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Quality Assurance for Aboriginal and Torres Strait Islander Medical Services (QAAMS Program) with MBS items 73839, 73840 and 73844 (monitoring diabetes) in Medicare 012-40020070



This document explains the administering of Medicare Benefit Schedule (MBS) items 73839, 73840 and 73844 for monitoring of diabetes in Aboriginal and Torres Strait Islander communities.

On this page:

Accessing the request from the practitioner

Processing and filing an application for QAAMS Program where the location is listed on the QAAMS Participant Database

Processing and filing an application for QAAMS Program where the location is not listed on the QAAMS Participant Database and the practitioner supplies a certificate of competency

Accessing the request from the practitioner

Table 1: this table describes how to process a request for an eligible medical practitioner to be registered to perform a diabetes test (Items 73839, 73840 & 73844). Tests are for members of the public who identify themselves as Aboriginal and/or Torres Strait Islanders. The process commences after the request from the medical practitioner has been opened through current workflow arrangements.

Step

Action

1

Assessing the paperwork + Read more ...

There is no application form for a medical practitioner to complete to request registration of the 601 Speciality code.

Requests are received in the form of a signed letter from the medical practitioner. The letter must specify:

  • The medical practitioner's name
  • The medical practitioner's request to access QAAMS POCT MBS item numbers 73839, 73840 or 73844
  • The location(s) where they will perform the QAAMS POCT, or
  • Provider number of the location(s) where they will perform QAAMS POCT
  • The medical practitioner's signature
  • Copy of the medical practitioner's QAAMS accreditation certificate must be included where the location is not included on the QAAMS Participant database

The letter cannot be signed by the practice manager or third party.

2

Checking eligible locations + Read more ...

To be eligible to provide a QAAMS POCT, the requested location must be listed in the QAAMS Database. If the practice is not listed, the medical practitioner must provide a copy of their QAAMS certificate of competency.

The Resources page contains a:

  • list of all practices on the QAAMS Participant Database, and
  • sample of the QAAMs certificate of competency

3

Check the location + Read more ...

In order to register the 601 speciality code, the medical practitioner must have an existing Medicare provider number or submit an Application for a Medicare provider number and, or prescriber number for a medical practitioner form (HW019).

Where the application for a provider number form has not been submitted, check the location has been previously issued.

Open the Provider Directory System (PDS):

  • Select Provider
  • Select View
  • Select Detailed Search
  • Family name field: key, the first 3 letters of the last name followed by a %
  • Given name field: key the first 3 letters of the first name followed by a %
  • Key date of birth in Date of Birth field
  • Select Search

A list of health professionals with a matching name will display.

  • Select View for the matching medical practitioner
  • Select the orange hyperlink at the top of the stem to return the list of previously issued provider numbers
  • Select View against the provider number in the request

If the location:

If assistance is required, contact a Local Peer Support (LPS).

The Resources page contains a link to the application for a provider number form.

4

Check PDS + Read more ...

  • Select View against the location on the request
  • Select Detailed Search
  • Family name field: key the first 3 letters of the last name followed by a %
  • Given name field: key the first 3 letters of the first name followed by a %
  • Key date of birth in Date of Birth field
  • Select Search

A list of health professionals with a matching name will display.

  • Select View for the matching medical practitioner

Check the medical practitioner has access to a Medicare benefit on the stem by checking the below specialty codes are present:

  • If an open 104, 130 or 198 are present on the stem, go to Step 5
  • If 110 and an open 132, 532, 530 or 540 (no 500/519), go to Step 5
  • If an open 180, 110 and open 132, 532, 530 or 540 and a 500 and 519 are present on the stem, go to the location the medical practitioner is requesting to perform the QAAMS POCT. Make sure a 519 specialty code or class exemption flag is present and current on the location:
    • If there is a 519 speciality code or class exemption flag that is current on the location, go to Step 5
    • If there is not a 519 speciality code or class exemption flag that is current on the location, go to Step 6
  • If there is 110 with a general practice 3GA speciality code present on the stem, go to the location where the medical practitioner is requesting to perform the QAAMS POCT. Make sure the location has a general practice 3GA speciality code present and current on the location:
    • If there is a general practice 3GA speciality code current on the location, go to Step 5
    • If there is not a general practice 3GA speciality code current on the location, the application is incomplete, go to Step 6

5

Eligibility to QAAMS + Read more ...

Determine eligibility to QAAMS. Has the medical practitioner submitted a copy of their QAAMS certificate of competency with the signed letter from the medical practitioner:

6

Returning documentation + Read more ...

Prepare and issue the letter:

  • Complete the letter template Z2306 Provider Registration – We need more information
  • Save letter as a PDF
  • Upload letter to PaNDA
  • Ensure the Surname First Name, Provider Number and Case ID fields are complete and correct in PaNDA
  • Add any appropriate notes to the PaNDA file
  • Issue the letter to the medical practitioner via post and HPOS if the medical practitioner has an active HPOS account
  • Select Complete
  • Select Save

Processing and filing an application for QAAMS Program where the location is listed on the QAAMS Participant Database

Table 2: this table describes how to add 601 speciality code to the Provider Directory System (PDS) where the location is listed on the QAAMS Participant Database. The 601 specialty code is required to be recorded at both stem and location level.

Step

Action

1

Adding specialty code at stem level + Read more ...

If the medical practitioner already has a 601 speciality code at stem level go to Step 2.

To add a specialty code to the stem on PDS, select the Edit button (at the bottom of page):

  • Select the Speciality tab
  • Select the Add Specialty Code
  • Key 601 in the Speciality Code Descriptor field
  • Key the date of lodgement in the Start Date field
  • Do not record an No End Date
  • Select Save button

Go to Step 2.

2

Adding specialty code to a location + Read more ...

Select the orange hyperlink at the top of the stem to take you to the list of previously issued provider numbers.

Identify the requested location:

  • Select Amend
  • Select Loc-Spec codes tab
  • Select Add Specialty Code
  • Key 601 in the Speciality Code Description field
  • Key the date of lodgement or the start date of the provider number, whichever is the later in Start date field
  • Do not record an End Date
  • Select Add New
  • Select Cancel
  • Select Save

3

Issue confirmation letter + Read more ...

Prepare and issue the letter:

  • Complete the letter template Z2754 Approval and removal of additional accreditation/program item access
  • Save letter as a PDF
  • Upload the letter to PaNDA
  • Ensure the Surname First Name, Provider Number and Case ID fields are completed and correct in PaNDA
  • Add any appropriate notes to the PaNDA file
  • Issue the letter to the medical practitioner via post and HPOS if the medical practitioner has a active HPOS account
  • Select Complete
  • Select Save

Processing and filing an application for QAAMS Program where the location is not listed on the QAAMS Participant Database and the practitioner supplies a certificate of competency

Table 3: this table describes how to add 601 specialty code to the Provider Directory System (PDS) where:

  • the location is not listed in the QAAMS Participant Database, and
  • the medical practitioner supplies a certificate of competency

The 601 specialty code is required to be recorded at both stem and location level.

Step

Action

1

Adding specialty code at stem level + Read more ...

If the provider already has a 601 speciality code at stem level go to Step 2.

To add a specialty code to the stem on PDS, select the Edit button (at the bottom of page):

  • Select Speciality tab
  • Select Add Specialty Code
  • Key 601 in the Speciality Code Descriptor field
  • Key the date of lodgement in the Start Date field
  • Do not record an End Date
  • Select Save

Go to Step 2.

2

Adding specialty code to a location + Read more ...

Select the orange hyperlink at the top of the stem to take you to the list of previously issued provider numbers.

Identify the requested location:

  • Select Amend
  • Select Loc-Spec codes tab
  • Select Add Specialty Code
  • Key 601 in the Specialty Code Description field
  • Key the date of lodgement or the start date of the provider number, whichever is the later in Start Date field
  • End Date is the Expiry Date on the certificate of competency
  • Select Add New
  • Select Cancel
  • Select Save

Add Note to stem:

  • Select medical practitioner’s name to go to the stem
  • Select Edit
  • Select Notes tab
  • Select New Note
  • Notes Subject key ‘QAAMS POCT (provider number/s)’
  • Notes Description key ‘601 spec code end dated in line with certificate of competency expiry date’
  • Select Add New
  • Select Save

3

Issue confirmation letter

Prepare and issue the letter:

  • Complete the letter template Z2754 Approval and removal of additional accreditation/program item
  • Save letter as a PDF
  • Upload letter to PaNDA
  • Ensure the Surname First Name, Provider Number and Case ID fields are complete and correct in PaNDA
  • Add any appropriate notes to the PaNDA file
  • Issue the letter to the medical practitioner via post and HPOS if the medical practitioner has and active HPOS account
  • Select Complete
  • Select Save