Public Eligibility quality checking processing 111-22090030

Status code categories

Table 1

Category	Displayed in QCS as…
Error-free	OK
Document status codes	ADM
Processing status codes	PRO

Error-free status code

Table 2

Error-free status code	Definition	Processing tip
001	Error-free	Quality check did not detect errors.

Document error status codes

Table 3

Error status codes	Definition	Processing tip
E06	Address details omitted.	It is an error when the address details were omitted from an enrolment form (or written correspondence) and there is no verification present.
E10	Reason for copy or transfer application omitted.	It is an error when the reason for a copy or transfer has not been notated/tickbox on the form.
E11	Name/s incomplete or omitted.	It is an error when a member of the public's: first name surname second name (if applicable) was incomplete or omitted from the form and no verification is present. Note: this error does not apply to the name stated in the declaration.
E12	Gender omitted.	It is an error when a member of the public's gender was omitted from the Medicare Enrolment Application form and no verification is present.
E13	Insufficient documentation to support enrolment action taken for child in state/foster care.	It is an error if there is inappropriate or insufficient documentation to support any enrolment action taken for a child under the age of 15 in state/foster care.
E16	Signature/declaration omitted or incomplete.	It is an error when an Enrolment was not signed/declaration not completed and there is no verification present (if applicable). Note: signatures may be required for all applicants over the age of 14 for EFT collection, 15 for all other forms.
E19	Insufficient, inappropriate or no documentation to support enrolment action taken.	It is an error if the following is not in the batch or not uploaded in PaNDA to support the enrolment amendment taken: enrolment form correspondence VEVO confirmation Documents not accepted and VEVO not completed in MEE portal
E20	Insufficient or incorrect identification to support enrolment amendment action taken.	It is an error when there is: insufficient or no certified copies of required identification to support enrolment amendment action taken
E22	DIAC/Applicant for permanent residency. Insufficient, inappropriate or no documentation to support enrolment action taken.	It is an error when a member of the public has been enrolled and: a Medicare Enrolment Application form has not been completed passports for all card members have not been sighted and notated on CDMS eligibility documentation has been sighted but not notated on CDMS DIAC link is not selected when present DIAC link for the incorrect customer is selected Documents not accepted and VEVO not completed in MEE portal Note: this may require referral to the Compliance Operations area, Program Review Division.
E23	Returning residents/citizens and New Zealand citizens residing permanently in Australia. Insufficient, inappropriate or no documentation to support enrolment action taken.	It is an error when a member of the public has been enrolled and: a Medicare Enrolment Application form has not been completed passports for all card members have not been sighted and notated on CDMS documents have been sighted but not notated on CDMS mandatory minimum residency document requirements have not been met statutory declaration incomplete
E24	New enrolment Reciprocal Health Care Agreement. Insufficient, inappropriate or no documentation to support enrolment action taken.	It is an error when a member of the public has been enrolled and: a Medicare Enrolment form has not been completed passports for all card members have not been sighted and notated on CDMS additional Reciprocal Health Care Agreement (RHCA) support documents have not been sighted and notated on CDMS (where applicable)
E39	More than four document errors.	If 4 document errors are detected, key all 4 error codes in the status value available. If more than 4 errors detected, key the first 3 errors with applicable code and key E39 as the fourth error. When more than 4 errors are made and there is a combination of document and processing errors, use E89 as the fourth error.

Processing error status codes

Table 4

Error status codes	Definition	Processing tip
E40	Incorrect Medicare card number or duplicate record created.	It is an error when an enrolment transaction has been processed under the incorrect card number. It is an error if a duplicate pin/ consumer ID was created when completing an enrolment activity. If a customer record already exists in CDMS, it must be used to associate the Medicare enrolment.
E41	Group contact first name or family name incorrect or not changed.	It is an error when the group contact: was keyed incorrectly selected does not match supporting documentation was not updated when group contact is: transferred to a new group/name change not actioned deceased
E42	Long name details incorrect/not required.	It is an error when the: group member's fields: applicants name keyed incorrectly For example as much of the applicant's name as possible should be keyed Medicare long name fields: first and surname have not been completed in full second name has been keyed in full name not shortened in group as requested It is an error to create a 'Long name record' when the name is not long. or long name process has not been completed. Note: only one member of the public can be associated with this Medicare card for quality control purposes, it is one error if both sections of fields are in error
E43	Address details keyed incorrectly or not updated when appropriate.	It is an error when the address was: keyed incorrectly not updated keyed in Personal inappropriately residential address recorded or not omitted for children under 15 years
E44 Note: non-critical error. This must not be recorded on QBBI, only on the online Error Explanation Sheet.	Comments field not completed when appropriate or completed inappropriately.	It is an error when the comments: keyed are inappropriate or not related to the correct: member of the public section of CDMS, for example, Personal, Entitlement or Group were not keyed when appropriate Note: see E73 for comments related to LHC letters.
E45	Ineligible member/s of the public enrolled.	It is an error when a member of the public was enrolled when the supporting documentation indicated that they were not eligible.
E46	Entitlement type incorrect or not changed when appropriate.	It is an error when the entitlement type has: been selected incorrectly not been changed
E47	Country of relevance/Reciprocal Health Care Agreement (RHCA) country selected incorrectly.	It is an error when the Country of Relevance/RHCA country selected does not match supporting documentation.
E48	Power of attorney (POA) details incorrect or not completed when appropriate.	It is an error when the POA details have been: keyed incorrectly selected incorrectly completed with insufficient documents
E49	Entitlement start date incorrect or not changed when appropriate.	It is an error when the entitlement start date has: been keyed incorrectly not been changed Note: it is not an error when the dates have been updated as per Department of Home Affairs link.
E50	Entitlement end date or entitlement end reason incorrect or not changed when appropriate.	It is an error when the: entitlement end date has been keyed incorrectly entitlement end date has not been changed or removed entitlement end reason has been selected incorrectly
E51	Return mail indicator selected incorrectly or not selected or type of return mail incorrect.	It is an error when the: return mail indicator was not recorded in Group or Personal return mail indicator selected incorrectly in Group or Personal type of return mail was selected incorrectly in Group or Personal return mail has been updated at Personal and not Group (where appropriate)
E52	Medicare Copy/Transfer not actioned or actioned incorrectly.	It is an error when an applicant/person has: been transferred to another group when a copy was requested been copied to another group when a transfer was requested not end-dated the association when appropriate MS004/FA081 - Newborn not copied to partner's card when requested in Part C of MS004 or FA081 Note: when both parents are shown on a family card, children under the age of 15 years should not be transferred without the authority of both parents as per the business rules.
E53	Replacement card not issued or issued incorrectly.	It is an error when: a request for a replacement card was not actioned a replacement card was issued incorrectly the source of a replacement card request was selected incorrectly the reason for replacement card selected does not match supporting documentation when indicated Note: when processing a notification of death for a multiple person enrolment, a replacement card is not to be issued unless requested.
E54 Note: non-critical error. This must not be recorded on QBBI, only on the online Error Explanation Sheet.	Title and/or suffix selected incorrectly.	It is an error when a title and/or suffix is incorrectly selected and has not been updated at Personal and/or Group.
E55 Note: non-critical error. This must not be recorded on QBBI, only on the online Error Explanation Sheet.	Personal contact details not keyed or keyed incorrectly.	It is an error when a member of the public's contact details are not keyed or keyed incorrectly. This includes when the: business phone number business comment home phone number home comment fax number fax comment mobile number mobile comment email address email comment does not match supporting documentation when legible.
E56	EFT banking details keyed incorrectly.	It is an error when a member of the public's EFT details were: not keyed keyed incorrectly not updated not ended recorded against the incorrect member of the public
E57	Name not keyed or keyed incorrectly.	It is an error when a member of the public’s name or only name has: been keyed incorrectly not been keyed not been keyed in full when appropriate not been updated at personal or group level when appropriate long name not keyed correctly in group names have not been amended as per the legal documentation in the MEE portal Note: a request for a name change at group level only must be notated in the personal comments. This field does not need updating where the second names or initial is already populated but not indicated on supporting documentation.
E60	Gender selected incorrectly or not changed when appropriate.	It is an error when a member of the public's gender does not match supporting documentation or as per the legal documentation in the MEE portal. Note: gender can only be amended for gender reassignment when relevant documentation requirements have been met.
E61	Date of birth keyed incorrectly.	It is an error when a member of the public's date of birth does not match supporting documentation or as per the legal documentation in the MEE portal.
E62	Date of death or notification source incorrect.	It is an error when a member of the public's date of death: has been keyed incorrectly has not been keyed notification of deceased source has been selected incorrectly
E63 Note: non-critical error. This must not be recorded on QBBI, only on the online Error Explanation Sheet.	Aboriginal/Torres Strait/South Sea Islander status selected incorrectly or not updated.	It is an error when the Aboriginal/Torres Strait/South Sea Islander status: selected is incorrect was not updated Note: where the Aboriginal/Torres Strait/South Sea Islander status is already populated but not indicated on supporting documentation the selection is not required to be updated.
E64	Eligibility and/or residency documents keyed/selected incorrectly or not entered.	It is an error when the required eligibility or residency documents sighted or notated were: selected incorrectly keyed incorrectly not selected It is an error if the reference date or text was omitted or incorrect.
E71	Work item not actioned completely	It is an error if a work item has not been actioned completely as per the business rules. It is also an error if a work item is closed in PaNDA without being processed and no comments in PaNDA/CDMS to explain the action taken. This also includes where the My Health Record (MHR) error has occurred during an enrolment activity.
E72	Sensitive indicators not selected/selected incorrectly.	It is an error if the sensitive indicators are not selected/selected incorrectly in CDMS as per the business rules.
E73	LHC request not actioned when appropriate.	It is an error if a Life Time Health Cover (LHC) letter has not been actioned: as per the customer’s request, or as per the business rules Note: it is also an error if no comments are left on CDMS when an LHC letter is issued.
E74	DVS not actioned/comments keyed when appropriate.	It is an error when Document Verification Service (DVS) business rules are not followed / comments not included in CDMS when DVS check has been actioned.
E75	Online enrolment not actioned/closed/actioned incorrectly.	It is an error if the online (includes Digital and Medicare Newborn Enrolment (MAENROL) Digital Medicare Enrolment (DME)) enrolment is not processed as per the business rules. It is also an error if: work item not closed completely in PaNDA/CDMS consent process not followed when adding a newborn to a different card DME application rejected incorrectly DME ID has not been recorded in CDMS
E76	Contact details recorded or not removed for children under 15 years	Contact details for children under 15 years must not be displayed in CDMS. It is an error when: Contact details are recorded Contact details have not been removed (when previously recorded in error by another Service Officer)
E89	More than four processing errors.	When four processing errors are detected key all four error codes in the status value available. When more than four processing errors detected key the first three errors with applicable code followed by error code E89 in the fourth field. When more than four errors are made and there is a combination of processing and document errors, use E89 as the fourth error.

Medicare Safety Net document error status codes

Table 5

Error status codes

Definition

Processing tip

E08

Insufficient, incomplete or no documentation/comments to support Medicare Safety Net confirmation.

To support action taken, it is error when:

the Medicare Safety Net confirmation form was incomplete
there was no Medicare Safety Net confirmation form

Medicare Safety Net processing error status codes

Table 6

Error status codes	Definition	Processing tip
E67	Medicare Safety Net registration member type keyed incorrectly or not updated.	It is an error when the member type does not match supporting documentation.
E68	Member omitted from, included in or not removed from a family Safety Net registration when appropriate.	It is an error when a member of the public was either: omitted included not removed from the family Safety Net registration when appropriate.
E69	Family confirmed incorrectly.	It is an error when the family composition for confirmation does not match supporting documentation.

My Health Record processing error status codes

Table 7

Error status codes

Definition

Processing tip

E70 Critical

Individual registered incorrectly without consent.

This is an error when the individual or a dependant has been registered and they have not given their authority.

The MHR error email template must be completed and sent for action to the Consumer IHI and My Health Record SME team (see 'Consumer enquiries' table).

Email template

Table 8

Email

Description

Subject

My Health Record processing error

Body

Complete the following information:

Your details

Date:

Your Name:

Your phone number:

Self reported or QC?

Processing details

Source office code:

Processing date:

Processor P number:

Form Type (FA081/MS004/Online/Other):

Error details (Registered/not registered incorrectly):

Consumer details

Name:

DOB:

IHI:

Phone no:

Dependent details (if applicable)

Name:

DOB:

IHI:

Please attach documents

Attachments

Do not share these attachments externally. See Freedom of Information - Information Publication Scheme.

$\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.png$ Guide to completing the online Error Explanation Sheet

$\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.png$ The Quality Control System (QCS) for Medicare

$\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.png$ CDMS Quality Control Quick Reference Guide

Intranet links

Error Explanation Sheet

Enterprise Quality Framework

Contact details

My Health Record Support team

Health Service Delivery Division - Quality, Performance and Technical Support

Medicare National Portfolio- Face to Face

Operational Information