Proof of energy reviews for Essential Medical Equipment Payment (EMEP) 008-01040050

Letters

An automatic letter is sent to the customer requesting the most recent energy account for the relevant EMEP residence and type of energy. It advises that EMEP will stop if they do not provide proof within 28 days of the date the letter was issued.

Review activities

When the letter is issued, a cancellation review activity is created on the Future Activity List (FAL) screen to mature in 28 days.

Search for scanned activities.

Use keyword POBCEM.

Both of the following criteria must be met:

• the evidence must be:
• the most recent energy bill in the name of the customer, their partner, or the equipment user, or
• a signed declaration from the account holder that the customer or equipment user contributes to the energy account
• the evidence must be for the type of energy being used to run the medical equipment and/or medically required heating/cooling at the residence for the EMEP claim linked to the review

Check:

• Claim contacts > Online and families claims > claim ID of relevant EMEP to view claim summary details
• the energy information in the claim matches the evidence provided. For example, claim for electricity and electricity bill provided

Was the evidence provided within 28 days?

• Yes, go to Step 5
• No, go to Step 4

Has acceptable energy account evidence been provided within 13 weeks of the date the review letter was issued?

• Yes, restore EMEP via the Benefit Action (BA) screen. Within the same activity, record proof of energy details
• No, the customer must lodge a new EMEP claim. Contact the customer to discuss EMEP eligibility and the need for a new claim. Record the proof of energy details so that the current or future EMEP claim is assessed correctly. If a new claim has been lodged, code details within an MEP NCL activity.

Go to the Medical Equipment Energy Proof Details (MEEP) page in the ISS/MEP system.

The screen will be protected if the customer has already provided acceptable proof of energy or is not required to provide proof. In this case, record details on a DOC, procedure ends here.

On the MEEP page, in the following fields:

• Date of effect, key the:
• date the evidence was received, or
• (if outside 28 days), date EMEP was cancelled
• Energy proof provided, select relevant option:
• 'provided and acceptable', or
• 'provided and not acceptable'
• Source and Receipt Date, key details
• select Update > Continue to submit the updates

Record details on a DOC and finalise activity on the Assessment Results (AR) screen.

If the energy account evidence was:

• Provided and acceptable, the MEEP page history will show that energy requirements have been met. Any future proof of energy review will be deleted
• Provided and not acceptable:
• when the review matures 28 days from the letter issue date, the customer's EMEP attached to the review will cancel reason NEN (no energy proof provided). A cancellation letter will issue
• any subsequent EMEP claims will reject reason NEN until the customer provides acceptable proof of energy. EMEP can be restored if acceptable proof is provided within 13 weeks

If the customer payment cancels NEN as the energy account was not provided and it is outside 13 weeks, the customer must provide proof of energy details before the claim can be assessed. If the energy account is not provided, the payment will auto reject with the code NEN.

If Medical Equipment Energy Proof Details are keyed and the payment does not restore after coding restoration, go to the Medical Equipment Explanation Summary screen via Workspace.

If the cancellation message reads No eligible equipment user:

• within the activity, go to the LS screen. Note: the previous link will show that the link has end dated as of date of cancellation. This now requires a new link to be coded
• Add New Link, key Y
• in the OCL screen:
• Link Type, key MEP
• From SVC Rsn, key MEP
• To, key MEU
• Start date, key the day after cancellation date
• review the activity before finalising. Check that payment has restored correctly.
• record the details on a DOC as per Quality standards in service delivery