Prescriber number for health professionals in Medicare 012-42010030

Check the application to make sure the following fields have been completed:

• First name and surname
• Date of birth
• Existing provider number (if applicable)
• Indicated prescriber number is needed
• Declaration must be signed

Note: make sure the HW088 has been completed.

Check that the eligible nurse practitioner:

• has a provider number (or is applying for a provider number)
• holds current Australian Health Practitioner Regulation Agency (Ahpra) registration as a nurse
• has 'Nurse Practitioner' endorsement on their Ahpra registration

Go to the Ahpra website and take a snip of the Ahpra registration details. Copy the image into a Word document, convert to a PDF and upload to PaNDA (even if a copy of the Ahpra registration has been supplied with the application).

Note: an APS5 delegate assessment is required if an application cannot be processed or if the request is incomplete. Continue assessing to get delegate approval before refusing the application.

Is there a processing note from an APS5 delegate advising if the application has been approved or refused?

• Yes, if the delegate has:
  • approved the application, go to Step 4
  • refused the application, go to Table 9
• No, if there is no processing note from an APS5 delegate, go to Step 3

Check if the nurse practitioner has a prescriber number issued as an ‘Authorised nurse prescriber'.

In the Provider Directory System (PDS):

• Select Individual view
• In the Search type field, select Shell Records
• In the Search ID field, type registration number. For example, 'NMW000123456'
• In the ID Type field, select Registration Number
• Select Search. A health professional with matching details will show
• Select View
• At the top of the screen with health professional's details, select Existing Prescriber Number
• Prescriber number details table displays with this record's details and existing details
• Assess the results:
  • Check the existing profession type
  • Check date of birth, surname, first name are the same as the application
  • Compare details from existing record row(s) to this record (the first row of the table)
    The existing record may include a midwife profession type

If the details:

• match the application or confirm there is an existing prescriber number, add a comment in PaNDA processing notes for the delegate, then go to Step 4
• do not match the application or cannot confirm there is an existing prescriber number, add a comment in PaNDA processing notes for the delegate to investigate further, then go to Step 5

In PaNDA:

• Make sure the Surname, First Name, Provider Number and Case ID fields are complete and correct
• Select Processing Notes
• Select Add Processing Note
• Add a processing note stating:
  • 'delegate approval required for prescriber number' or
  • 'delegate confirmation required for refusal of prescriber number'
• Select Confirm
• Select Details
• Select Send for Delegation

Note: if the application is for an initial provider number, send the work item to the delegate via Send for delegation in PaNDA.

When the eligible nurse practitioner works:

• In private practice - a provider number is issued for billing appropriate Medicare Benefits Schedule (MBS) items. The specialty code 651 is added to the stem and location. The location provider number may be released to the nurse practitioner or appropriate third party
• In a government funded clinic/hospital/health service listed on a 19(2) or 19(5) Direction - a provider number is issued for billing appropriate MBS items. The specialty code 651 is added to the stem and location. The location provider number may be released to the nurse practitioner or appropriate third party
• In public hospital with refer and request rights, or where only prescribing access is required - a provider number is issued for refer and request only. The specialty code 651 is added to the stem and location with the location service ruled to prevent claiming of Medicare benefits when not eligible to claim Medicare benefits. The location provider number may be released to the nurse practitioner or appropriate third party

Allocate a prescriber number in PDS edit mode:

• Select the Qualification tab
• In the Prescriber Status field, select Prescriber
• Select Save

Note: where an eligible nurse practitioner has asked for a prescriber number only and a provider record has not previously been created, see Table 9 > Step 14 in Provider Directory System (PDS) specialty codes, for allied health and non-medical health professionals.

A confirmation letter must be sent to all applicants advising the outcome of their application.

Select and complete the appropriate letter through Digital Messaging Capability (DMC) > Medicare Provider and Third Party letters > Provider registration.

Outcome letter options:

• Prescriber number issued in conjunction with a new provider number:
  • Z2599 - Your Medicare provider/prescriber number - non-medical letter
• Prescriber number only application:
  • Z3241 - Approved PBS Prescriber number letter
• Where a nurse practitioner has an existing prescriber number as an authorised nurse prescriber and the application is approved, staff must issue both outcome letters:
  • Issue Z2599 - Your Medicare provider/prescriber number - non medical letter and select the Existing prescriber number option (Endorsed as an authorised nurse practitioner and authorised nurse prescriber), and
  • Issue Z3241 - Approved PBS Prescriber number letter

Convert the letter into PDF format and Save the letter to the Customer Information folder on the team's secure drive. Then upload to the original file, making sure that the file name is correct. For help, see Associate documents to a work item.

Then:

• Print the letter and send to the provider by post and by HPOS (if the provider has an active HPOS account)
• Add any appropriate notes to the PaNDA file
• Select Complete
• Select Save
• Close the file

Note: start date of the prescriber number on the letter is the date of issue or first location start date, whichever is later.