Eligibility and Location Specific Practice Number (LSPN) practice registration for Diagnostic Imaging (DI) and Radiation Oncology (RO) 012-41040000

Before the application is processed, it must be assessed to make sure it is complete.

Check:

• the application is on the current version of the Application to register or amend a diagnostic imaging or radiation oncology practice (HW061) form
• all mandatory questions are correctly completed

If an old version of the form has been submitted, or any mandatory questions are incomplete or incorrectly completed:

• continue checking the application for other incomplete or incorrect information
• return the application

If any optional question is incomplete or incorrectly completed:

• continue checking the application for other incomplete or incorrect information
• process any correctly completed questions
• prepare a Z2374 – We need more information to process your application letter outlining the incorrect or incomplete information

See the Resources page for links to the HW061 form and refusal letter.

Question 1 is mandatory for all application types.

Questions 2, 3 and 4 are mandatory for all other application types, including new LSPNs processed as part of a relocation.

Escalate the application to the Provider Engagement for consideration by the Pathology and Diagnostic Imaging team if the request is or appears to be for:

• to renew or amend a cancelled LSPN, or
• to register a new LSPN at the same location as a cancelled LSPN

The application is incorrectly completed if ‘register for a new LSPN’ is selected at Question 1 and:

• any other option is selected at Question 4, or
• another practice is already registered at the same location

For all options at Question 4:

• Questions 2 and 3 must match the existing details recorded in PDS
• the address does not need to exactly match PDS, as long as it clearly describes the same premises
• if the address is different and update LSPN details is selected, check to see if a cover letter or HPOS message was included advising of a minor administrative address change

For:

• applications for new LSPNs, closures or relocations, go to Step 3
• update LSPN details, review the completed questions on the form using the relevant instructions in this table
• add or remove MRI providers, go to Step 19
• renew registration, go to Step 21 if no other questions are answered

Question 5 is mandatory when the following options are selected at Question 4:

• close an existing LSPN
• relocate a practice

If a date is entered for this question and any other option is selected for Questions 1 or 4, the application should be refused.

Questions 6, 7 and 8 are mandatory when the following options are selected:

• register for a new LSPN (Question 1)
• relocate a practice (Question 4)

If No is selected for Question 6, use the date of lodgement (as recorded in PaNDA).

For:

• applications for new LSPNs or relocations, go to Step 4
• closures, go to Step 21

Question 9 is optional. Use the date of lodgement as the effective start date of the new information when:

• updating LSPN details selected at Question 4, and
• new business information is entered in Questions 10 to 22

Return the application if:

• a date is entered at Question 9 but no business information is included in Questions 10 to 22 or
• the registered business name entered at Question 10 does not match the information returned by PDS when the Australian Business Number (ABN) is entered

Questions 10, 11 and 12 are mandatory for new LSPN registrations, including those created as part of a relocation.

At Question 12:

• Refuse the application if more than one option is selected, as the application is incorrectly completed
• If Government agency or public body is selected, record the ABN at Question 11 in a comment within PDS

Which box was selected at Question 12?

• Individual, go to Step 5
• Partnership, go to Step 6
• Company, go to Step 7
• Government agency or public body, go to Step 8

Question 13 - both Family name and First given name are mandatory when Individual is selected at Question 12.

Go to Step 9.

Question 14 - at least one Full name (first and last name) or ACN must be entered.

It is acceptable for a trust to be entered under full name on the application without an ACN.

Note: the application may include an attachment with additional partnership information if there are more than 3 partners.

Go to Step 9.

Questions 15 and 16 are mandatory when Company is selected at Question 12.

Go to Step 9.

Questions 17 is mandatory when Government agency or public body is selected at Question 12.

If an individual’s name has been entered as the Proprietor at Question 17, refuse the application.

Go to Step 9.

Question 19 is mandatory for new LSPN registrations, including those created as part of a relocation:

• Question 20 is mandatory if Group A is selected at Question 19
• Question 21 is mandatory if Group B is selected at Question 19
• Question 22 is mandatory if Group C is selected at Question 19

The application is incorrectly completed and must be refused if:

• more than one option is selected for any of these questions, or
• a question is completed which does not correspond to the option selected at Question 19

For:

• new LSPN registrations, including those created as part of a relocation, go to Step 10
• applications where update LSPN details was selected, continue to review the completed questions on the form using the relevant instructions in this table

Question 23 is mandatory for new LSPN registrations, including those created as part of a relocation.

When completed, it must include all of the following:

• Street number
• Street name
• Suburb
• State
• Postcode

The application is incorrectly completed and must be refused when:

• an address is entered that is different to the one recorded in PDS, and
• the application is not for a relocation or a new LSPN

For:

• new LSPN registrations, including those created as part of a relocation, go to Step 11
• all other applications, continue to review the completed questions on the form using the relevant instructions in this table

Questions 24 and 25 are:

• mandatory when Partnership, Company or Government Agency or public body are selected at Question 12 for new LSPN registrations, including those created as part of a relocation
• optional for Individual proprietorships and all applications for existing LSPNs

Questions 26 and 27 are optional for all applications, although it is recommended that authorised representatives provide their PRODA number.

Questions 28 to 31 are optional. When a secondary authorised representative is recorded, Questions 28 and 29 must be completed.

Go to Step 12.

Question 32 is mandatory for new LSPN registrations, including those created as part of a relocation.

If Yes is selected, the address must include at a minimum:

Street number and name, or PO Box number

• Suburb
• Postcode

Question 33 is mandatory for mobile bases only.

The address must include at a minimum:

• Street number and name, or
• PO Box number
• Suburb
• Postcode

Go to Step 13.

Question 34 is optional (but recommended)

This question includes a checklist the applicant uses to declare which equipment types they will register.

Questions 35 to 39 include fields to register specific types of equipment and all are optional. A correctly completed answer to at least one of these questions is:

• mandatory for new LSPN registrations, including those created as part of a relocation
• optional for all other applications

Equipment cannot be listed on an LSPN record unless all mandatory fields have been correctly completed. Multiple copies of the same page may be provided if they are adding more than one equipment of the same type.

Where only the month and year is provided for the date manufactured or date upgraded fields, it is acceptable to enter the date as the first day of the month into the system.

The application is incorrectly completed and must be refused if:

• no equipment details are entered (for new applications or relocations), or
• none of the equipment details is entered correctly
• both the date manufactured and date first installed are completed

Note: for all equipment types, if more than one tick box option is selected for any question, then the question has been incorrectly completed.

For equipment specific requirements:

• Ultrasound, go to Step 14
• Diagnostic radiology/Nuclear Medicine/Computed Tomography, go to Step 15
• Magnetic Resonance Imaging (MRI), go to Step 16
• Radiation Oncology (Linear accelerator), go to Step 17
• Radiation Oncology (all others), go to Step 18

The following fields are mandatory for Question 35:

• Are you (adding/changing equipment) (one box only)
• Equipment type (one box only)
• With echocardiography? (one box only)
• Serial number
• Model/type number
• Manufacturer/company
• Date manufactured or Date first installed in Australia
• Does any diagnostic imaging provider or group of providers (ctd) (one box only)

Assess all required equipment. Go to Step 19.

The following fields are mandatory for Question 36:

• Are you (adding/changing equipment) (one box only)
• Diagnostic radiology unit you are registering (one box only)
• Serial number
• Model/type number
• Manufacturer/company
• Date manufactured or Date first installed in Australia
• Does any diagnostic imaging provider or group of providers (ctd) (one box only)

Assess all required equipment, then go to Step 19.

The following fields are mandatory for Question 37:

• Are you (adding/changing equipment) (one box only)
• Eligibility type (one box only)
• Magnetic strength
• Serial number
• Model/type number
• Manufacturer/company
• Date manufactured OR Date first installed in Australia
• Does any diagnostic imaging provider or group of providers (ctd) (one box only)

When assessing the answers to Eligibility type:

• Located in MM1 and fully eligible for Medicare as granted by DHAC/ Located in MM1 and partially eligible for Medicare as granted by DHAC
• Search for the practice location in DoctorConnect as entered in Question 23 using the Modified Monash Model (MM) 2019 option in the classification filter
• If this search returns the address as an MM 1 (2019) location, the application needs to be escalated to the Pathology and Diagnostic Imaging team via Provider Engagement after all other questions have been assessed and actioned
• This question is incorrectly completed and must be refused if any other MM location is returned by this search
• Located in a comprehensive practice within MM 2-7
• Search for the practice location in DoctorConnect as entered in Question 23 using the Modified Monash Model (MM) 2019 option in the classification filter
• If this search returns the address as an MM 2-7 (2019) location, the equipment can be processed
• If this search returns the address as an MM 1 (2019) location, the application needs to be escalated to the Pathology and Diagnostic Imaging Team via Provider Engagement after all other questions have been assessed and actioned
• Note: the agency does not assess whether the LSPN meets the criteria to be a comprehensive practice
• Medicare ineligible
• Ineligible MRI equipment can be processed without further assessment if all other fields are correctly completed

The Resources page contains a link to DoctorConnect.

Note: Service Officers do not have system access to record upgrade details for partially eligible MRI equipment (MR3 equipment code). Escalate to Provider Engagement through Local Peer Support (LPS). The Pathology and Diagnostic Imaging team will process.

Assess all required equipment, then go to Step 19.

The following fields are mandatory for Question 38:

• Are you (adding/changing equipment) (one box only)
• Dual modality/Single photon linear (one box only)
• Serial number
• Model/type number
• Manufacturer/company
• Additional features (MLC and EPI) (one box only for each question)
• Date manufactured or Date first installed in Australia
• Does any diagnostic imaging provider or group of providers (ctd) (one box only)

Assess all required equipment, then go to Step 19.

The following fields are mandatory for Question 39:

• Are you (adding/changing equipment) (one box only)
• Equipment type (one box only)
• Serial number
• Model/type number
• Manufacturer/company
• Number of workstations (when ‘With CT’ selected)
• Does any diagnostic imaging provider or group of providers (ctd) (one box only)

Assess all required equipment, then go to Step 19.

Question 40 is:

• mandatory if at Question 4 - add or remove MRI providers is selected
• optional for all other applications

All providers must meet the following requirements:

• both provider number and name are entered on the form
• these details match the record in PDS
• the provider number’s address is for the same location as the LSPN
• current and valid registration is recorded in PDS
• the provider is eligible to access Medicare benefits at the location
• a current 046 or 047 spec code is present on the provider’s stem

Any provider records which fail to meet these requirements must be refused.

Note: although it is preferred that the provider number’s address matches the LSPN, some variation can be accepted. Escalate to Provider Engagement via LPS for help if unsure the address meets this requirement.

See Amend Location Specific Practice Number (LSPN) register for Medicare for checking MRI provider eligibility.

Go to Step 20.

This information is for the applicant’s information only.

Go to Step 21.

Question 42 is mandatory for:

• new LSPNs
• relocations
• updating LSPN details
• adding or removing MRI providers
• renewing registration

Question 42 must be signed by a currently recorded proprietor or authorised representative for:

• updating LSPN details
• adding or removing MRI providers
• renewing registration

Note: a different person can sign the form if all authorised persons are unavailable. See Amend Location Specific Practice Number (LSPN) register for Medicare

Question 42 must be signed by the proprietor for:

• new LSPNs
• relocations
• business details changes – must be signed by the proprietor of the incoming company

Note: closure requests cannot be processed if only Question 42 is signed.

For government/public bodies where the proprietor is not one single person, a responsible officer can sign the form, this includes but is not limited to:

• Chief Executive Officers
• Account Managers, and
• Directors

If unsure the applicant is authorised, escalate to Pathology and Diagnostic Imaging Team to decide.

Question 43 is mandatory for:

• closures
• relocations
• business details changes – must be signed by the proprietor of the outgoing company

Go to Step 22.

LSPN applications cannot be processed unless they meet the following signature requirements:

• Forms submitted via post, fax or form upload by someone other than the signatory:
• the tick box must be selected to declare whether the person is a proprietor or authorised representative
• the full name of the signatory must be entered
• physically signed and dated by an authorised person
• Form submitted via HPOS form uploaded by the signatory, all of the above apply, except:
• the form does not need to be signed
• the declaration above the signature field must be selected

For both forms submitted by HPOS and forms submitted by post/fax:

• the time between when the application is signed (or the declaration box is ticked) and sent to the agency must be less than 3 months
• for renewals, the date the application is signed (or the declaration box is ticked) and sent to the agency must be less than 3 months before their current approval expires

The following fields are mandatory for each of the declarations to be considered complete:

• I have the appropriate authority to sign this document in my capacity as: (one box only)
• Full name
• I have read, understood and agree to the above (if no signature and submitted via form upload by the signatory)
• Signature (if not submitted via form upload by the signatory - electronic signatures of any type are not accepted)

The position held field is optional.

Exceptions to the signatory requirements

An authorised person may not be available to sign an LSPN application. See Amend Location Specific Practice Number (LSPN) register for Medicare for the process for applications in these circumstances. This process only applies to existing LSPNs.

Go to Step 23.

Question 44 is optional.

It is designed to ensure the applicant is aware of the requirements for each application type.

Go to Step 24.

The assessment process of the HW061 form is now complete.

Are all mandatory questions correctly completed?

• Yes, go to Step 25
• No, at least one mandatory question is incorrect/incomplete. Go to Step 26

For processing instructions see:

• Register for a Location Specific Practice Number (LSPN) for Medicare for new LSPNs
• Amend Location Specific Practice Number (LSPN) register for Medicare for existing LSPNs

Did the application contain any optional answers that were incorrect or incomplete?

• Yes, go to Step 26
• No, the assessment ends here

Any LSPN application with an answer that is incomplete or incorrect must be returned without notice. When returning an application, staff must:

• note the reason(s) for refusal in PaNDA notes
• draft the LSPN refusal letter
• attach a copy of the letter to the Work Item in PaNDA
• for refusals of new LSPNs, send the Work Item for delegation; the delegate will send the letter after making the decision
• for all other applications, send the letter via post (and HPOS if relevant) before completing the Work Item

See Processing and National Demand Allocation (PaNDA).

The LSPN refusal letter (Z2374) must be:

• addressed to the applicant if details are available, or the first authorised contact if not
• Include all relevant reasons
• printed and posted
• sent to the applicant via HPOS if this was the channel of submission
• attached to PaNDA in PDF format before the Work Item is closed