays
    • Key Y in the Indigenous field
    • Press [Enter] - the message PF9 TO UPDATE displays
    • Press [PF9 - UPDATE] - the message update successful will display
    • Procedure ends here

Add an encounter to an immunisation encounter claim

Table 4: claims can include multiple encounters (vaccines) given over multiple service dates. Note: it is not possible to add an encounter to IDI, API, or WEB (online) claims.

Step

Action

1

Add encounter to claim + Read more ...

Is the Service Officer still in the encounter claim, having previously added vaccine details?

  • Yes:
    • Select [PF15 - NEW ENC] to add next encounter
    • Key vaccines, press [Enter] and action any pends
    • Select [PF9 - UPDATE] to finalise
  • No, go to Step 2

2

Access processing screen in AIR mainframe + Read more ...

To access the Immunisation Encounters screen:

  • Key YIEM
  • Press [Enter] - the YIEM - Immunisation Encounters Menu screen displays
  • Key option 2 - Claim Selection (Encounter Processing) (YICE)
  • Press [Enter] - the YICE - Claim Selection (Encounter Processing) screen displays

3

Enter claim details + Read more ...

To search for claim details:

  • Key provider number
  • Key claim ID
  • Press [Enter]. Claims entered previously with these search criteria will display

Amending the Rcpt Date From and To fields narrows the search.

4

Select claim + Read more ...

To select claim details

  • Key (/) in the Cursor field to select correct claim
  • Select [PF15 - ADD ENCTR] - the YXCB - Selection screen will display

5

Record encounter and finalise + Read more ...

To record encounter:

Amend manually created header details

Table 5

Step

Action

1

Locate the claim header to amend + Read more ...

To locate the claim:

  • Key YCUI anywhere on a blank screen
  • Press [Enter] - the Registration Amendment Search screen displays
  • Key Medicare number or individual's details from form
  • Press [Enter] - the Amendment Registration screen displays
  • Press [PF14] - (shift + [F2)] the YIRD - Episode History-Basic screen displays

2

Select claim to be amended + Read more ...

To select claim in the YIRD screen:

  • Key (/) next to claim to be amended
  • Press [PF5] – the YIAE Encounter details screen displays
  • Press [PF4 - Claim] – Claim selection screen displays
  • Key (/) next to claim to be amended
  • Press [PF17 - Upd Header] - (shift + [F5]) - the Create/Amend Header Update Header Details screen displays
  • Message Key/amend header details displays

3

Amend header + Read more ...

Only unprotected fields can be updated, (e.g. immunising provider number and immunisation date).

Update details as required:

  • Press [Enter] - the message PF9 to update displays
  • Press [PF9] to update - the YICE - Claim Selection Encounter Processing screen is displayed and details are updated

Get provider number where details not supplied

Table 6

Step

Action

1

Check date of service corresponds with vaccination date to possibly get provider number + Read more ...

Check individual's Medicare history in AIR mainframe to see if a date of service that corresponds to the vaccination date can be found:

Key anywhere on blank AIR mainframe screen type.

  • NHSI
  • (,) comma
  • Medicare number
  • (,) comma
  • Medicare individual reference number
  • Press [Enter] - the Medicare - Patient History screen appears

2

Determine if corresponding + Read more ...

Is a corresponding date found?

3

Search for provider contact number + Read more ...

Using the provider number shown against the relevant date of service:

For outbound calls, Service Officers must use the script in Table 2, Step 4 in the Authentication and release of information for Australian Immunisation Register (AIR).

Can the provider be contacted?

4

Advise encounter form not received and ask if provided immunisations + Read more ...

Tell the provider more information is needed to process the immunisation data.

Did they provide the immunisations in question?

5

Record as history form claim or note information + Read more ...

6

Unable to determine provider number + Read more ...

Abandon/delete a claim for the AIR

Table 7: only abandon a claim if:

  • a payment to the provider has not been made (for encounter claims only)
  • a claim has been recorded and the incorrect provider information has been keyed or the header information has been keyed twice. Note: identifying a claim as being keyed twice, the claim sequence number is 002

    Step

    Action

    1

    Access Immunisation Encounters menu + Read more ...

    Log into AIR mainframe

    To access the Immunisation Encounters menu:

    • Key YIEM
    • Press [Enter] - the YIEM - Immunisation Encounters Menu screen displays

    2

    Access processing screen + Read more ...

    To access Abandon Claim screen:

    • Press [PF6] - Abandon claim
    • Press [Enter] - the YICA - Abandon Claim Processing screen displays

    3

    Locate list of claims + Read more ...

    To locate claim to abandon:

    • Key provider number
    • Key claim ID (an asterisk * is required after claim ID if abandoning a history form claim)
    • Press [Enter] - a list of claims matching the search criteria displays

    4

    Select claim(s) to abandon + Read more ...

    To select claim to abandon:

    • Select (/) claim to be deleted
    • Press [PF21] - Abandon - the message press PF23 to confirm abandon displays
    • Press [PF23] - CONF ABDN to complete the process. The message claim abandoned successfully displays and the claim disappears from the screen

    More than one claim may be abandoned at the same time.

    Reject or accept an episode from an individual's immunisation history

    Table 8

    Step

    Action

    1

    Enquire on immunisation history + Read more ...

    2

    Select episodes to reject or accept + Read more ...

    To select an episode:

    • Select (/) the relevant episode
    • Press [PF6] - Antigen - the YIAN - Antigen details screen displays

    3

    Reject or accept an episode + Read more ...

    To reject or accept an episode:

    4

    Delete vaccine dose + Read more ...

    To reject the episode:

    • Delete vaccine dose from relevant antigen. Do not delete the vaccine code
    • Press [Enter] - the message Vaccine code and vaccine sequence number must be present displays and the Status field displays as P

    5

    Update the Status field and finalise processing + Read more ...

    To process a P status episode:

    • Key R to replace the P
    • Press [Enter]
    • Key Z to replace the R
    • Press [Enter]
    • Press [PF9] to update - the message Update processing complete displays

    Episodes at Z status appear on AIR mainframe but do not display on immunisation history statements.

    Procedure ends here.

    6

    Update the Status field and finalise processing + Read more ...

    To accept an episode:

    • Key C to replace the current status
    • Press [Enter]
    • Key Y to replace the C
    • Press [Enter]
    • Press [PF9] to update

    Immunisation history statements will only show accepted episodes at Y status.

    Procedure ends here.