Processing Child Care Subsidy (CCS) claims 007-17103136

A CCS Social Application (SOA) new claim is automatically generated on the customer's record in Process Direct when:

• an online claim is submitted by a customer or their correspondence nominee
• an Assisted Customer Claim (ACC) is submitted, or
• a paper claim (FA084) is scanned to the customer's record and the details are manually recorded. The new claim activities has no claim information apart from the Customer Reference Number (CRN), personal details and the receipt date (date of claim)

Note: if documents are provided separately, scan the documents to the customer's record and update the relevant Task in Process Direct to show the information has been provided.

For most CCS online and staff assisted claims, the system will determine if the claim meets the criteria for straight through processing (grants or rejections). This is generally an overnight process. In these cases, the customer will receive more timely advice about the outcome of their claim. If the claim does not meet the criteria for straight through processing, it will be allocated to an appropriately skilled Service Officer for processing.

Note: Straight Through Processing for CCS claims has been switched off since March 2023. Staff will be notified when this is turned back on again.

Claims requiring exception management or validation of selected data items, and new claims after a customer has been cancelled due to the second deadline:

• will not auto assess, and
• are allocated via Workload Management to a staff member to manage

All ACCS applications (grandparent, transition to work, temporary financial hardship and child wellbeing) are allocated to appropriately skilled staff to validate information and/or evidence supporting the application.

Appropriately skilled staff are allocated claims that do not meet criteria for straight through processing. Their role is to:

• review and update claim relationships
• review warnings against customer circumstances
• make sure the claim data is applied to the customer record accurately for all relevant screens
• action any errors
• validate evidence as prompted, and
• make sure the claim outcome aligns with payment eligibility and entitlement

Exception management, where the claim needs staff assessment, may include:

• checking all required evidence has been provided, and requesting further information if necessary
• assessing 'Other' recognised activities
• assessing age/school status exemptions
• referring or assessing exceptional circumstances (for example, request for more than 100 hours of child care)
• assessing CCS Activity Test exemptions
• assessing or handing off any specialised processing (for example, residence or immunisation exemptions)
• all CCS claims combined with an ACCS application
• when a customer has been cancelled due to the second deadline (2DL):
• checking income requirements are met, and
• any outstanding CCS debts are repaid or an adequate debt repayment arrangement is in place

For ACCS applications, all evidence is to be reviewed to make sure it sufficiently supports the customer's application.

Customers may contact requesting their CCS claim be processed urgently. Referral for urgent processing is only considered where the customer meets the definition of a family in crisis or a family experiencing financial hardship. For more information about how to manage progress of claim enquiries, see Claiming Child Care Subsidy (CCS) and Additional Child Care Subsidy (ACCS).

All CCS claims are processed in Process Direct which:

• is used to check and record claim progress
• has the claim information provided by the customer online or collected through the Assisted Customer Claim (ACC) workflow
• lists documents the customer has been asked to provide
• uploads claim data into a CCS claim activity or CCS Social Online Application (SOA)
• includes staff tasks that need to be completed before the claim can be finalised

Although Process Direct has functionality to assess and finalise claims without the need for staff intervention, staff must confirm assessment results before finalising claims allocated for processing.

CCS claims can be re-indexed where the benefit level is either rejected or cancelled (CCS-CAN/CCS/REJ). If a claim is rejected or cancelled at the child level (CCS benefit will be current (CCS-CUR)), a CCS Social Online Application (SOA) may be generated to reassess any entitlement if the original claim was not assessed correctly.

Claims that have been withdrawn cannot be re-indexed. The customer will need to lodge a new claim.

See Indexing, re-indexing and cancelling claim activities for reasons for re-indexing claims.

The Date of Receipt (DOR) for CCS claims is the actual date the claim is lodged. This shows in Process Direct claims as the Claim submission date.

The start date or Date of Effect (DOE) can only be backdated a maximum of 28 days, however the start date must be the Monday of a CCS fortnight. This is unless residency requirements have been met from a later date. In this instance, the customer will be eligible from the date they meet residency requirements.

The start date is determined by the system when the claim is processed. This is known as the Deemed Date of Receipt (DDOR). In most circumstances it will be the earliest CCS Monday within 28 days of claim submission

When processing a CCS claim, the Receipt Date field at the top of the screen shows the DDOR.

A record may need further investigation where care may not apply correctly when the claimant is a step parent.

If the claimant is a step parent and they and/or the other biological parent are a Child Support mutual customer the P24845 workaround is required.

The Process page has more information.

A customer cannot reclaim CCS again until they meet all the CCS income requirements for outstanding financial years.

Note: an outstanding financial year is one where the either the first or second deadline has been applied. For example, customers who received entitlement during 2018-19, must have met the reconciliation conditions for this year in order to re-claim CCS during the 2020-21 year.

The new CCS claim can only be backdated to the later of:

• the date the customer met all the CCS income requirements, or
• by using the 28 day backdating rules

The customer must also have either:

• repaid any outstanding CCS debts, or
• have an adequate debt repayment arrangement in place for any CCS debts
  (noting the general debt hierarchy rules apply, where the customer may have to pay off an older debt for another payment before they start repaying the CCS debt)

Note: the granting of the CCS new claim, if the customer is entitled to more than 0%, will meet this requirement as the customer will have automatic debt withholdings applied.