Teaching Payment Claims for Practice Incentives Program (PIP) 012-10110000

Scenario

Claim status

Action required

Claim form is completed correctly

• Sessions listed match sessions claimed

Waiting for payment

Paid

• No action required
• Add processing note to PaNDA and complete as a duplicate work item
• The IP006 does not need to be uploaded

Claim form is completed correctly

• The claim form is showing more sessions than were claimed online
• There is no accompanying correspondence from the practice explaining the discrepancy

Waiting for payment

Paid

• Call the practice to confirm the sessions on the form
• Process the missing sessions
• Upload the IP006
• Add a comment explaining the ‘part processed’ claim

Claim form is completed correctly

• The claim form is showing less sessions than were claimed online
• There is no accompanying correspondence from the practice explaining the discrepancy

Waiting for payment

• Call the practice to check if there was a claiming error
• Amend the session details on the original claim
• Add a comment explaining the amendment
• Upload the IP006 to the practice profile

Claim form is completed correctly

• The claim form is showing less sessions than were claimed online
• There is no accompanying correspondence from the practice explaining the discrepancy

Paid

• Call the practice to confirm there was a claiming error
• Advise the practice that recovery of the overpaid sessions will be required
• Commence recovery action for the overpaid sessions

Claim form has not been completed correctly.

Waiting for payment

If the sessions are not eligible based on the submitted claim form:

• Withdraw the claim
• Escalate for a free text letter

Claim form has not been completed correctly.

Paid

If the sessions are not eligible based on the submitted claim form:

• Escalate to Policy team for review
• Policy team will provide a free text letter advising the action required from the practice
• The letter will advise recovery action will be taken in the required information is not provided

Claim form shows sessions not supervised by a GP.

These sessions have been claimed.

Waiting for payment

• Delete the ineligible sessions
• Send the Z1657 letter to advise the practice the sessions are not eligible for payment

Claim form shows sessions not supervised by a GP.

These sessions have been claimed.

Paid

• Commence recovery of the ineligible sessions

PIP approved date

Claim processed before

Quarter in which claim is paid

1 - 18 February

30 April

May quarter

19 February - 30 April

30 April

August quarter

1 - 18 May

31 July

August quarter

19 May - 31 July

31 July

November quarter

1st - 18 August

31 October

November quarter

19 August - 31 October

31 October

February quarter

1 November - 18 November

31 January (following year)

February quarter

19 November - 31 January

31 January

May quarter