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Escalation process for Medicare Eligibility and Child Dental Benefits Schedule (CDBS) 011-44015000

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This document explains how to escalate a Medicare enrolment enquiry. It also details how to escalate a CDBS enquiry. Medicare Enrolments enquiries are included in First Contact Resolution.

On this page:

Work types processed by each branch

Face to face Service Officer escalation

Smart centre Service Officer escalation

Escalation process for LPS

Escalate an enrolment application for customers that are experiencing hardship or are vulnerable

Escalate a request to copy or transfer a child under 15 years to another Medicare card due to FDV

Escalate a Department of Child Protection (DCP) enquiry

Escalate a CDBS enquiry

Escalate a statutory declaration

Request an International Movement Record (IMR)

Work types processed by each branch

Table 1

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Step

Description

1

Face to face Service Delivery network
  • Enrolment work received from a customer when attending a service centre
  • An urgent request to enrol a newborn using the Newborn Child Declaration (FA081) form
  • A request to process the following enrolments where the customer is vulnerable or in hardship:
    • Customers enrolling in Medicare for the first time
    • A returning resident enrolment
    • Reciprocal Health Care Agreement (RHCA) enrolment
    • Extending Medicare eligibility
  • A CDBS enquiry

If a face to face Service Officer does not have access to the Visa Entitlement Verification Online (VEVO) program, they must submit a request to get access.

In the interim:

  • contact Medicare and Aged Care - Local Peer Support (LPS), and
  • ask for a copy of the customer's VEVO details

LPS will upload the customer's VEVO details to the PaNDA ID.

Service Officers must not escalate an enrolment application because of no VEVO access.

If a face to face Service Officer does not have access to Document Verification Service (DVS), they must:

  • see a Team Leader
  • complete the DVS training package, and
  • submit a request to get access

In the interim, Service Officers should:

  • contact Medicare and Aged Care - Local Peer Support (LPS), and
  • ask for a customer's DVS check to be completed

LPS will provide the DVS result and Verification Response Number (VRN) to the Service Officer.

Service Officers must not escalate an enrolment application because of no DVS access.

2

Medicare Eligibility and Enrolments (MEE) work types

Note: if a Service Officer cannot resolve the enquiry using all available resources, including Operational Blueprint, Communications, and Network News Updates (NNU), they must seek help from LPS. See Tier 0 technical support - self-sufficiency.

If escalation is required Service Officers must:

  • leave appropriate escalation notes in PaNDA
  • include snips of failed DVS results
  • attach VEVO results
  • make sure the work status is open before escalating
  • escalate to MEE LPS for assessment, and
  • not escalate directly to National Office folders in PaNDA, they must seek help from LPS

3

Medicare Eligibility and Enrolments (MEE) Escalated work types

LPS may receive complex eligibility and enrolments work escalated in PaNDA or Workload Management (WLM):

LPS escalate work items to Service Support Officers (SSO) if they identify Medicare Consumers Program Support advice or action is needed. If escalation is required, LPS must see Table 3.

If a work item is reassigned from the Escalations folder for processing, LPS must recategorise the work to the appropriate work type in PaNDA in open status for the next available Service Officer to action.

Service Officers must escalate requests to remove children under 15 years from a Medicare card (unrelated to FDV) using work type Medicare eligibility and enrolment, Nat. Office Escalations DCP (ME_NO_ESCALATION_DCP).

Note: LPS must not pend work items as 'future release date' in the Escalations folders.

4

Medicare Consumers Program Support escalated work types

The work types that Medicare Consumers Program Support assess or provide advice on are:

  • 410 visa holders
  • PALM family accompaniment 403 visa holders
  • Complex enrolments that need to be escalated to the Department of Home Affairs or the Department of Health, Disability and Ageing. This includes:
    • Ministerial Interventions
    • Administrative Review Tribunal (ART)
    • Families and Child Care (FCC) complex enrolments, and
    • Extending Reciprocal Heath Care Agreement (RHCA) eligibility beyond six months to Italian citizens due to medical reasons
  • Request to remove children under 15 from a family Medicare card where FDV is not involved
  • Fourth Medicare card requests
  • Surrogacy arrangement where documentation provided does not meet standard requirements
  • Complex Child Protection Agency enquiries
  • Complex adoption enrolments
  • Escalated unresolved DVS D results
  • MSN concessional status that requires escalation to PBS and Centrelink

Medicare Consumers Program Support investigates and provides advice on escalated enquiries before reassigning to the Escalations folder.

If a work item is reassigned from the Escalations folder for processing, LPS must recategorise the work to the appropriate work type in PaNDA in open status for the next available Service Officer to action.

The work types that Medicare Consumers Program Support process are:

  • Removal of Pending Bridging 070 visa holders
  • Victims of People Trafficking programme
  • Fulbright Scholar enrolments
  • Postcode locality update
  • Process Record Amendment (PRA) file fix requests
  • MSN (CDMS only):
    • out of pocket expenses (OOPS)
    • registration amendment
    • PRA (file fix) - incorrect family created, or family circumstances change
    • affected by incorrect date of death

Note:


Face to face Service Officer escalation

Table 2

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Step

Description

1

Try to resolve the enquiry

A face to face Service Officer must first try to resolve the customer enquiry by using:

2

Contact Medicare LPS for help

The face to face Service Officer must Contact Medicare and Aged Care - Local Peer Support (LPS) if they cannot resolve the customer's enquiry.

If the enquiry is deemed not urgent, scanall enrolment documents to PaNDA via the Multi-Function Device (MFD).

A Medicare Eligibility and Enrolment trained Service Officer or LPS will finalise this work.

If the enquiry is urgent, the face to face Service Officer must escalate to LPS. To do this they must:

  • Scan all enrolment documents
  • Contact Medicare Eligibility and Enrolments (MEE) LPS to escalate the work item

A Medicare Eligibility and Enrolment trained Service Officer or LPS will This work will finalise this work.

Face to face Service Officers not currently serving the customer must escalate to LPS using the online form Technical Support Tool (LPS and SSO) - Health.

For technical support, see Tier 0 technical support - self-sufficiency.

Service Officers not trained in MEE must contact MEE LPS using the online request form. LPS must take ownership of the request and contact the Service Officer if they need more details.


Smart centre Service Officer escalation

Table 3: this table is for all Service Officers not serving face to face.

First Contact Resolution (FCR) for Medicare enrolment applications and copy/transfers:

  • gives the best possible customer experience
  • minimises extra customer contact and touchpoints
  • applies when customers have given all documentation

The first principle of FCR is to complete work if Service Officers have the skills and experience to do so.

Expand table

Item

Description

1

Service Officers trained in Medicare Eligibility and Enrolments

For customer enquiries or processing, all Service Officers trained in Medicare Eligibility and Enrolments must complete the work if they have all the:

  • training/skills
  • required delegation
  • necessary details and documents

If Services Australia gets an enrolment application and all relevant documents:

  • assess the customer's eligibility, and
  • process the enrolment regardless of the date of lodgement

If the customer indicates they are experiencing hardship or are vulnerable, and all documentation is not provided, see Table 5.

2

Service Officers not trained in Medicare Eligibility and Enrolments

Service Officers must:

  • follow Tier 0 technical support - self-sufficiency, and research:
    • Operational Blueprint
    • Communications, and
    • Network News Updates (NNU)
  • search CDMS and PaNDA to locate:
    • customer records
    • enrolment application and supporting documents
  • authenticate the customer from CDMS or the Medicare Enrolment form (MS004)
  • complete a basic assessment of the enrolment application and check:
  • all customer and contact information are complete and all pages are received
  • the declaration is complete
  • all requested documents are provided

If the customer has provided all documents and the enrolment application form is complete:

If the customer indicates they are experiencing hardship or are vulnerable, Service Officers not trained in MEE must see Table 5.

3

More documents or details are needed to complete an activity

If more documents or details are needed to complete an activity, for:

  • inbound calls - tell the customer what details and/or documentation is needed and that they can:
  • email documents to MES@servicesaustralia.gov.au. They must include the PaNDA work ID (WID) in the subject line of the email or write it on the enrolment application form
  • lodge documents in person at a service centre if they cannot send an email
  • processing - Service Officers must:
  • attempt to contact the customer by phone to tell them what documents are needed before sending a request for information (RFI) letter
  • not access positional mailboxes or contact LPS to access documents emailed during the contact with the customer

4

Digital Medicare enrolment applications (DME/DMX)

Service Officers must follow the process in Digital Medicare enrolments and extensions in the MEE Portal.

All Service Officers trained in digital Medicare enrolment (DME)/digital Medicare extension (DMX) must review document(s) provided and check if any other documents or details are needed. If the:

  • customer has provided relevant documents, assess their eligibility and process the enrolment regardless of the date of lodgement
  • agency needs more documents, request more documentation through the Medicare Eligibility and Enrolments (MEE) Portal

If the customer indicates they are experiencing hardship or are vulnerable, Service Officers not trained in DME/DMX applications must see Table 5.


Escalation process for LPS

Table 4

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Step

Description

1

Escalation pathway

Before escalating any work, make sure all resources are used to resolve the query. See Tier 1 technical support - Local Peer Support (LPS).

If the escalation is urgent, go to Step 2.

If LPS cannot resolve the enquiry for PaNDA work items, LPS must:

If LPS cannot resolve the enquiry for digital Medicare enrolment (DME)/digital Medicare extension (DMX), LPS must:

  • leave notes in the activity log in the MEE Portal explaining the reason for escalation
  • update the status in the MEE Portal to On hold - Escalated to- National Office or DVS Operations
  • tell the processing Service Officer to:
    • return to the work item in Work Optimiser - Medicare
    • reassign and recategorise the work item to the LPS using escalation work type: ME_DME_ENROLMENT_ESC
  • escalate to Service Support Officers (SSO) See Tier 1 technical support - Local Peer Support (LPS)

SSOs review the escalated work item and either:

  • provide advice to LPS, or
  • escalate the work item to Medicare Consumer Program Support

SSOs must:

  • leave comments in the processing notes or activity log of the enrolment application
  • unassign and recategorise to Medicare Consumer Program Support using work type, for:
    • Digital Medicare enrolments ME_DME_NO_ESC
    • PaNDA work items ME_NO_ESCALATION

The Medicare Consumers Program Supportteam sends a response within 10 business days.

For escalations about DVS, see Table 3 in Identity verification for Medicare enrolments, re-enrolments and extensions in the Medicare Document Verification Service (DVS) Portal.

2

Escalate an urgent enquiry

LPS must:

SSOs review the escalated work item and either:

  • provide advice to LPS, or
  • escalate the work item to Medicare Consumer Program Support

SSOs must:

  • leave comments in the activity tab of the digital enrolment application - include 'urgent' in comments
  • unassign and recategorise to Medicare Consumer Program Support using work type, for:
    • Digital Medicare Enrolments ME_DME_NO_ESC
    • PaNDA work items ME_NO_ESCALATION

The Medicare Consumers Program Support team responds to urgent requests within 2 business days. The team assess urgent requests and responds to them in order of priority.

Note: the response time may be longer if the case needs external stakeholder advice.

3

Incorrect escalated enquiries
  • Work items incorrectly escalated to Medicare Consumer Program Support will be returned to the referring Service Officer
  • LPS, SSO or Medicare Consumer Program Support will provide feedback via the Staff Feedback Tool

Escalate an enrolment application for customers that are experiencing hardship or are vulnerable

Table 5

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Step

Action

1

Customers experiencing financial hardship or vulnerability

Customers:

  • experiencing financial hardship or vulnerability may ask for urgent processing of their Medicare enrolment
  • vulnerability can occur because of various risk factors including:
    • Financial hardship
    • Safety concerns. See Family and domestic violence procedure to conduct the risk identification and referral process, and to offer suitable services and referrals
    • Health concerns
    • Housing
    • Crisis or trauma
    • Visa circumstances

2

How to escalate an enrolment application

If a customer says they are experiencing hardship or are vulnerable, Service Officers:

3

Escalated enrolment applications

LPS:

  • take ownership of the request
  • take over the customer call, and
  • review the enrolment application to check if more details are needed

If:

  • no more documentation is needed, LPS must complete the enrolment
  • more documentation is needed, LPS tell customers to:
    • email documents to MES@servicesaustralia.gov.au, and
    • include the PaNDA ID in the subject line of the email or write it on the enrolment application form

LPS must:

  • include comments in PaNDA and pend the work item (using validate information) to themselves for a period of 48 hours, and
  • review the MES mailbox for details

Once LPS gets the details, they must process the enrolment and contact the customer to tell them the outcome.

If the customer does not provide the documentation in 48 hours, LPS must make one genuine contact attempt.

If contact is:

  • successful:
    • tell the customer the agency does not have the documentation needed. They can call back once they have lodged all the required documentation
    • record comments in PaNDA, and
    • return the work item to the queue
  • unsuccessful:
    • record comments in PaNDA advising of unsuccessful contact attempt, and
    • return the work item to the queue

Escalate a request to copy or transfer a child under 15 years to another Medicare card due to FDV

Table 6

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Step

Action

1

Copy or transfer

All 'Application to copy or transfer from one Medicare card to another forms (MS011)' received for a child under 15 years, involving family and domestic violence (FDV), must only be assessed by a Service Officer (SO4) skilled tagged in FDV.

Service Officers not skill tagged in FDV must recategorise all enrolment applications received to copy or transfer a child under 15 years due to FDV. Recategorise to work type: ME_FDV.

Service Officers must not:

  • tell the customer that a child will be copied or transferred
  • provide a timeframe as these cases are sensitive in nature

Note: Service Officers and Local Peer Support (LPS) must not contact customers by phone or send letters if required documentation is not submitted with the enrolment application. SO4s skill tagged in FDV make all follow up calls.

2

How to handle a face to face request

Face to face Service Officers must:

  • apply a FDV sensitive indicator to the customer's record (if one is not already applied)
  • scan enrolment applications directly to Dept of Child Protection (ME_DCP_ESCALATIONS in PaNDA) via the Multi-Function Device (MFD)
  • LPS will recategorise the work item to ME_FDV

3

How to escalate enrolment applications received in PaNDA

Service Officers must apply a FDV sensitive indicator to the customer's record before recategorising (if one is not already applied).

Service Officers and LPS must check:

  • work items received in PaNDA and identified as FDV are recategorised to work type ME_FDV
  • the work status is in Open before recategorising, to make sure timely processing of work items

Note: Service Officers and LPS must not action or recategorise work items in the ME_FDV folder in PaNDA unless they are skill tagged in FDV.

4

How to escalate requests for customers with immediate concerns for their wellbeing or safety
  • If the customer has concerns about their immediate wellbeing or safety, Service Officers must contact Medicare and Aged Care - Local Peer Support (LPS). Service Officers may email Health Service Delivery Division for advice when LPS are unavailable
  • If LPS decide immediate attention is needed, they must email Health Service Delivery Division (Medicare Customer) for advice

5

How to escalate a complaint related to a request to copy or transfer a child under 15 years due to FDV

If a complaints Service Officer (APS4) needs help with a complaint related to enrolment applications to copy or transfer a child under 15 years due to FDV, they must email Health Service Delivery Division for advice.

Note: FDV trained Service Officers will not take over the complaint.


Escalate a Department of Child Protection (DCP) enquiry

Table 7

Expand table

Step

Description

1

How to handle a face to face DCP enquiry

Face to face Service Officers must:

  • escalate the query to Medicare and Aged Care - Local Peer Support (LPS)
  • scan all the documents and forms to PaNDA (if processing is required)

The DCP or a non-government organisation may make a verbal request for a child's Medicare card details. Do not give out these details. The DCP or non-government organisation must call a Medicare Eligibility trained Service Officer and give their agency ID and password.

Any request from a non-government organisation must not be actioned. For example, Anglicare or Wesley Mission. Call the Medicare Eligibility LPS Team for help.

2

DCP queries for a Service Officer

If an enrolment application from a Child Protection Agency needs escalation, Service Officers must contact Medicare and Aged Care - Local Peer Support (LPS) for help.

Examples of enrolment applications that need escalation, include:

  • third card requests
  • the Child Protection Agency has provided a letter on agency letterhead advising they cannot provide an acceptable proof of birth document
  • the name on the provided court order does not match the child's legal name on the provided birth certificate or CDMS
  • if Service Officers are unsure of the intent of a provided court order or its validity

If LPS asks the Service Officer to escalate the enquiry, the Service Officer must:

  • leave appropriate notes in PaNDA to explain the reason for the escalation
  • make sure the work status is open before escalating
  • escalate the application in PaNDA using work type ME_DCP_Escalations

LPS must:

SSOs reviews the escalated work item and either:

  • provide advice to LPS, or
  • escalate the work item to Medicare Consumer Program Support. Go to Step 3

3

DCP queries for Medicare Consumers Program Support

If escalation to National Office is needed, SSOs must:

  • leave comments PaNDA
  • unassign and recategorise to Medicare Consumer Program Support using work type: ME_NO_ESCALATION_DCP

The Medicare Consumers Program Support Team responds directly to the LPS. LPS or a Service Officer completes the enrolment.


Escalate a CDBS enquiry

Table 8

Note: consent to access Centrelink to investigate eligibility is a mandatory requirement for all enquiries.

Expand table

Step

Description

1

Face to face CDBS enquiry

Face to face Service Officers must try to resolve the customer enquiry. See Eligibility for Child Dental Benefits Schedule (CDBS) in Medicare.

If the face to face Service Officer cannot resolve the enquiry, they must:

Note: Service Officers must not create a PaNDA work item using the LPS/SSO cover sheet to escalate a CDBS enquiry.

2

Smart centre CDBS enquiry

This process is for all Service Officers not serving face to face.

Service Officers must:

  • try to resolve the enquiry using all available resources before escalation
  • confirm the child/teenager's details are correct in CDBS. This includes:
    • name
    • DOB, and
    • the Consumer ID in CDBS matches the child/teenager's Consumer ID in CDMS
  • get consent from the eligible child/teenager or their parent/guardian to access Centrelink to confirm payment eligibility
  • not disclose CDBS information to anyone other than the eligible child/teenager or their guardian/parent listed on the CDBS guardian/parent tab
  • confirm the child/teenagers is age and benefit eligible in Customer First, before completing a refresh

If a Service Officer cannot resolve the CDBS enquiry they must contact a Medicare and Aged Care - Local Peer Support (LPS). If LPS are not available, Service Officers must:

  • complete Part A of the CDBS Eligibility Enquiry Form. This must include consent from the parent/guardian
  • email the completed form to Medicare Provider Services Eligibility

Note: Service Officers must not create a PaNDA work item using the LPS/SSO cover sheet to escalate a CDBS enquiry.

Service Officers must not save the CDBS Eligibility Enquiry Form to their desktop or personal H: drive. They must:

  • save the completed CDBS Eligibility Enquiry Form to their team's Customer Information secure folder. The file name must include the Service Officer's logon ID or P Number. For example: P11111.CDBSEligibility
  • email the form to MPS Eligibility as per approved business process
  • delete the form from the secure folder after successful email

Incomplete forms will be returned to the Service Officer to complete.

3

PaNDA CDBS enquiry

CDBS Eligibility Enquiry Forms emailed to MPS Eligibility are uploaded to Child Dental Benefits Scheme (ME_CHILD_DENT_BFT) in PaNDA for a suitably skilled Service Officer to action.

Service Officers trained in CDBS must review the escalation form and confirm:

  • the child/teenager's details are correct in CDBS, including:
    • name
    • DOB, and
    • the Consumer ID in CDBS matches the child/teenager's Consumer ID in CDMS
  • the child/teenager is age and benefit eligible in Customer First before performing a refresh

If the Service Officer:

  • can resolve the CDBS enquiry they must make one outbound call attempt to the customer to tell them of the outcome. See Table 1 >Step 8 in Telephone standards for Medicare and Health Delivery
  • cannot resolve the PaNDA enquiry they must:
    • leave appropriate escalation notes in PaNDA, and
    • make sure the work status is open before escalating
    • escalate the enquiry to LPS via PaNDA using work type Escalations (ME_ESCALATIONS)

4

LPS escalation to CDBS National Office

CDBS Eligibility Enquiry Forms are escalated to MEE LPS in PaNDA for suitably skilled LPS to action.

MEE LPS who:

  • have CDBS training but do not have CDBS refresh access, see Table 3 in Eligibility for Child Dental Benefits Schedule (CDBS) in Medicare
  • are not trained in CDBS must:
    • leave appropriate notes in Panda, and
    • unassign the CDBS escalation in open status so the next available skilled LPS can action it
  • have CDBS training and refresh access must check:
    • the child/teenager's details are correct in CDBS, including name, DOB, and
    • the Consumer ID in CDBS matches the child/teenager's Consumer ID in CDMS
    • the child/teenager is age and benefit eligible in Customer First before performing a refresh
    • consent has been provided on the Eligibility Enquiry Form. If consent is not on the form, LPS must return the work item to the escalating Service Officer in PaNDA

If LPS:

  • can resolve the enquiry, they must make one outbound call attempt to the customer to tell them of the outcome. See Table 1 > Step 8 in Telephone standards for Medicare and Health Delivery
  • cannot resolve the enquiry, they must:
    • complete Part B (the LPS section) of the CDBS Eligibility Enquiry Form and upload the form to the PaNDA work item
    • leave appropriate notes in Panda
    • make sure the work status is open before escalating
    • escalate the enquiry to the CDBS Helpdesk via PaNDA using work type Medicare Eligibility CDBS Nat Office Escalation (ME_CDBS_NO)

LPS must not save the CDBS Eligibility Enquiry Form to their desktop or personal H: drive. LPS must:

  • save the completed CDBS Eligibility Enquiry Form to their team's Customer Information secure folder. The file name must include the LPS logon ID or P Number. For example: P11111.CDBSEligibility
  • upload the form to the PaNDA work item as per approved business process, see Table 5 in Processing and National Demand Allocation (PaNDA)
  • delete the form from the secure folder after successful upload

The CDBS Helpdesk will:

  • assess enquiries and respond in order of priority. The response time may be longer if the case needs external stakeholder advice
  • return escalations in open status to ME_ESCALATIONS for LPS to action. LPS must make one outbound call attempt to the customer to tell them of the outcome. See Table 1 > Step 8 in Telephone standards for Medicare and Health Delivery

5

Escalation of complaints to CDBS National Office

If a CDBS enquiry is related to an escalated complaint, the Complaints Service Officer must:

  • make sure the eligible child/teenager or their listed parent/guardian has given consent to access Centrelink
  • complete all sections of the CDBS Eligibility Enquiry Form, and
  • email the form and any relevant additional information to CDBS Medicare Branch National Office

The CDBS Helpdesk assesses enquiries and responds within 5 business days, in order of priority. The response time may be longer if the case needs external stakeholder advice.


Escalate a statutory declaration

Table 9

Expand table

Step

Action

1

Acceptable use of a statutory declaration when enrolling or re-enrolling in Medicare

In some cases, it is acceptable for a customer to complete a statutory declaration in support of an enrolment application to enrol or re-enrol in Medicare. That is, if the necessary residency documents cannot be provided.

The statutory declaration must be signed by an approved witness and include comprehensive details about why the customer cannot provide 2 acceptable residency documents. The statutory declaration must also include:

  • the customer's previous country of residence
  • steps taken to cease residing overseas
  • confirmation the customer has returned to reside in Australia
  • any other steps taken to establish residency in Australia

If a digital statutory declaration is provided, do not scan the QR code on your personal device to authenticate it. Authenticity can be confirmed by:

  • myGov logo
  • Date and time the declaration was created
  • Name of the customer making the declaration
  • Location or place where the declaration was made
  • Document ID generated when the user's identity is verified using Digital ID
  • Legislative references for Identity and myGov as a prescribed online platform
  • QR code (s)
  • Page count

A statutory declaration cannot be used in lieu of:

  • 2 residency documents within the first 6 months of arrival for migrants and eligible New Zealand citizens
  • specific documents required for visitors to Australia requesting enrolment under a Reciprocal Heath Care Agreement (RHCA) (except Italian citizens)

See Document types for Medicare eligibility and enrolment.

2

Australian citizens who return to Australia to reside after an absence of 5 years or more

Where an Australian citizen was residing overseas for 5 years or more and has returned to reside in Australia, they must provide 2 documents to confirm residency. If they cannot provide residency documents after 6 months they can submit a Commonwealth statutory declaration.

Service Officers can accept statutory declarations provided after 6 months as they do not need escalation.

In some cases, a statutory declaration can be made available to an Australian citizen within 6 months from their arrival date.

Service Officers must:

  • leave appropriate escalation notes in PaNDA
  • make sure the work status is open before escalating, and
  • escalate to MEE LPS for assessment and approval

LPS must:

  • assess the statutory declaration and leave appropriate approval comments in PaNDA
  • recategorise the work to ME_Enrolments for the next available Service Officer to action

3

New Zealand citizens who have entered Australia to reside

When a customer cannot provide 2 residency documents after being in Australia for 6 months or more, they can submit a Commonwealth statutory declaration along with any documents they have.

Statutory declarations provided after 6 months do not require escalation and can be accepted by a Service Officer.

4

Permanent residents who have entered Australia to reside more than 12 months after their visa grant date or returned residents

When a customer cannot provide 2 residency documents after being in Australia for 6 months or more, they can submit a Commonwealth statutory declaration together with any documents they have.

Statutory declarations provided after 6 months do not require escalation and can be accepted by a Service Officer.

5

Italian citizens enrolling in Medicare under RHCA

If the Italian citizen cannot provide evidence of a valid EHIC or a valid Italian Health Insurance Card, it is acceptable for them to complete a statutory declaration.

Service Officers can accept statutory declarations provided by Italian citizens under RHCA as they do not need escalation. The declaration must state they are eligible for medical and hospital services under the national health legislation of Italy. It is not necessary for them to state the validity date.


Request an International Movement Record (IMR)

Table 10: this table describes how Service Officers request an IMR through PaNDA or the MEE Portal.

Expand table

Step

Action

1

Request an IMR

An IMR is used to determine:

  • when a customer arrived in Australia
  • when a customer departed Australia
  • how long a customer has been absent from Australia

Service Officers must request an IMR immediately to avoid delays.

For IMR requests in:

IMR trained Service Officers actioning an IMR request go to Step 4.

2

Request IMR in MEE Portal
  • Leave notes in the Activity Log of the MEE Portal explaining the reason for escalation. For example: 'requesting IMR'
  • Leave DME/DMX application ID Open
  • Return to the PaNDA work item in Work Optimiser – Medicare, unassign the work item and recategorise to ME_IMR Referral
  • IMR Skilled Officers will:
    • action the IMR request, and
    • reassign the DME/DMX work item back to the requesting Service Officer

Go to Step 8 once the IMR trained Service Officer reassigns the work item back to the referring Service Officer.

3

Request IMR in PaNDA
  • Leave a processing note on the work item stating 'requesting IMR'
  • Leave enrolment applications Open. Do not place on hold
  • Recategorise the work item to: ME_IMR_Referral
  • IMR Skilled Officers will:
    • action the IMR request, and
    • reassign the DME/DMX work item back to the requesting Service Officer

Go to Step 8 once the IMR trained Service Officer reassigns the work item back to the referring Service Officer.

4

IMR trained Service Officers
  • Select Ready in Work Optimiser - Medicare Worklist
  • WLM allocates work item - IMR requests are prioritised
  • Review Processing Notes tab or Activity Log in the work item to determine if an IMR is required

If an IMR is not required, go to Step 7.

If an IMR request is required:

  • Open and log on to the DIAC session
  • Follow the Department of Home Affairs taskcard to email the IMR to their own email address:
    • Preview the document to make sure the IMR is for the correct customer
    • Save the document attached to the email to the teams Customer Information secure folder
  • Upload the IMR to:

5

Upload IMR to MEE Portal

Upload the IMR page to the customer's digital Medicare enrolment (DME)/digital Medicare extension (DMX) application ID, select:

  • Documents tab
  • Upload file (returns Add Medicare enrolment documents page)
  • Document type - IMR
  • Document Sub-type - Movement check (IMR)
  • Assessment - Accepted
  • Date of lodgement - date uploaded by the IMR trained Service Officer
  • Choose file - select correct IMR document from the group Customer Information secure folder
  • Upload

Reassign the work item back to the requesting Service Officer and recategorise the work item to the work type: ME_DME_ENROLMENT.

Note: work items associated or stored incorrectly can result in:

  • privacy breaches, and
  • incorrect assessment of an enrolment

IMR trained Service Officers must:

  • check IMR reports match the work item
  • delete the:
    • IMR email received from the Department of Home Affairs
    • document from the group Customer Information secure folder, once successfully uploaded

There may be a delay of up to 10 minutes for the WLM status to update in Work Optimiser - Medicare. That is, after the DME/DMX application status is changed in the MEE Portal.

6

Upload IMR to PaNDA

Upload the IMR document to the relevant PaNDA work item see Table 13 in Processing and National Demand Allocation. Make sure the IMR is added to the correct work item. Add a processing note, 'IMR page uploaded'.

Reassign the work item back to the requesting Service Officer and recategorise the work item to the work type ME_ENR.

Note: work items associated or stored incorrectly can result in:

  • privacy breaches, and
  • incorrect assessment of an enrolment

IMR trained Service Officers must:

  • check IMR reports match the work item
  • delete the:
    • IMR email received from the Department of Home Affairs
    • document from the group Customer Information secure folder, once successfully uploaded

7

IMR page requested in error

If a IMR page is not required/requested in error, IMR trained Service Officers must reassign the work item back to the requesting Service Officer.

IMR trained Service Officers must:

  • Add a processing note with an explanation, for example: 'IMR not required/requested in error' and give a reason
  • Reassign the work item back to the requesting Service Officer and recategorise the work item to the relevant work type, for:
    • Digital Medicare enrolments ME_DME_ENROLMENT
    • Digital Medicare extensions ME_DME_ENROLMENT_DMX
    • PaNDA work items ME_ENR

8

Referring Service Officer to assess the work item

The work item has been reassigned back to the requesting Service Officer.

Has the customer's IMR been uploaded to the Medicare enrolment work item?

  • Yes:
    • the request for an IMR is approved
    • use this information to assess the customer's Medicare enrolment application
  • No:
    • the request for an IMR is rejected. There is no IMR document to support the Medicare enrolment
    • complete the customer's Medicare enrolment application with the documents already provided

See Register a customer for Medicare in the Consumer Directory Maintenance System (CDMS).