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

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

If received through:

• HPOS, go to Step 2
• Email or SOC (Scanning Operations Centre), go to Step 8

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:

• provider, delegate acting on behalf of the provider or organisation, see Table 2
• unidentified, go to Step 3
• patient, go to Step 7

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:

• successful, go to Step 4
• unsuccessful, go to Step 5

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 through HPOS by <Sender Name in HPOS> cannot be processed
• AIR forms lodged through 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.

Do not process the form:

• Reply to the individual through HPOS message
• Go to Step 6

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:

‘IM018 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.

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.

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:

• successful, go to Step 9
• unsuccessful, go to Step 11

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 Technical Support Tool (LPS and SSO) - Health Online form and request that an AIR Business Development Officer (BDO) contacts the practice.

LPS to include the below information for BDO referral:

• a copy of the form that prompted the call
• 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?

• Yes, go to Step 10
• No, go to Step 11

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

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