Incentive Programs quality checking in QST 111-22140000

Error-free status code

Definition

Processing Tip

INC01

Error-free

Quality check did not detect errors.

Error status codes

Definition

Processing tip

INC02A

Critical

Form incomplete

It is a critical error when a mandatory field has not been completed on the form.

INC03

Critical

Insufficient supporting documentation supplied

It is a critical error if:

• there is insufficient documentation to support the request, and
• there is no comment on PaNDA or PIP/WIP-Practice Stream Online to support the action taken

For example:

• Ownership evidence
• Evidence of Accreditation
• Letter from old or new owner/s confirming practice arrangements where applicable

INC04A

Critical

Declaration not signed by the correct signatory.

It is a critical error when the form has been processed by a Service Officer and the Declaration is:

• not signed by an owner or authorised contact person registered with the practice, or
• not signed by the General Practitioner or Nurse Practitioner indicated on the form

INC04C

Critical

Declaration incomplete

It is a critical error when the Declaration is missing the following information, and there is no notation on PIP/WIP – Practice Stream Online:

• Signature
• Name
• Date (where mandatory)

INC05

Critical

University Certification on Teaching Claim form is incomplete or incorrect

It is a critical error when the:

• University Declaration is missing the following information, and there is no notation on PIP/WIP – Practice Stream Online:
• University name
• University representative’s full name and signature
• University declaration date
• or the University Declaration date is:
• invalid
• future dated, or
• dated American style

INC05A

Critical

Teaching – Student Session details incorrect

It is a critical error when the teaching claim is keyed incorrectly:

• Date of session is invalid
• Number of sessions keyed incorrectly
• Missed sessions
• General practitioner not on practice profile
• General practitioner has not signed form
• Student has not signed the student declaration
• Authorised contact person or owner has not signed the declaration
• Duplicate claim keyed resulting in recovery action

INC06

Critical

Practice Name incorrect

It is a critical error when the Practice Name is keyed incorrectly.

INC07

Critical

Authorised Contact Person Details incorrect, including contact not added/removed from the practice profile

It is a critical error when any of the following Primary/ Secondary Contact Details are keyed/ selected incorrectly, or not keyed/ selected/ removed from the practice profile:

• Family Name
• First Given Name
• RA Number (if applicable)

INC08B

Non-critical

Practice Contact Details incorrect

It is a non-critical error where any of the following Practice Contact Details have been keyed incorrectly or not keyed:

• Phone number
• Fax number
• Email address

INC09

Critical

Practice Address details incorrect

It is a critical error when any of the following details have been keyed/ selected incorrectly or not updated:

• postal address
• main practice location
• additional location

INC10A

Critical

Practice Accreditation details incorrect

It is a critical error when any of the following have been keyed/ selected incorrectly:

• Accreditation Status
• Start and End Dates
• Address (checking of address on the accreditation certificate against the practice profile)
• Accreditation standards, (must be the Standards for General Practice)

INC10B

Non-critical

Practice Accreditation details incorrect

It is a non-critical error when the following has been keyed/ selected incorrectly:

• Accreditation Body
• Accreditation Number

INC11

Critical

Additional practice locations incorrect

It is a critical error when the additional practice location has been keyed or selected incorrectly.

This is when the additional location has been added and may include when:

• the additional location has been incorrectly added to a practice profile.
  This includes provider eligibility check and confirming the provider works at both the main and additional location
• the additional location has been added to an incorrect profile
• an incorrect closure date of an additional location has been entered

INC12

Critical

Incorrect Incentive selected

It is a critical error when:

• an individual PIP incentive has not been approved or withdrawn correctly, or
• an incentive payment tier or level has not been selected or has been selected incorrectly

(Note: this does not include Procedural GP. See Error code INC45)

INC13A

Critical

Bank details incorrect

It is a critical error when any of the following Bank details have been keyed incorrectly or not updated:

• BSB
• Account number

INC13B

Non-critical

Bank details incorrect

It is a non-critical error when the following information has been keyed incorrectly or not updated:

• Account name

INC14

Critical

Details of Practice Ownership incorrect

It is a critical error when any of the following Practice Ownership details have been keyed/selected incorrectly, or not keyed/selected:

• Ownership Type
• Date of sale
• Company Name
• Owners/ Partners/ Associates names

INC14A

Non-Critical

Details of Practice Ownership incorrect

It is a non-critical error when any of the following details were supplied on the form but were keyed incorrectly, or not keyed

• Trading Name
• Ownership Address

INC15

Critical

Practitioner Start and/or end dates are incorrect

It is a critical error when the start and/or end date for the following have been keyed incorrectly, or not keyed and there is no notation on PIP/WIP – Practice Stream Online:

• Provider
• Nurse Practitioner

INC44

Critical

Public Liability insurance details incomplete/incorrect

It is a critical error when the Public Liability insurance has been:

• selected incorrectly, or
• not selected when indicated on the form

INC18

Critical

Program status field incorrect

It is a critical error when Program status field (withdrawn or closed) is selected incorrectly or not selected.

This includes when:

• a practice is incorrectly withdrawn
• a practice is incorrectly closed
• a practice branch location is not closed or an incorrect closure date is keyed

INC20

Critical

Relocation or Amalgamation date incorrect

It is a critical error when the Relocation or Amalgamation date has been keyed incorrectly.

INC23

Critical

Provider has not been registered or registered incorrectly, including physical location miss-match

It is a critical error when the provider details:

• do not match the physical location, or have been registered to the incorrect practice location
• have not been registered to a practice location
• have not been correctly transferred when updating a practice relocation or amalgamation

INC45

Critical

Procedural GP Payment Tier level incorrect/ not updated

It is a critical error when a provider’s Procedural GP tier level has been selected incorrectly or has not been updated or removed.

INC24

Critical

Professional Indemnity insurance expired

It is a critical error when:

• the Individual GP or nurse practitioner details (IP003) form has been processed and the provider does not have professional indemnity insurance. (They have ticked No on the form)
• Professional indemnity is blank or ticked No and there is no comment stating insurance cover was confirmed verbally

.

Error status codes

Definition

Processing tip

INC26

Critical

RA number has been added to incorrect profile/ person

It is a critical error when the Registration Authority (RA) number has been added to the incorrect profile or keyed incorrectly.

INC28

Critical

Annual confirmation statement not updated or updated incorrectly

It is a critical error when an Annual Confirmation Statement has been updated incorrectly or not been updated.

INC29

Critical

Quarterly Confirmation Statement not updated or updated incorrectly.

It is a critical error when the Quarterly Confirmation Statement, including average weekly hours have been updated incorrectly, or not updated.

INC30

Non-critical

PaNDA work item details are incorrect

It is a non-critical error when the following Work Item details have been keyed incorrectly or not updated:

• Work classification
• Practice ID
• Case ID
• Processing Notes as required as per Operational Blueprint
• Completion reason

INC31

Critical

IHI Patient details are incorrect or have not been added to the practice profile

It is a critical error if the:

• incorrect patient has been linked to the practice based on the information supplied
• patient has not been added to the profile
• patient consent date is after the date of lodgement
• patient is over 15 years of age and the parent has signed on their behalf

INC32

Non-critical

Aboriginal or Torres Strait Islander indicator incorrect

It is a non-critical error when the Aboriginal or Torres Strait Islander indicator has been supplied on the form but was selected incorrectly.

INC33

Critical

IHI patient information incorrect (doesn't match source documents)

It is a critical error when:

• the incorrect information has been entered and the information is not supplied on the forms, or
• the patient information entered does not match source documents

Patient information includes:

• Aboriginal or Torres Strait Islander indicator
• IHI chronic disease
• IHI health check
• IHI patient consent date

INC34

Critical

Incorrect documents uploaded to practice profile or not uploaded to practice profile or PaNDA

It is a critical error when a form or document has:

• been uploaded to the incorrect Practice Profile
• has not been uploaded to the practice profile or PaNDA

INC34A

Non-Critical

Documents not uploaded to practice profile or PaNDA

It is a non-critical error when a form or document has been uploaded and practice has not been clearly identified

INC36A

Critical

Letter incorrect – Communication Channel

It is a critical error when a letter has been sent via the incorrect communication channel

The letter was sent via:

• HPOS and mail was indicated
• mail and HPOS was indicated

INC36B

Critical

Letter incorrect – practice details and address

It is a critical error when:

• the following information in the letter is incorrect:
• Addressee - not addressed to the primary authorised contact person
• Practice address - including the letter is addressed to the main practice location and not the postal address on the profile
• Practice ID
• Practice name
• the letter has been sent to the wrong address

INC36C

Non-Critical

Letter incorrect - Typos

It is a non-critical error when the following information is incorrect:

• Spelling errors
• Incorrect (Titles)

INC36D

Critical

Letter incorrect – Rejection Reasons

It is a critical error when the following information is incorrect:

• Incorrect rejection reason selected
• Missing rejection reason

INC46

Critical

Old form version processed

It is a critical error when an outdated version of a form has been processed after the appropriate grace period.

INC40

Critical

Incorrect action taken on payment hold

It is a critical error when a payment hold is not added when it should be or wasn’t removed correctly:

• Practice details have been updated and the hold has not been removed
• Payment hold has not been applied when further information has been requested
• Payment hold removed before eligibility has been confirmed

INC47

Critical

Held Payment – Payment release not requested or cancelled when it should have been

It is a critical error when:

• release of a held PIP/ WIPPS payment has not been requested
• a held WIPPS payment has not been cancelled

INC48

Critical

Recovery action not taken

It is a critical error when:

• a work item is not processed or was incorrectly processed, resulting in an overpayment, and
• recovery action is not commenced by the operator

INC49

Non-critical

Associated Documents

It is a non-critical error when the upload type, document, and/or description is incorrectly keyed or selected in PIP and/or WIP-Practice stream online – as per the Operational Blueprint process.

INC50

Non-critical

Comments on Practice Profile are missing

It is a non-critical error when a comment is not added to the practice profile where the Operational Blueprint process instructs the Service Officer to add a comment.