Provider Registration quality checking in QST 111-22160000

Error-free status code

Definition

Processing Tip

PR01

Error-free

Quality check did not detect errors.

Error status codes

Definition

Processing tip

PR02 Critical

Provider stem created when not needed.

It is a critical error when:

• an additional stem was created under the same profession against processing rules
• a stem was created manually where a shell record was present
• a stem is created based on incorrect assessment of a providers registration details

PR03 Non-critical

Provider stem details not updated.

It is a non-critical error when the following details have not been updated on a providers stem, or have been updated incorrectly:

• title
• language/s
• email
• telephone
• fax number
• pager

Or a minor keying error that would not have a critical impact on a provider's ability to access Medicare benefits.

PR04 Critical

Update made against incorrect provider.

It is an error if the information contained in an application was updated against the incorrect provider.

PR06 Critical

Family name, first name and/or other given name/s keyed incorrectly or not amended where appropriate.

It is an error when the provider's family name, first and/or other given name/s were not keyed or amended as per the registration certificate.

Note: the name/s need to be the same as the evidentiary documents, however any additional names (i.e. second names) supplied on the application can be added when not on documentary evidence.

PR08 Critical

Date of birth incomplete or keyed incorrectly.

It is a critical error when a provider's date of birth was:

• keyed incorrectly
• not updated when required
• updated without supporting documentation and no verification is present

PR10 Critical

Termination date or reason for termination incomplete, omitted or keyed incorrectly.

It is a critical error when a:

• provider's record was terminated without supporting documentation and no verification is present
• termination date keyed/selected incorrectly
• termination reason keyed/selected incorrectly

PR11 Non-critical

Residency status omitted, keyed incorrectly or not keyed.

It is a non-critical error when

• a provider's residency status has not been updated as per the supplied evidentiary documents, and
• it does not have a critical impact on the provider's ability to access Medicare benefits

For example, a provider that is not subject to legislation in section 19AB

PR12 Critical

Residency status incomplete, omitted, keyed incorrectly or without evidence.

It is a critical error when the following fields were not updated or have been keyed incorrectly (when required):

• Residency status
• Date of permanent residency
• Passport number
• Country of issue
• Visa type

It is an error when the provider's residency status was actioned with incomplete or no supporting documentation and no verification is present.

PR13 Non-critical

Qualification details keyed incorrectly or not keyed.

It is a non-critical error when the following has been keyed incorrectly or not keyed on an established stem:

• place obtained
• year of base qualification
• vocational qualification (e.g.: MBBS 'FRACGP')

PR14 Critical

Qualification details incomplete, omitted or keyed incorrectly.

It is a critical error when it:

• does not match the supporting documentation, and
• was not processed in accordance with processing rules upon creation of an initial stem:
• type of qualification
• place obtained
• year of base qualification

PR16 Critical

Vocational details incomplete, actioned without supporting documentation or keyed/selected incorrectly.

It is a critical error when the:

• vocational details were updated without documentation from college or provider
• college documentation is incomplete
• application is incomplete
• vocational notified date keyed incorrectly
• vocation status selected incorrectly
• vocational organisation selected incorrectly

PR18 Critical

Prescriber number not issued when requested or issued in error.

It is a critical error when:

• the provider has requested a prescriber number and one is not issued where appropriate, or
• a prescriber number has been issued incorrectly or not in accordance with business rules

PR19 Non-critical

Preferred mailing address incomplete or keyed incorrectly.

It is a non-critical error when a provider's preferred mailing address has been keyed incorrectly where:

• the address is abbreviated when the full address can be entered
• Rapid Address Entry Tool (RAET) address has not been applied
• there is a minor keying error that would not present a security risk to the provider or prohibit the provider from receiving correspondence

PR20 Critical

Preferred mailing address incomplete or keyed incorrectly.

It is a critical error when the:

• preferred mailing address has not been keyed or has been keyed incorrectly
• provider's personal address details were actioned with incomplete or no supporting documentation or no verification is present

PR22 Critical

Registration details actioned without supporting documentation, keyed incorrectly or not keyed.

It is a critical error when:

• the following fields have not been updated or have been keyed incorrectly:
• area of registration
• registration number
• status
• start date
• end date (if applicable)
• AUS line has not been keyed where applicable
• the provider's registration details were actioned without supporting documentation and no verification is present

PR23 Non-critical

Registration comments or notes on PDS keyed incorrectly or not keyed.

It is a non-critical error when comments in PDS were not keyed or keyed incorrectly, and:

• is considered a minor keying error which does not impact the provider's ability to claim Medicare Benefits has been made, or
• notes/comments were applied to stem when not required, or
• notes do not match preferred format

PR24 Critical

Registration comments or notes on PDS keyed incorrectly or not keyed.

It is a critical error when comments in PDS were not keyed or were keyed incorrectly for:

• Australian citizenship dates
• documentation for New Zealand doctors
• data feed and non Ahpra registration updates
• declaration residency status
• visa details

PR26 Critical

19AB Exemption or Class Exemption applied incorrectly or not applied.

It is an error when class exemption details have been applied incorrectly or not applied. This includes:

• s19AB Class Exemptions
• Non-location Specific Exemptions
• Location specific Exemptions
• Exemptions issued by the Department of Health and Aged Care
• Declined Health 19AB Exemption

Note: it is an error if the appropriate class exemption flag is not applied at the location and/or relevant notes are not left on stem.

PR28 Critical

19AB spreadsheet updated incorrectly or not updated.

It is an error when the 19AB spreadsheet was updated with incorrect data, not completed when required or in accordance with processing rules.

PR29 Non-critical

Specialty codes applied incorrectly at stem level – no critical impact on accessing Medicare benefits.

It is a non-critical error when the following fields have been keyed incorrectly:

• speciality code
• start date
• end date (where applicable), and
• does not have a critical impact on the provider's ability to access Medicare benefits

For example, Specialty Code 507 has been applied with incorrect start date.

PR30 Critical

Specialty code details keyed incorrectly or not keyed at stem level.

It is a critical error when the following does not:

• match the supporting documentation, or
• is not keyed in accordance to processing rules, and
• has a critical impact on the provider's ability to access Medicare benefits:
• speciality code
• start date
• end date (where applicable)

PR31 Non-critical

Location request incomplete, omitted, keyed incorrectly or not keyed.

It is a non-critical error when the following fields have been keyed incorrectly or not keyed:

• incorrect field for shop/suite/unit type
• telephone
• email
• fax number
• address is abbreviated when the full address can be entered
• building or department and/or property fields exceeded the 26 character limit
• The Rapid Address Entry Tool (RAET) address has been overridden incorrectly

Or

• a minor keying error that would not have a critical impact on a provider's ability to access Medicare benefits

PR32 Critical

Location request incomplete, omitted, keyed incorrectly or not keyed.

It is a critical error when the following fields have been keyed incorrectly:

• Location start/end dates
• Address
• a duplicate location was created when not in accordance with the business rules
• a location was not created when requested and in accordance with the business rules
• the location type is not selected or the incorrect selection has been made (including ATSIHS and AMS flags)

Note: it is not an error when overnight address standardisation matching has resulted in changes to the address keyed, or if the address had been condensed to 26 characters.

PR34 Critical

Application actioned without signature.

It is an error when an application was actioned without a signature or actioned with an electronic signature.

PR35 Non-critical

Ahpra registration screen not included with application to support action taken.

It is a non-critical error when evidence of Ahpra check is not evident, where an application or data feed has been actioned, and:

• a provider has applied for an initial provider number and Ahpra certificate not supplied
• where a provider has conditions on their registration

PR36 Critical

3GA placement details keyed incorrectly or not keyed.

It is an error when the following does not match the supporting documentation and in accordance with business rules:

• description drop down box
• start date
• end date

PR38 Critical

Specialty codes applied or keyed incorrectly at the location level.

It is an error when the following does not match the supporting documentation and in accordance with business rules:

• speciality code
• start date
• end date (where applicable)

PR40 Critical

Service rule details keyed incorrectly or not keyed.

It is an error when the following does not match the supporting documentation and in accordance with business rules:

• service rule number
• activity code
• start date
• end date (if applicable)

PR42 Critical

Organisation details keyed incorrectly or not keyed.

It is an error when the following does not match the supporting documents or not keyed in accordance with business rules:

• employment type
• ABN details
• registered business name
• trading as name
• business type
• premises type

PR43 Non-critical

EFT details keyed incorrectly.

It is a non-critical error when the:

• bank account name in PDS has a minor keying error or was not keyed in line with processing rules
• BSB and bank account number supplied matches an existing record on the provider's file, however the account name does not match and the existing record has been used
• incorrect generic minor ID has been applied and would not have a critical impact on a provider's ability to access Medicare benefits

Note: if the BSB and/or account number are incorrect this is to be classed as a critical error in every instance (see P44 Critical).

PR44 Critical

EFT details omitted, incomplete or keyed incorrectly.

It is an error when the following fields have been keyed incorrectly, not keyed or do not match supporting documentation:

• account number
• BSB number
• EFT start date
• organisation Minor ID

Note: it is not an error when an invalid minor ID has been supplied and the relevant generic minor ID has been used instead.

PR45 Non-critical

Duplicate Pay Group link created or created incorrectly.

It is a non-critical error when:

• a duplicate pay group link has been created where an existing link can be identified, or
• a minor keying error has been made and does not affect payments being made to the correct party

PR46 Critical

Pay group link details keyed incorrectly, omitted or not keyed.

It is an error when a pay group link was created or amended for new or existing pay group links where the following fields are keyed incorrectly, no verification present or does not match supporting documentation:

• provider number on application does not match provider number on PDS
• business type
• request payee name
• address of payee
• signature of payee
• address of payee
• pay group name
• business type
• building or department
• property
• suite/unit number
• street number or name or type
• postal type
• postal number
• locality
• postcode
• start date
• end date (if applicable)

Note:

• If no business type is stated on the application it is to be treated as incomplete.
• It is not an error when overnight address standardisation matching has resulted in changes to the address keyed, or if the address had been condensed to 26 characters.
• As the pay group link cannot be backdated it is not an error if the date on the application is in the past and the date of processing has been entered.

PR48 Critical

Mainframe keyed incorrectly or not keyed.

It is an error when Mainframe has not been keyed in line with processing rules.

PR49 Non-critical

90 day cheque has been actioned inappropriately.

It is a non-critical error when a minor keying error has been made and does not affect payments being made to the correct party

PR50 Critical

90 day cheque registration details keyed incorrectly or not keyed.

It is an error when the following does not match the supporting documents and in accordance with processing rules:

• commencement date
• contact person
• facsimile country code, facsimile area code or facsimile number
• email address
• date received
• text

PR52 Critical

Copy of letter not attached to work item in PaNDA and/or HPOS.

It is an error when the copy of the letter was not attached to the work item in PaNDA and/or HPOS (when required).

PR53 Non-critical

Delegate approval not evident (PaNDA comments).

It is a non-critical error when delegate approval has been applied although is not evident on a work item.

For example, no delegate approval comments in PaNDA.

Note: if delegate approval at the appropriate level has not been applied this is a critical error.

PR54 Critical

Incorrect level of delegate approval applied.

It is a critical error when the appropriate level of delegate approval has not been applied in accordance with processing rules.

PR55 Non-critical

Letter incorrectly keyed – non eligibility.

It is a non-critical error when the incorrect information was entered/keyed in a letter and:

• does not affect the provider's:
• eligibility information, or
• provider number
• does not affect the provider receiving the letter, and
• presents low or no risk of significant harm to the reputation of Services Australia

PR56 Critical

Letter incorrectly keyed or selected – eligibility.

It is an error when incorrect information was entered/keyed on a letter:

• has a critical impact on the provider's
• eligibility information or
• provider number, or
• has an incorrect address that affects the provider receiving the letter, or
• incorrect letter template used

PR57 Non-critical

Appropriate contact attempts not evident.

There is no evidence of appropriate contact attempts to the provider being made in accordance with processing rules.

PR59 Non-critical

PaNDA comments not evident.

Appropriate comments have not been left in PaNDA.