Change of circumstances for Essential Medical Equipment Payment (EMEP) 008-01040040

If a customer notifies more than one CoC, changes may be recorded in the same activity. This is so the system can, (where appropriate):

• cancel for the correct reason, and
• send the correct letter

In Customer First to access EMEP screens:

• Enter SVMEP in the NEXT field
• Select system ISS
• Press Enter

See the Resources page for EMEP screens in Customer First.

To view a summary of EMEP payments, select Payments & Services > Clean Energy payments > Medical equipment payment explanation summary page.

Is EMEP current?

• Yes, go to Step 4
• No, go to Step 2

EMEP can be restored for certain cancellation reasons. See Cancellation and rejection codes for EMEP to determine if EMEP can be restored.

• If EMEP can be restored and the Service Officer is suitably skilled to restore EMEP, go to Step 3
• If the Service Officer is not suitably skilled and EMEP can be restored create an open work item using Fast Note with the following information:
• Select Auto Text, use EMEP, EMEP restoration > EMEP restoration request
• Select Confirm
• Edit Auto Text: include relevant details
• Select Continue
• Procedure ends here
• If correcting address details for customer and/or equipment user, see Table 2 > Step 1
• If allocated a review activity work item:
• Check the MEPSUM screen to review the history of equipment paid for and payment dates to ensure the customer has not already been paid in the last 12 months for the same item(s) of equipment at the same address
• If the claim meets requirements, index and run a MEP/NCL activity using the anniversary date as the Date of Receipt
• Process the claim, go to Processing Essential Medical Equipment Payment (EMEP) claims, procedure ends here

For all other circumstances, where EMEP is not current, advise customer of:

• the cancellation
• their review and appeal options
• new claim requirements

Procedure ends here.

Only suitably skilled EMEP Service Officers can restore payment.

EMEP can be restored for certain cancellation reasons. See Cancellation and rejection codes for Essential Medical Equipment Payment (EMEP)

Make any other CoC prior to restoring EMEP.

To restore EMEP, in Customer First go to the Benefit Action (BA) screen:

• Select the Service Reason MEP – Medical Equipment Payment
• Select Action – Restore
• Enter Effect Date as the original claim date
• Select Source
• Enter Receipt Date
• Select Submit Change
• Go to the AR screen to check outcome

If EMEP does not restore, coding is required on the Medical Equipment Payment Override (MEOV) screen. Refer to Service Support Officer to update the MEOV screen.

Complete restoration:

• Finalise activity
• Record details in a DOC

Is another CoC required?

• Yes, go to Step 4
• No, procedure ends here

A customer and/or equipment user may contact to advise of a CoC.

If the contact relates to:

• adding an equipment user, medical equipment type or medically required heating/cooling, see Claiming Essential Medical Equipment Payment (EMEP)
• changing address details, go to Step 5
• updating medical equipment or medically required heating/cooling, go to Step 6
• updating contribution to energy account, go to Step 8
• withdrawing equipment user consent, go to Step 9
• equipment user going overseas, go to Step 11
• customer going overseas, go to Step 10
• cancellation reason NIA, go to Step 12
• advising death of a customer or equipment user, go to Step 13
• equipment user temporarily enters a hospital/prison/care facility, go to Step 14

A change of address will cancel EMEP and a new claim will then be required to receive EMEP for the new residence or address.

This includes correcting a customer and/or equipment user’s current address (such as street name spelling). To correct a customer and/or equipment user’s address, see Table 2 > Step 1

Where equipment user leaves care, a change of address of the equipment user is required.

When the change of address is recorded for an EMEP:

• customer who is an equipment user:
• EMEP will cancel reason MOV (moved from claim address, claimant)
• customer who is a carer:
• EMEP will cancel reason MOV
• all links with equipment users will be end dated
• Link status will be blank on MEUS screen
• equipment user and the EMEP customer is the carer:
• EMEP will cancel for the equipment user
• cancellation reason MOE (moved from claim address, equipment user)
• EMEP will also cancel at the customer level unless they receive EMEP for themselves or another equipment user

See Updating address details for more information.

See Table 2 > Step 2.

If the customer and/or equipment user advises:

• an item of medical equipment has been updated or replaced with the same equipment type at the same address:
• Do not update EMEP details
• The current anniversary date still applies
• Record details on a DOC
• an item of medical equipment has been recorded incorrectly, and the correct equipment was verified by their medical practitioner in their initial claim:
• update EMEP equipment details, go to Step 6
• of additional/new medical equipment and/or medically required heating cooling, they must lodge a new EMEP claim and provide proof of medical needs, procedure ends here
• medical equipment and/or medically required heating/cooling is no longer being used, update EMEP equipment details, go to Step 6

If details were incorrectly recorded:

• Select MEUD
• Select the medical equipment type
• Update or Delete the details

EMEP will cancel for the updated medical equipment and/or medically required heating/cooling.

See Table 2 > Step 2.

In the EMEP customer’s record, select Workspace select Payments & Services > Energy payments > Medical equipment task selector (METS):

• Select MEUS and MEUD
• Select Continue
• MEUS will present:
• Select equipment user
• Select Continue
• MEUD will present:
• Select medical condition or equipment type
• Correct the Date of Event
• Select No in Is equipment being used field
• Complete Source: and DOR: fields
• Select Update

See Table 2 > Step 2.

Energy account details can be viewed through Workspace, select Payments & Services > Energy payments > Medical equipment task selector (METS):

• Select MEUS and MECD
• Select Continue
• MEUS with present:
• Select equipment user
• Select Continue
• MECD will present:
• Details can only be recorded within an MEP NCL activity

Energy account reviews

Customers selected for an energy account review need to provide evidence, outside these reviews evidence is not required.

If the customer and/or equipment user advises they no longer contribute to the energy account, check if energy account requirements are still met.

If energy account requirements are no longer met cancel EMEP manually, in Customer First go to the Benefit Action (BA) screen:

• Select the Service Reason MEP – Medical Equipment Payment
• Select Action – Cancel
• Select Reason – LEN - No liability for energy account
• Enter Effect Date as the date of cancellation
• Select Source
• Enter Receipt Date
• Select Submit Change

Go to the AR screen to check outcome.

See Table 2 > Step 2.

If a customer claims EMEP as a carer and the equipment user is not a dependent child, the equipment user is required to give their consent for the customer to be paid EMEP.

Non consent reason details can be viewed and updated through Workspace select Payments & Services > Energy payments > Medical equipment task selector (METS).

• Select MEUS and MEUD
• Select Continue
• MEUS will present:
• Select equipment user
• Select Continue
• MEUD will present

The equipment user may withdraw their consent by Lodging an EMEP claim:

• When the claim is processed:
• consent will be withdrawn
• the current customer's EMEP will be automatically reassessed
• Go to the AR screen to check outcome
• Once the activity is assessing correctly, select Finalise

The current customer's EMEP will cancel reason WDC (consent withdrawn) if they have no other qualifying equipment or equipment user.

If the equipment user wishes to claim in their own right, invite them to claim EMEP. See Claiming Essential Medical Equipment Payment (EMEP).

Procedure ends here.

To receive EMEP, the customer must be in Australia on the date they claim EMEP and on each anniversary date.

If the customer is not in Australia on the 12 monthly anniversary date, EMEP will cancel and a new claim will need to be lodged on return to Australia.

If the customer advises they are going overseas use the Portability script to record details.

For permanent departures:

• EMEP will cancel immediately NIA - not located in Australia

For temporary absence:

• EMEP will remain current and eligibility for the annual payment will be determined on the 12 monthly anniversary date

Has the customer's EMEP cancelled NIA, and it is not the anniversary date?

• Yes, go to Step 11
• No, see Table 2 > Step 2

If the equipment user is not the EMEP customer, the portability script should only be used if they are a current customer for other payments such as a social security pension, social security benefit or ABSTUDY Living Allowance.

EMEP will cancel automatically when an immigration data match for an equipment user advises they have left Australia.

If they are not receiving a social security pension, social security benefit or ABSTUDY Living Allowance and going overseas:

• temporarily:
• Record details on a DOC on the equipment users record
• Procedure ends here
• permanently within 14 days, update address for equipment user, this will:
• automatically reassess the link to the carer's EMEP
• end the link to the equipment user
• cancel EMEP when no other qualifying equipment user is linked
• record details on a DOC on the equipment user’s record
• Procedure ends here
• permanently outside 14 days, advise the equipment user to:
• update portability via online services within 14 days of travel, or
• where they don’t have online services, contact to advise
• record details on a DOC on the equipment user’s record
• Procedure ends here.

If the customer is overseas and EMEP cancels but not on the EMEP anniversary date, this is an incorrect cancellation and restoration of EMEP is required.

In Customer First:

• Activate the Department of Home Affairs datalink for the date of return (DOR) on the Carer record
• Once link is established, restore the payment via the BA screen
• Select ‘MEP’ in the Svc Rsn: field
• Select ‘RES' in the Action: field
• Complete the Source: and DOR: fields
• Select Submit Change
• Event Date: field defaults to cancellation date
• Select Submit Change
• Within the restoration activity:
• Go to the Link Summary (LS) screen
• Note the previous link end date = date of cancellation. A new link is required from the day after the cancellation date
• Key Add New Link - Y
• On the Other Customer Links (OCL) screen key:
• Link type - MEP,
• From SVC Rsn - MEP
• To - MEU
• Start Date - day after cancellation date
• Source and DOR
• Finalise activity
• Record details in a DOC

Procedure ends here.

If the equipment user dies and they are not the EMEP customer:

• Record the death action on their (equipment user’s) record
• An automatic reassessment occurs for the EMEP customer
• If the deceased was the only qualifying equipment user:
• EMEP will cancel NUE - no eligible equipment users

If the EMEP customer dies and they are the equipment user:

• Record the death action
• EMEP will cancel DEA - Death/Executor information

If the EMEP customer dies and they are not the equipment user:

• Record the death action
• EMEP will cancel DEA - Death/Executor information
• If the person notifying of the EMEP customer’s death is the equipment user, advise them they may still qualify for EMEP and to lodge a new claim

See Table 2 > Step 2.

If the equipment user temporarily enters a hospital/prison/care facility:

• Select the Equipment User Manual Qualification (MEMQ) in Next
• Key the original claim receipt date in Date of effect
• Select applicable Eligible outcome (Yes or No)
• If No is selected, select applicable reason. For example, if they are in hospital or in prison
• Select Update
• Select Continue
• Select Finalise
• Record details on a DOC

If correcting a customer's address, EMEP will auto cancel.

If EMEP has been cancelled and the customer has not moved address:

• in Customer First, create a manual review on the Review Registration (RVR) screen and complete the fields as follows:
• Service Reason: BBY - due to system limitation
• Review Reason: OTH (Other)
• Due Date: next EMEP anniversary date
• Source: INT
• Date of receipt: today's date
• Notes: ‘If the customer has not moved, reassess entitlement to EMEP at next anniversary date.’
• Keyword: EMEPCOA
• Workgroup: leave blank
• Position: leave blank
• Transfer to Region: CRM

EMEP can be manually cancelled in Customer First via the Benefit Action (BA) screen (if necessary).

• In Next key AR
• Select Continue
• Assessment Results (AR) screen will present with the cancellation reason:
• A future cancellation date may display with the next anniversary date
• Once the activity is assessing correctly, select Finalise

Has EMEP cancelled Not in Australia (NIA)?

• Yes, go to Step 3
• No, go to Step 4

If the EMEP payment is showing as cancelled, and the customer is not overseas on the anniversary date, restore the customer’s payment as follows:

• Activate the Department of Home Affairs datalink for the date of return on the Carer record
• Once link is established, restore the payment via the BA screen
• Within the restoration activity, navigate to the Link Summary (LS) screen
  Note: the previous link will show it has ended as of the date of cancellation. This requires a new link to be coded the day after the cancellation date
• On the LS screen, next to Add New Link, key Y
• On the Other Customer Links (OCL) screen:
• Link type, key MEP
• From SVC Rsn, key MEP
• To, key MEU
• Start Date, key the day after cancellation date
• Record the Source and DOR
• Finalise activity on the Assessment (AR) screen

Record details of the reassessment on a DOC.

An automatic letter is issued advising the result of the change of circumstance.

For cancellation reason OTH, a manual letter (Q999) is required. Note: OTH should only be used as a final option where no other cancellation, suspension or change in circumstance coding is appropriate.

Where required, advise the customer or equipment user to make a new claim, see Claiming Essential Medical Equipment Payment (EMEP).

Has EMEP cancelled due to death of an equipment user, carer or customer?

• Yes,
• Create an EMEP Bereavement - Cancellation advice and issue to executor/estate, see Letters and electronic messaging sub site
• Record details of Q999 issued in DOC
• Procedure ends here
• Note: XCANMEPNQR advice will be deleted from the BLST screen by EMEP Program team
• No, procedure ends here