Claim management - Medicare Compensation Recovery 011-15040010

This process covers the enquiry work steps:

• Check Medicare
• Check existing compensation
• Evaluate

Is the enquiry an inbound call?

• Yes, Authenticate the customer, see Table 1 in Enquiries and authenticating a customer - Medicare Compensation Recovery
• No, go to Step 3

The work item will open in a new MCRS Enquiry case.

• Select the icon on the right side of the screen to expand the utility pane, if not already open
• Review all attached documents from the Files and documents section
• Select the hyperlink to open and review each document
• See Process Correspondence and Document Assessment to assess incoming correspondence

Is the enquiry on the Check Medicare screen?

• Yes, go to Step 4
• No,
• Kofax has identified a WIN, case will be at Evaluate screen. See Email extraction in Mail process and Work Optimiser - Medicare Compensation Recovery
• Go to Step 6

• Key search parameters into the available fields in MCRS. For example:
• First name
• Family name, and
• Date of birth
• Select Search. A list of matches will display, if available
• Select the Medicare card hyperlink to view the Consumer details screen such as entitlements and address history to help identify a match

Note:

• if search is only by Medicare card number, all persons listed on the card will return in the result, make sure to select the correct injured person
• using fewer search parameters will create a wider search and more potential matches will return
• if only one member is listed on the Medicare card MCRS will move to Check existing compensation screen

Search results - is there a match to the name, date of birth and address?

• Yes, go to Step 5
• No, go to Table 5

• Select the button next to the injured person that matches the enquiry
• Select Continue

Was an existing claim identified that matches the date of injury and description?

• Yes, go to Step 7
• No, go to Table 3

To perform a search from Check existing compensation screen

• Select the Basic or Advanced link to manage search parameters.
  Note: if the notifiable person for the claim is known, use Advance search to narrow the search and return less results
• Select Search. A list of potential matches will present
  Note: doing a search through the WIN will display a hyperlink for the WIN and the Medicare card number.

Was an existing claim identified that matches the date of injury and description?

• Yes, go to Step 7
• No, go to Table 3

• Select the WIN hyperlink to view Summary of claim information. The Summary of claim helps to identify if the correspondence is about:
• an existing claim, or
• a new claim that needs to be registered
• Check the claim status in the top middle of the window, see Table 4 on Resources page in Medicare Compensation Recovery System (MCRS), if an:
• Active claim or a Sleeping claim was created in CCMS, staff must migrate it to MCRS to continue to process the claim. Go to Table 2
• Active-Provisional or Active-Standard claim was already migrated or created in MCRS, proceed through Step
• For claims with:
• matching details, select the button next to the WIN that matches the enquiry, select Continue
• no matching WIN, register the claim, go to Table 3

Note: staff cannot reopen terminated claims in MCRS. Staff can only reopen claims that were finalised and closed because of a:

• Notice of judgement or settlement (NOJS), or
• Notice of reimbursement arrangement (NORA)

• Select a document type from Please choose the document type dropdown menu
• Depending on which document type has been selected, questions vary, for:
• an Enquiry case (document assessment) allocated from Work Optimiser - Health, go to Step 9
• documents attached to a Notice of judgment or settlement (NOJS) enquiry, see Notice of judgment or settlement (NOJS) - Medicare Compensation Recovery

Note: Service Officers must select the higher priority document from the dropdown menu if more than one document is received for a single MCRS Enquiry case.

The following questions appear for a work item (document assessment). Staff should select the relevant button to confirm.

Does the Medicare customer selected match the injured person named in the document?

• Yes, select this button to turn on Summary of existing compensation details
• No, select the Check Medicare link to locate the correct record for the injured person

Does the claim selected match the details in the documents?

• Yes, select button and continue
• No, select the Check existing compensation link to search for the correct claim. If the date or description of injury/illness does not match, go to Table 4

Are the documents received incomplete?
Note: this question does not appear if Statement by claimant is selected as the document type.

• Yes, select this button to issue either a:
• You do not need to tell us about the compensation claim/reimbursement arrangement (Z2797) letter, or
• We are unable to process (Z2802) letter
• For more details see Table 8 in Process Correspondence - Medicare Compensation Recovery

Is this duplicate correspondence?

Select this button to record the document as a duplicate so that no further processing occurs on this work item.

Is update to existing details required?

Select this button to update details on the claim. For example, a sensitive category is identified or address update for injured person is required. Go to Table 4.

Is an extension to be processed?

• This question allows Service Officers to:
• decide to grant or refuse a request for an extension of time to submit a statement, and
• issue an Extension of period to give a statement (Z2804) letter

Do you want to refuse to issue a Notice to claimant (NTC)?

Select this button to refuse to issue an NTC

See Extensions, decisions and reviews - Medicare Compensation Recovery

Do you want to refuse to issue a Notice of past benefits (NOPB)?

Select this button to make the decision to refuse to issue a NOPB or Notice of charge and to issue a Notice of refusal (Z2806) letter.

Re-capture the NOJS details?

Select this button to recapture Notice of judgment or settlement (NOJS) details which have previously been entered. See Notice of judgment or settlement (NOJS) - Medicare Compensation Recovery

Is the Claimant removing previously verified services? Or responding to a S23B notice?

Go to Step 11.

Escalate options

Used escalate claim to Program Management or APS5. For more information on when to select these buttons see Escalations - Medicare Compensation Recovery.

To add a case note, see Table 6.

• Select Continue
• A message displays that will take the Service Officer to the next stage of processing, if required
• Procedure ends here

To migrate a legacy claim if:

• found through an Enquiry case search, go to Step 2
• woken up after being pended, go to Step 3

Note: if a claim is located from a telephone enquiry, authenticate the customer, see Table 1, in Enquiries and authenticating a customer - Medicare Compensation Recovery

Select the compensation claim to be migrated:

• Select the button next to the work identification number (WIN), to migrate
• Select Continue. MCRS displays a banner, This claim is a legacy claim - if migrated it must be reviewed and updated.
• The claim to be migrated will have a status of:
• Active (unmigrated)
• Sleeping (unmigrated), or
• Closed (unmigrated)
• If the claim is closed staff will only be able to reopen based on the document type that was used to close the claim originally
• If staff access a closed claim, the claim will reopen at update. However, at the Review page staff will be able to close the claim again when prompted by MCRS.
• A claim can also be closed using the Close Claim option from the Actions dropdown menu. However, if the case is not finalised any changes made will not be saved.

Select a document type from Please choose the document type dropdown menu.

If migrating a claim due to a new document that needs processing, select the document type received, for example Notice of past benefits request, Notice of judgement or settlement or Notice of reimbursement arrangement, or Other - all other documents if the form type is not available. Proceed to update the claim.

Note: never select Phone enquiry from the Document type dropdown menu for this scenario, as any documents on the enquiry will fail to link to the claim.

The following questions display for a work item (document assessment). Select the relevant button to confirm.

Does the Medicare customer selected match the injured person named in the document?

• Yes, select the button and a summary of Existing compensation details displays
• No, select the Check Medicare link to locate the correct record for the injured person

Does the claim selected match the details in the documents?

• Yes, select the button to confirm, go to Step 5
• No, select the Check existing compensation link to search for the correct claim

• Select Continue or Reopen
• A message displays, ‘This claim is a legacy claim - if migrated it must be reviewed and updated’
• Select Yes

Staff must update the addresses for all parties on a legacy claim, Rapid Addressing should be used to update addresses, unless the address suggested is different to that provided on the document.

• Check the details are correct
• Select Clear to delete the legacy address
• Key the address update if required

• Check the details are correct, update if needed
• Declaration signed and dated - must be the signature date of the first valid document that was used to register the claim
• Date received - is the date of email receipt or mail room stamp on physical documents received through Australia Post. This is the date of the receipt for the first valid document that was used to register the claim
• Authorisation start date - for the injured person’s authorised third party, on the Claimant screen must be the receipt date of the first valid Third party authority (MO021) received for the claim
• Sensitive indicator - has a sensitive situation been identified? Turn on Sensitive indicator button and select appropriate category. See sensitive categories on Resources page
  Note: assigning the Deceased, BPA, Staff, or High Profile sensitive indicator will label the claim for Program Management action only. If a Sensitive indicator needs to be added without an update to the claim, go to Table 9
• Check if the written authority is saved in documents (Court document, Medicare card or MO021) for each claimant
  Note: if there is no authority on file, remove the solicitor details from the claimant section
• Select Continue
  Note: existing claimant details will default into the Claimant fields. If the claimant is the injured person, a separate claimant entry for that person is not required and should be removed
• Make sure that all addresses are re-entered using the Rapid Addressing

Is there evidence of a Public Trustee/private trustee/legal representative/guardian/parent acting as claimant, and a valid Authorised Third party (provided a valid Third Party authority (MO021) form)?

• Yes, proceed through the update flow:
• On the Capture claimant details screen, select Add claimant
• Select the appropriate category from the Relationship to injured person menu (Parent, Guardian, Power of attorney, Legal representative, Public trustee, Authorised third party)
• Authorisation start date - key the date of receipt of the document
• Key Business name, Reference number (if trustee or authorised third party), Address and Contact details. If parent, guardian, legal representative or power of attorney is provided as claimant, key their Family name, First name, Address and Contact details
• If the Public Trustee/private trustee/legal representative/guardian/parent are authorised to receive the refund, select the Claimant is the refund recipient button and the Refund authority indicator button. Key Account details, if provided. This option is not to be used for an Authorised Third Party
• If more than one claimant exists, select Add claimant again. Then repeat the previous 3 points to add additional claimant details. Up to 3 claimants can be added
• Select Continue
• No, select Continue, go to Step 8

Claim status updates to Active Standard claim

Does the Notifiable Party appear on the Bulk Payment Agreement (BPA) list?
See Resources page for the BPA list:

• Yes, go to Table 9
• No, if processing:
• an SBC only on a migrated claim see Table 5 on Process page in Statement by claimant (SBC) - Medicare Compensation Recovery
• an SBC and NOJS on a migrated claim go to Notice of judgment or settlement (NOJS) - Medicare Compensation Recovery
• a NOPB request, see Notice of past benefits request and Notice to claimant (NTC) - Medicare Compensation Recovery

This follows on from, Table 1 > Step 6

• Do not select a button for an existing work identification number (WIN)
• Select Continue

• Select a document type from Please choose the document type dropdown menu
  Note: if the document received is a/an:
• S23A Statement (MO023) form without a Notice of judgement or settlement (MO022) form, Select Notice of judgement or settlement as the form type
• Third party authority (MO021) form or Banck account details collection (MO024) form on its own, select Notice of past benefits request as the form type
• Select the relevant button to confirm, Does the Medicare customer selected match the injured person named in the document?
• Go to Step 3

• To create a provisional claim or register a new claim select the relevant buttons to confirm information received
• Based on the selections in Step 2, MCRS will notify of the registration status.
  This will be:
• Invalid
• Create a provisional WIN, or
• Register a new case

Note: to create a Provisional WIN, either the injured person's name and address or the injured person's name, notifiable person name (business name only), and address are required. If no address is provided for either party, the document is invalid, and no letter will be sent. In this instance, call the sender to notify them of the invalid document. Key National Compensation Recovery Information (NCRI) notes against the injured person’s record.

While the buttons in the Evaluate section provide information about whether a claim is Provisional or Active Standard, it does not definitively determine the final nature of the claim. Regardless of whether the button shows Create a Provisional WIN or Register a new claim, the details recorded in the Capture screens are more crucial.

In Capture complete all date fields to create an Active standard WIN

If a mandatory data field is blank, a Provisional WIN will be created. If not enough mandatory information is provided and a provisional claim is needed:

• leave the Declaration button turned off on the Evaluate screen, and
• do not complete the Declaration field on the Capture injured person details screen

• Key the injured person’s details from the document into the relevant fields
• If applicable, select the relevant button to confirm:
• Only name - if the injured person has only one name
• Claim number - if there is a reference number for the injured person
• Aged care indicator - if the claimant or injured person identifies that care costs are related to the claim
• Description of injury /illness - acronyms and abbreviations must not be used. See Medicare Compensation Recovery
• Sensitive Information Indicators - if a sensitive category is identified, such as terminal illness/injury.
  Note: assigning the Deceased, BPA, Staff, or High profile sensitivity indicator will label the claim for Program Management action only. If a Sensitive indicator needs to be added without an update to the claim go to Table 9
• Use the signature date of the first valid registration document (MO026/MO022/MO027) as the declaration date on the claim
• Do not select the Declaration signed and dated button if the claim is a Provisional registration, BPA, Staff or High profile claim
• Select Continue

Note: information selected in previous work steps auto populate.

Is there a claimant involved in the claim?

• Yes, select Add claimant, to record the claimant details:
• Key claimant details from the document into the corresponding fields
• Select the relationship to the injured person from the dropdown menu
• Add authorisation start date. use the date of receipt of the first valid MO021 relevant to the claim
• If applicable select the Claimant is the refund recipient button to key account information
• If the party is authorised to receive the refund, select the Refund Authority Indicator button
• If more than one claimant exists, select Add claimant again. Then repeat the previous 3 points to add additional claimant details. Up to 3 claimants can be added
• Select Continue
• Go to Step 6

Note: do not add details if there is no valid third party authority form or supporting documents

• No,
• Select Continue
• Go to Step 6

Note: to remove a claimant select Remove next to the Claimant title.

Are the notifiable person's details provided?

• Yes, to record the notifiable person details:
• Select Add notifiable person
  Note: if only an individual’s name is provided, see Table 1 in Notifiable and not notifiable claims - Medicare Compensation Recovery
• Key notifiable person's details from the document into the corresponding fields
• Select Does notifiable person have a solicitor or agent button if the solicitor details are provided on the document. Key details into corresponding fields
• If more than one notifiable person exists select Add notifiable person. Then repeat the previous 3 points to add additional notifiable person details. Up to 2 notifiable parties and their solicitor/representative can be added
• Select Continue
• Go to Step 7
• No,
• Select Continue
• Go to Step 7

Note: to remove a notifiable person select Remove next to the Notifiable person title.

For help contact a Program Support Officer (PSO).

Review the information entered:

• If an error is identified or information is missing, select Edit link beside the relevant section
• Update required information. This will go back through all Capture screens once the required information is updated
• Select Submit
• Go to Step 8

If all required information has:

• been entered, go to Step 12
• not been entered, a warning message displays advising a provisional WIN will be registered

For BPA claims provisionally registered (make sure the Declaration signed and dated button is deselected) Go to Table 9

Has all the provided information been entered?

• Yes,
• Select Yes
• Go to Step 9
• No,
• Select No
• Go to Step 4, and
• Key missing information

Is the document on which the provisional claim registered:

• the S23A Statement (MO023) form received without a Notice of judgment and settlement (MO022) form?
• If so, skip correspondence. When an MO022 is received go to Table 1
• If not, proceed through this step
• a Third party authority (MO021) form or Bank account details collection (MO024) form without any other documents?
• If so, skip correspondence. When an MO022, MO026 or MO027 is received go to Table 1
• If not, proceed through this step

Is the case notifiable?
See Notifiable and not notifiable claims - Medicare Compensation Recovery.

Select Yes or No from the dropdown menu:

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

To issue the We need more information to register a compensation claim (Z2798) letter:

• Select the relevant tick boxes requesting the information/reason claim cannot be registered
• Select the button against the recipient of the letter
• Select the Preview link to view the letter
• Enter a case note advising all actions taken and information received
• Select Submit to send the letter

Procedure ends here.

To issue the You do not need to tell us about the compensation claim/reimbursement arrangement (Z2797) letter:

• Select the claim type from the dropdown menu
• Select the button against the recipient of the letter
• Select the Preview link to view the letter
• Enter a case note advising of all actions taken and information received
• Select Submit to send the letter

Procedure ends here.

The system displays a message advising that one of the following needs to be processed:

• Notice of judgment or settlement (NOJS), see Notice of judgment or settlement (NOJS) - Medicare Compensation Recovery
• Notice of reimbursement arrangement (NORA), see Notice of reimbursement arrangement (NORA) - Medicare Compensation Recovery, or
• Notice to claimant (NTC), see Notice of past benefits request and Notice to claimant (NTC) - Medicare Compensation Recovery

Select Yes on the message.

To issue the 'Information about a compensation claim' (Z2799) letter:

• Select the informant from the dropdown menu
• Select the correct notifiable person button (the recipient automatically selects)
• Select the Preview link to view the letter
• Enter a case note advising all actions taken and information received
• Select Submit to send the letter

Note: MCRS automatically directs the work item to the correct work step.

Assess the case or create a phone enquiry case.

Service Officers processing an existing case assigned through Work Optimiser - Health, go to Step 2, otherwise proceed:

• Select Create and then Enquiry from the left-hand panel on the MCRS homepage. A new enquiry case is created:
• Key the Medicare card number or the injured person’s details on the Check Medicare screen and select Search, or
• Select Continue and enter the work identification number (WIN) on the Check existing compensation screen and select Search
• Identify and select the correct claim
• Select Continue
• Choose the relevant document type from the dropdown menu

Go to Step 2

• Choose appropriate document type from the dropdown menu
• Select the buttons:
• Does the Medicare customer selected match the injured person named in the document?
• Does the claim selected match the details in the documents?, and
• Is update to existing details required?
• Select Continue
• A pop-up message displays Are you sure you want to update the claim?
• Select Yes

Do the injured person’s details need updating?

• Yes, key the injured person’s updated details into the relevant fields:
• Only name indicator - if the injured person has only one name
• Claim number - if there is a reference number for the injured person
• Aged care indicator - if the claimant or injured person identifies that care costs are related to the claim
• Date of injury (DOI) or illness - if the updated DOI is provided on a Notice of judgment or settlement (NOJS), see Table 2 in Document Assessment - Medicare Compensation Recovery. If provided on a Notice of past benefits request form (MO026) see Table 6 in Document Assessment - Medicare Compensation Recovery
• Description of injury or illness - update the injury description, adhering to professional standards see Resources page in Medicare Compensation Recovery. Select the Skip correspondence option to prevent issuing unnecessary letters
  Note: do not use acronyms and abbreviations in injury descriptions
• Declaration date - must be the signature date of the first valid document
• Date document received - of any document type is the date of email receipt or mail room stamp on physical documents received through Australia Post
• Sensitive indicator - if a sensitive category is identified. For example, Bulk Payment Agreement (BPA), terminal injury/illness
  Note: assigning the Deceased, BPA, Staff, or High Profile sensitive indicator will label the claim for Program Management action only. If a Sensitive indicator needs to be added without an update to the claim, go to Table 9
• Select Continue
• Go to Step 4
• No,
• Select Continue
• Go to Step 4

Note:

• before updating an address, staff must select Clear
• Skip correspondence must be selected in every instance if there is an update of injury description from historical abuse to psychological or where a minor update has occurred. For example, correcting spelling errors or expanding abbreviations to full injury description.

If the claim details need an authority to be revoked:

• select Remove to clear the existing claimant details
• Select Continue
• Go to Step 4

Do the claimant details need updating?

• Yes, to update the claimant details:
• Select Add Claimant to enter a new claimant to the record
• Select the relationship to the injured person from the dropdown menu
• Add authorisation start date. Use the date of receipt of the first valid Third party authority (MO021) form relevant to the claim. If updating to a new authorised third party, the new valid MO021’s receipt date must be used
• If applicable select Claimant is the refund recipient to key account details
• If the party is authorised to receive the refund, select the Refund Authority Indicator
• If there is more than one claimant, select Add claimant. Then repeat the previous 3 points to add claimant details, up to 3 claimants
• If all that is required is an update to existing details, key updated claimant details from the document into the corresponding fields
• Select Continue
• Go to Step 5
• No,
• Select Continue
• Go to Step 5

Note: if errors are made, view previous details by selecting Revert to original. This will clear all data entered and details will need to be entered

Is there evidence of a Public Trustee/private trustee/legal representative/guardian/parent acting as claimant, and a valid Authorised Third party (provided a valid Third Party authority (MO021) form)?

• Yes, select Add claimant:
• Select the appropriate category from the Relationship to injured person menu (Parent, Guardian, Power of attorney, Legal representative, Public trustee, Authorised third party)
• Authorisation start date - key the date of receipt of the document
• Key Business name, Reference number (if trustee or authorised third party), Address and Contact details
• If parent, guardian, legal representative or power of attorney is provided as claimant, key their Family name, First name, Address and Contact details
• If the Public Trustee/private trustee/legal representative/guardian/parent are authorised to receive the refund, select the Claimant is the refund recipient button and the Refund authority indicator button. Key Account details, if provided
  Note: this option is not to be used for an Authorised Third Party
• If more than one claimant exists, select Add claimant again. Then repeat the previous 3 points to add additional claimant details. Up to 3 claimants can be added
• Select Continue
• No, Continue, go to Step 6

To update the notifiable person details:

• Refer to information provided on the most recent document. Enter any new details into the corresponding fields
• If solicitor details are provided on the document, select Does notifiable person have a solicitor or agent, and key the details into the corresponding fields
• If there is more than one notifiable person, select Add Notifiable person. Key the details into the corresponding fields. Up to 2 notifiable parties can be added

Does the updated notifiable party appear on the Bulk Payment Agreement (BPA) list?

See Resources page for BPA list.

• Yes, If Program Management have:
• already advised the relevant BPA does not apply go to Step 7
• not advised the relevant BPA does not apply go to Table 9
• No, go to Step 7

• Review the information entered:
• If an error is identified or information is missing, select Edit against the relevant field
• This will go back through all Capture screens, update the required information. Once the required information is updated, select Submit
• A message Are you sure you want to update claim is displayed?, will display, select Yes
• A message Thank you! The next step in this case has been routed appropriately will display, select Exit work item

Procedure ends here

• To issue an Information about a compensation claim (Z2799) letter:
• Select the informant from the dropdown menu
• Select the correct notifiable person
• The recipient is automatically selected
• Select the Preview link to view the letter
• Add a case note to document this process
  Note: for BPA claims only or where a MO021, MO024 or S23a has been received on its own, once submitted, select Skip Correspondence
• Procedure ends here
• Select Submit to send the letter

A message displays Keep assigned to me, or Assign to queue:

• Select:
• Keep assigned to me to action the next work step. Continue to action the work item if proficient, or
• Assign to the queue if not proficient in completing this work. A message advising that the case has been routed appropriately will display
• Select Yes

If the notifiable person appears on the Bulk Payment Agreement (BPA) list, go to Table 9.

• Select the Basic or Advanced link to manage search parameters
  Note: if the notifiable person for the claim is known, use Advance search to narrow the search and return less results
• Select Search. A list of potential matches will present

Was an existing claim identified that matches the injury date and description?

• Yes, go to Table 1 > Step 7
• No, go to Step 2

• Select the Continue button to proceed to Evaluate screen
• Select relevant document type from Please choose the document type dropdown menu

• Select the relevant buttons to confirm information received.
• If mandatory information is missing from the form, deselect the Signature button to create a provisional work identification number (WIN)
• Select Continue

Note: to create a Provisional WIN, either the injured person's name and address or the injured person's name, notifiable person name and address are required. If no address has been provided for either party, the document is invalid, and no letter will be sent.

• Key the injured person’s details from the document into the relevant fields
• If applicable, select the relevant buttons to confirm:
• Only name - if the injured person has only one name
• Claim number - if there is a reference number for the injured person
• Aged care indicator - if the claimant or injured person identifies that care costs are related to the claim
• Sensitive indicator - if a sensitive category is identified such as a terminal injury/illness
• Deselect the Declaration signed and dated button so the date field is not presented
• Select Continue

Is there a claimant involved in the claim?

• Yes, select Add claimant, to record the claimant details:
• Key claimant details from the document into the corresponding fields
• Select the relationship to the injured person from the dropdown menu
• If more than one claimant exists, select Add claimant again. Key claimant details into the corresponding fields. Up to 3 claimants can be added
• Select Continue
• Go to Step 6

Note: do not add authorised third party details where there is no valid Third party authority (MO021) form or supporting documents.

• No,
• Select Continue
• Go to Step 6

Note: to remove a claimant select Remove next to the Claimant title.

Are the notifiable person's details provided?

• Yes, to record the notifiable person details:
• Select Add notifiable person
• Key notifiable person's details from the document into the corresponding fields
• Select does notifiable person have a solicitor or agent button if the solicitor details are provided on the document. Key details into corresponding fields
• If more than one notifiable person exists, select Add notifiable person. Key additional notifiable person details into the corresponding fields. Up to 2 notifiable parties can be added
• Select Continue
• Go to Step 7
• No,
• Select Continue
• Go to Step 7

Note: to remove a notifiable person select Remove next to the Notifiable person title.

• To review information entered:
• select the relevant field, or
• expand all
• If an error is identified or information is missing, select Edit against the relevant field
• Update required information. This will go back through all Capture screens once the required information has been updated
• Select SubmitIf document received was an:
• MO022 form, go to Table 1 > Step 3
• MO026 form, go to Step 8

See Notice of past benefits request and Notice to claimant (NTC) - Medicare Compensation Recovery

• In an Enquiry case, select the plus sign in Case notes in the right hand utility panel, or
• Through Restricted Claim Actions:
• search for the work identification number (WIN), under Search results
• select Actions from the dropdown menu next to the WIN
• select Record case note
• The Add case note window appears

• Select a type of case note from the Type dropdown menu
• Select the most relevant case note heading
• Key any relevant information into the case note
• Go to Step 3

• Document any significant and relevant activity relating to the claim that falls outside of core system processes already recorded in MCRS
• Select Save

Note: a Case note must be added and saved before case is finalised. If not saved before case is finalised an error message will present advising to save case notes before finalising case. Users cannot proceed to submit until this is done. If case note input window has disappeared, select the plus sign from Case notes in the utility panel. Select Add to WIN.

• Select the case note link from the right hand tile titled Case note, or
• Open the View compensation details modal using the work identification number (WIN) hyperlink and access from the Case notes tab

Note: case notes added to an open Enquiry case will show in the Case notes tab once the case note is finalised and saved.

• Select the WIN hyperlink from the left hand menu to launch the View Compensation Details screen
• Select the Case Notes tab from the View Compensation Details screen to view a list of all available case notes
• Select any case note title from the list to view the content of a case note

If no items appear, there have been no case notes recorded on the claim.

Service Officers can also check for case notes by:

• selecting Restricted Claim Actions from the left hand panel and search for the WIN
• locating the WIN hyperlink from the search results
• selecting the Case Notes tab from the View Compensation Details screen to view a list of all available case notes
• selecting any case note title from the list to view the content of a case note

Note: case notes added to an open Enquiry case do not show in the Case notes tab until the Enquiry case is finalised.

If a Service Officer identifies a case note that is incorrect or inappropriate, send an email to a Service Support Officer (SS05), requesting the case note to be amended/deleted.

Information that must be provided on the request email:

• WIN
• Injured person’s name
• Case reference (if applicable)
• Date and time of case note
• Login ID of staff member who completed the original case note
• Actions required (such as remove note, remove specific sections and replace with...)
• If amending a case note include details of the amended case note

• Select Restricted Claim Actions from the left side bar on MCRS
• Select the Search Compensation tab
• Key the WIN into the Work Identification Number field
• From the Actions dropdown menu, select Edit Case Note
• Select the edit icon in the top right hand corner of the case note window
• Amend case note as required, adding at the start 'Case note amended/removed as per request from <Service Officer logon ID>
• Select Save

See Resources page for the list of available sensitive categories.

Is a sensitive indicator update required on the claim?

• Yes, go to Step 2
• No, go to Step 3

Select Is update to existing details required? button, proceed through the Update workflow:

• On the Capture injured person details screen, select the Sensitive indicator button
• Select the relevant category from the Sensitive category dropdown menu
• Continue through the Update workflow, updating relevant details as necessary
• At the Review screen make sure all details on claim are accurate, select Submit
• Select Yes to update popup Are you sure you want to update claim?

Is the sensitive indicator being updated for a Bulk Payment Agreement (BPA)?

• If so, select the Skip correspondence? button on the Set correspondence details screen
• If not, issue correspondence if relevant. Continue. Select Submit to finalise the enquiry case

Is the required Sensitive indicator for a BPA or deceased estate where no executor or administrator can be located?

• Yes, go to Step 4
• No, procedure ends here

• Select RCA through the left hand panel in MCRS
• Select the Search Compensation tab
• Key the Work Identification Number (WIN) into the field below Claim details. Select Search
• When presented with the claim record under Search results, select Actions dropdown menu, then select Set sensitive category
• Select the Sensitive indicator button
• Select the appropriate sensitive category from the list
• Select Submit

Is the required Sensitive indicator for a Bulk Payment Agreement or a deceased estate where no executor or administrator can be located?

• Yes, go to Step 4
• No, procedure ends here

• Capture the WIN
• Return to home screen
• Create a new enquiry
• Add a clear case note explaining any actions taken and that the case requires assessment from Program Management
• Select the Escalated to PM button
• On the pop-up message which displays - Have you provided an appropriate case note and now want to escalate the task to PM? Select Yes
• Select Exit work item to exit the case
• The case will be escalated to PM for review

Procedure ends here