Quality checking dispute process for Health Service Delivery Division 111-23051519

Staff:

• can dispute Quality Control System (QCS) quality checking results on the:
• Medicare Quality Control System (QBBI)
• Quality and Support Tool (QST)
• Report Management and Distribution System (RMDS)
• can initiate a quality checking dispute if they receive incorrect feedback or an unwarranted error
• must refer to their Quality Check (QC) feedback email and speak to their Team Leader

Note: face to face Service Officers do not follow this process.

Quality Checkers have the right of reply if the original decision and/or feedback provided is deemed incorrect. This includes where other errors or actions were not initially identified from the check.

Staff:

• can dispute Quality On Line (QOL) and Quality Management Application (QMA) checking results
• may dispute a quality checking outcome if they think it is incorrect or inappropriate

Staff responsibility when submitting disputes

Staff submitting disputes must:

• support their dispute with evidence, that is:
• the relevant Operational Blueprints (including the Table and Step number where applicable), and/or
• other nationally endorsed references current when the Quality Checker completed their check, for example, Network News Update (NNU) or Roxy
• finalise all actions on the customer's record before lodging the dispute, that is:
• complete all actions on the customer's record as a priority
• talk to their team leader if unsure of the correct action to take, pending the outcome of the dispute

Staff must not ‘HOLD’ or leave a ‘NOT’ or ‘STA’ activity on the customer's record, pending the outcome of a dispute.

Timeframes

Staff must lodge disputes within 30 days of the Quality Checker finalising the check unless they have been on leave. If they were on leave, the staff member lodges the dispute within 14 days of their return to work.

Independent Reviewer

• A Service Support Officer (SSO) in the Health Service Delivery team (HSDD Aged Care Customer) with the relevant technical expertise will do the independent review
• If the SSO network does not have the technical expertise in a particular area, they will consult with a technical specialist
• HSDD Aged Care Customer SSOs must ensure they have access to the QMA Dashboard for SSO. The system limits access to 6 months. SSOs should reapply for access before it expires (the system does not send an expiry reminder)