Mail process and Work Optimiser - Medicare Compensation Recovery 011-15070020

The Medicare Compensation Recovery mailbox receives:

• hardcopy mail, which is scanned by Service Officers through the Multi-Function Device (MFD) and emailed to the Medicare Compensation Recovery mailbox, see Table 1.
• facsimiles which are automatically converted to email, and
• emails, usually with attachments

Kofax software automatically captures and identifies incoming correspondence received in the Medicare Compensation Recovery mailbox and stores it to FileNet.

Emails and attachments are:

• converted to portable document format (PDF)
• batched and named by the form with the highest priority
• assigned to MCRS Enquiry cases, and
• allocated to Service Officers for processing in MCRS through Work Optimiser - Health

Note: if a single document contains information for multiple claimants and claims, it must be:

• manually redacted for each claim, and
• resent to the mailbox as separate documents, See Table 1

See the Correspondence types and KOFAX labelling priority table for details about:

• processing and assessing incoming correspondence, including
• how to access work, and batch document names when more than one is received in a single MCRS Enquiry case

Where an email (size, links or imbedded info) or attachments (file type) cannot be recognised by Kofax, the message and attachment/s are sent to the MCRS Rejections mailbox.

Kofax will:

• recognise and action emails and their attachment/s when one of the following email attachment file types are used:
• PDF
• JPG
• PNG
• TIF
• TIFF
• BMP
• GIF, and
• TXT
• accept most file types of DOC and DOCX depending on how much rich content the document contains, for example:
• bold
• underline
• colours
• fancy fonts, or
• custom formatting
• most likely reject file types that are:
• ZIP
• HEIC, or
• ACCDB

Note: the total size of the email including attachments should be less than 5MB. This reduces the risk of customers providing large documents, especially when using the photo function to take a photograph of the document/s

Kofax will not action emails or attachments that contain:

• embedded images or videos and/or URLs (email or web addresses)
• 'read receipt' requests
• links to documents stored in online storage facilities like Dropbox or Google Docs
• attachments that are password protected/encrypted or in a WinZip or RAR file

Emails containing any of these will be moved to the MCRS Rejections mailbox.

The MCRS Rejections mailbox must be checked daily to action each rejected email, See Table 2.

Where possible, attachments are converted enabling them to be read by Kofax, and then sent to the Medicare Compensation Recovery mailbox. If this is not possible, an email will be sent to the original sender telling them to resend the information, noting the above rules to minimise the possibility of email rejections.

Most remittance advice emails have details listed in the Email extraction list. Kofax often assigns remittance advices to claims in MCRS. Instructions on the Medicare Compensation Recovery Notice of Judgment or Settlement form (MO022) form tells stakeholders that they must send remittance advices to the Compensation finance mailbox, not to the Medicare Compensation Recovery mailbox.

Service Delivery staff do not action remittance advices unless the advice has only been sent to the Medicare Compensation Recovery mailbox and not sent to the Compensation finance mailbox.

If a remittance advice has only been sent to Medicare Compensation Recovery, See Table 5.

If multi-remittances are allocated to an enquiry in MCRS, Service Officers must follow the unlinking documents or manually separate email correspondence process. Do not add multi-remittances to claims for privacy reasons. See Process Correspondence - Medicare Compensation Recovery.

If Kofax is unable to determine the appropriate work-step for the correspondence, the work is allocated in Work Optimiser as an 'unclassified document'. Unclassified documents may include documents and forms:

• intended for Medicare Compensation Recovery for action
• not intended for Medicare Compensation Recovery, and
• for other programs or agencies. For example:
• Medicare Disclosure
• Subpoena Team
• Centrelink Compensation Recovery
• National Disability Insurance Scheme (NDIS)
• Department of Veterans' Affairs (DVA), or
• Medicare Public

Medicare Compensation Recovery do not action correspondence that is not intended for the program, with the exception of subpoenas. When correspondence is received that is not intended for the program, an automated response is sent to all senders (maximum once per day, per sender) to:

• confirm receipt of their email, and
• tell the sender that no action will be taken with the correspondence

See Authority to access a claim - Medicare Compensation Recovery.

Kofax searches for and extracts the following details from incoming emails:

• Form code:
• Kofax will search the bottom left corner of each page
• If Kofax identifies more than one form code, it will label the whole batch based on highest priority. See Correspondence types and Kofax labelling priority table
• Work item number (WIN):
• Kofax will search whole pages for text which matches the format of a WIN (9 characters - 8 numbers and an alpha)
• If a document has more than one WIN, Kofax will use the first WIN identified

A form code extraction allows the document batch to be named based on the form code with the highest priority. The extracted WIN can be searched for in MCRS.

Note: errors in WIN extraction may occur if:

• there are multiple WINs, or
• handwritten WINs cannot be read

If the WIN has been misread, details of the attachment/s can be updated to link to the correct WIN during the Enquiry case, before it is finalised. See Claim Management - Medicare Compensation Recovery.

Once hard copy documents have been scanned and emailed to the Medicare Compensation Recovery mailbox, retain hard copies for 70 days and then securely destroy.

Hard copies are securely stored in archive boxes in order of date of receipt. Archive boxes must be labelled with the date period covered, relevant to the documents in the box, in line with the Medicare Public scanned document retention schedule.

If a scanning error of a document is identified during processing, for example, a page is missing from a scanned statement, Service Officers should locate the document from the archives and re-scan them using a Multi-Function Device (MFD), see Table 2.

Medicare Compensation Recovery uses Work Optimiser - Health to allocate work items created by MCRS.

Work Optimiser - Health automatically allocates work items for MCRS to staff (inclusive of Service Officers, APS5, Team Leaders, Program Management)for action based on:

• security roles assigned in ESSentials
• skill tags assigned in ESSentials
• work type processing priorities determined by Operational Planning Health, Integrity and Child Support Branch (OPPLNHIC)

MCRS creates work items for allocation in Work Optimiser - Health when:

• an email is received (Kofax, FileNet and MCRS - see Preparation for processing)
• a work item requires a decision by a staff member with a different skill tag or higher delegation level
• a work item needs to be reassigned after being worked on by a staff member with a different skill tag or higher delegation

For:

• information about how to access MCRS and Work Optimiser - Health, skill tags and work types, see Medicare Compensation Recovery System (MCRS)
• instructions on how to use Work Optimiser - Health for MCRS, see Table 4
• general information about how to manage work in Work Optimiser - Health, see:
• Work Optimiser for staff
• Work Optimiser for Team Leaders and Analysts
• Work Optimiser for Analysts