Immunisation medical exemptions on the Australian Immunisation Register (AIR) 011-10060000

Go to the Services Australia Intranet homepage and select:

• My Tools tab
• under Customer Service select Medicare Portal
• the Medicare - eBusiness Gateway screen displays

In eBusiness, select:

• Source Office and the relevant source office code from the dropdown menu. Note: select the correct source office code before selecting Submit. Service Officers must check with their Team Leader if unsure
• Provider Directory System from the dropdown menu
• Submit

The PDS home page displays.

From the left-hand menu, select:

• Provider
• View

The Provider View Search screen displays.

Is the provider number available?

• Yes,
• from the Search page, select the Basic Search tab
• enter the provider number stem (first 6 digits of the provider number) in Search ID field
• from the ID Type dropdown select Provider Stem
• select Search. The Provider details page displays, go to Step 6
• No, go to Step 5

Contact the parent/guardian or the individual by phone to verify the details of the provider.

If the provider is confirmed:

• Return the form to the provider with a standard letter
• Record a comment on AIR Mainframe and PaNDA:

’New MEDE received on (PaNDA lodgement date) from provider (provider number), form incomplete. Form and letter sent back to provider only, provider number missing from form’

• Finalise the work item as per WLM processing guidelines

If Service Officers are unable to contact the parent/guardian or individual by phone or cannot verify the details of the provider:

• Return the IM011 form back to parent/guardian or individual with a standard letter
• Record a comment on AIR Mainframe and PaNDA:

‘New MEDE received on (PaNDA lodgement date) from provider unknown, form incomplete, form and letter returned to parent/guardian or individual, as provider number or name is missing from form'

• Finalise the work item as per WLM processing guidelines

Procedure ends here.

Check the provider has current registration.

Check registration

The provider’s registration, including start and end dates, are displayed towards the bottom of the page.

Note: A provider is not registered if the status column does not have ‘Current’ and all registration lines have an end date, plus any one or more of the following:

• Suspended
• Non-practising
• Cancelled
• Not registered
• Other

Does the provide have a current registration?

• Yes, check speciality codes, go to Step 7
• No, go to Step 9

See Resources page for list of Speciality codes.

Does the provider have one of the listed codes and is current, as at the processing date?

• Yes, continue processing. See Table 2
• No,
• if the provider is suspended go to Step 9, otherwise
• go to Step 8

• Return the form to the provider and parent/guardian or individual with a standard letter
• Record a comment on AIR Mainframe and PaNDA:

’New MEDE received on (PaNDA lodgement date) from ineligible provider (provider number), form and letter sent back to provider and parent/guardian or individual over 14 years of age’

• Finalise the document as per WLM processing guidelines

Procedure ends here.

A non-registered provider is not eligible to record an immunisation medical exemption.

Return the form to the provider and parent/guardian or individual with a standard letter.

Service Officers must make a note on AIR Mainframe that includes:

• the date of contact, and
• the medical exemption that cannot be recorded due to the provider not having current registration

Finalise the document as per WLM processing guidelines.

Note: If a customer or provider calls AIR regarding an exemption request from a non-registered provider, tell the caller:

• the individual will need to see another eligible provider. Staff must not advise or recommend providers
• exemptions signed by a non-registered provider cannot be recorded on the AIR regardless of the date of processing or the date signed

Procedure ends here.

Check the Source Location for the form on the PaNDA work item.

If received via:

• HPOS, go to Step 2
• Email or SOC, go to Step 8

If multiple forms for different individuals are lodged together, these must be split before continuing.

Follow the process for splitting work items in PaNDA, see the Splitting work items table:

• Record a comment in PaNDA: ‘This document has been split from another document’:
• Include how the document was received. For example: HPOS (include the HPOS reference number), email, or SOC)’
• Example comment: This document has been split from another document received via HPOS from upload ref 123456789-1
• Assign the work item(s)to yourself and continue

PaNDA work types configured to receive work items from HPOS will display an Open in HPOS button in the top right-hand corner of the Work Item and Document Details screen.

In the PaNDA work item:

• Select Open in HPOS in top right corner of work item
• The Form Upload Mail Centre - View Mail screen displays, including the details of the form lodged
• Check details in Text to see who sent the form:
• Individual provider (Doctor) - provider's name shows in ‘Sent by’
• Delegate - shows as ‘Sent for’ doctor's name, ‘by’ delegate's name
• Organisation - shows as ‘Sent for’ organisation's name, ‘by’ authorised person’s name
• Unidentified, or name in ‘From/Sent by’ matches patient's name on form or is another individual HPOS user (check this by opening the attachment under File Name)

If the form was sent by:

• the individual provider, a delegate on behalf or the provider or organisation, see Table 3
• the patient, go to Step 6
• an unidentified source, go to Step 3

AIR forms submitted by an individual other than the individual Provider (Doctor) or a delegate on behalf of the Provider/Organisation, must not be processed.

One attempt to contact the practice must be made.

Is contact successful?

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

For outbound calls, Service Officers must use the script in Step 4 in Authentication of recognised vaccination providers for AIR enquiries table.

• ‘Hello this is <first name> from Services Australia. Before we proceed with this call, I need to inform you the call may be recorded or listened to for quality and coaching purposes’

Tell the practice:

• The form submitted via HPOS by <Sender Name in HPOS> cannot be processed
• AIR forms lodged via HPOS can only be accepted if submitted by:
• the provider that signed the form
• a nominated HPOS delegate, acting on behalf of the provider who signed the form, or
• an individual acting on behalf of a PRODA organisation
• to resubmit via the correct delegation channel

After successfully contacting the Practice, go to Step 6

Do not process the form

Reply to the individual via HPOS message.

Go to Step 6.

• Select Open in HPOS in top right corner of PaNDA work item
• Select Reply
• Open the Z2924 HPOS text template (one note document)
• Copy the message into the text field
• Add the individual’s (sender’s) name and form number (IM011) to the message

Attach infographic

• Save the infographic to desktop (or a file of choice)
• Select choose file and navigate to where the infographic was saved
• Select open - file can be seen next to ‘choose file’
• Select Add File – ensure the correct file is attached - if not, select remove and
• search again

Finalise Message

• Double Check the attachment, message and name are correct
• If not correct – select cancel
• Confirm cancellation
• Start again
• If correct - select Send

Add comments in PaNDA: ‘IM011 form submitted by <person name> has been returned as not sent via correct delegation channel. <Called practice and spoke to <name> and advised to resubmit using correct HPOS delegation. <<Attempted to contact practice/provider on <date/time>> no answer. Returned form via HPOS messages ref <HPOS reference number from PaNDA (eg 123456789-1)’

Mark the work as complete in PaNDA.

Procedure ends here.

Do not process the form

• Return the form to the patient with a standard letter
• Add comments in PaNDA and Mainframe - 'Form submitted by <patient>, returned with letter'
• Check the correct Medicare number and provider number have been saved on the work item
• Upload/ Add letter to PaNDA work item
• Complete the work item in PaNDA. See Work Optimiser for staff

If it is suspected the form was not completed by the provider, consider reporting Suspected Fraud and Corruption.

Procedure ends here.

Make one attempt to contact the practice to confirm they sent the form.

For outbound calls, Service Officers must use the script in Step 5 in Authentication of recognised vaccination providers for AIR enquiries table.

If contact is:

• made, go to Step 9
• not made, go to Step 10

Tell the practice contact that when forms are received manually Services Australia will contact them to confirm they sent the form.

Promote digital options. If the Service Officer is:

• internet trained, help the practice or organise another time to call back
• not internet trained, offer to transfer to the AIR Internet helpdesk and give the practice the phone number

Note: if promotion of digital options generates a negative response from the practice, complete an LPS referral form and request an AIR Business Development Officer (AIR BDO) contact the practice. LPS will escalate to AIR helpdesk who will refer the request to AIR BDOs.

Include in the referral form:

• it is a Manual Lodgement of form, (email/SOC)
• the Provider Number
• the Name of practice
• the name of the contact person the service officer spoke to
• the initial conversation/outcome
• the reason for not submitting digitally, and
• attach a copy of the form received, that prompted the call

Did the practice confirm that they sent the form?

• Yes:
• once verified and digital options have been promoted, add comments in PaNDA and Mainframe- 'Confirmed with <doctor/nurse/receptionist> form sent by practice'
• process the form, see Table 3
• No, go to Step 10

If the Service Officer is unable to determine who sent the form:

• return the form to the patient with a standard letter
• add comment in PaNDA and Mainframe - 'Unable to confirm who sent the form, returned with letter'
• check the correct Medicare number and provider number have been saved on the work item
• complete work item in PaNDA. See Work Optimiser for staff

Procedure ends here.

The AIR can only accept an immunisation medical exemption notification from an eligible medical practitioner:

• online directly through the AIR site
• the Practice Management Software, or
• a correctly completed IM011 form

Note: the previous version of the IM011 form can only be accepted for 6 months after the new form was published. The version number and date is shown on the bottom left hand corner of each page. For example, IM011.2310, the year is 23 (2023) and 10 is the month (October).

Has the request been made in the approved form and manner?

• Yes, go to Step 3
• No, go to Step 2

If the immunisation medical exemption notification is not on the approved form:

• Return the document back to the provider with a standard letter
• Record a comment on AIR Mainframe and PaNDA:

’New MEDE received on (PaNDA lodgement date) from provider (provider number) on unapproved form, document and letter sent back to provider’

• Finalise the document as per WLM processing guidelines

If a Vaccination objection form, statutory declaration or letter is received:

• Return the form to the provider and parent/guardian or individual with a standard letter
• Record a comment on AIR Mainframe and PaNDA:

‘New (vaccination objection/statutory declaration/letter) received on (PaNDA lodgement date) from provider (provider number), document sent back to provider and parent/guardian or individual over 14 years of age’

• Finalise the document as per WLM processing guidelines

If a State or territory health department medical exemption form is received:

• Return the form to the provider and parent/guardian or individual with a standard letter
• Record a comment on AIR Mainframe and PaNDA:

‘State/territory form received on (PaNDA lodgement date), document sent back to provider and parent/guardian or individual over 14 years of age’

• Finalise the document as per WLM processing guidelines

Procedure ends here.

Read all recent comments in Mainframe:

If the same form is lodged multiple times, it is not appropriate to make a new assessment or return the form to the provider again. If a quality control issue is identified, escalate to the AIR Local Peer Support (LPS).

Check the comments in mainframe for any previous lodgement details:

• From the YCUA – Amendment Registration screen press [PF3]. The YCCO – Comments List screen displays
• Select (/) for the comment to read and press [Enter]
• Press [PF13] to go back to the list and choose another comment

Go to the current version of the IM011 form. If the form submitted by the provider is:

• altered or amended, go to Step 4
• partially completed or is incomplete, go to Step 5
• a temporary exemption with COVID-19 vaccines and has an end date of more than 6 months, go to Step 6
• to be processed, see Table 4

• Return the document back to the provider with a standard letter
• Record a comment on AIR Mainframe and PaNDA:

‘New MEDE received on (PaNDA lodgement date) from provider (provider number), form returned to provider due to being altered and/or not completed correctly’

• Finalise the document as per WLM processing guidelines

Procedure ends here.

Check if any details are missing:

• signatures
• provider number
• personal details
• Medicare card number, and
• any questions that have insufficient, or incomplete details

If the signature date is missing, use the date of lodgement in PaNDA as the start date for the medical exemption.

If there are insufficient details to uniquely identify the individual on the AIR:

• Return the document back to the provider with a standard letter
• Record a comment on AIR Mainframe and PaNDA:

New MEDE received on (PaNDA lodgement date) from provider (provider number), form returned to provider due to being altered and/or not completed correctly

• Finalise the document as per WLM processing guidelines

Procedure ends here.

If exemption information such as contraindication reason, anaphylaxis date, exempt vaccines, natural immunity diseases, laboratory test date or clinical diagnosis date is not supplied:

• Return the document back to the provider with a standard letter
• Record a comment on AIR Mainframe and PaNDA:

’New MEDE received on (PaNDA lodgement date) from provider (provider number), form returned to provider due to being altered and/or not completed correctly’

• Finalise the document as per WLM processing guidelines

Procedure ends here.

Do not process an IM011 form if the provider has:

• not ticked any of the boxes or entered any vaccine brands in the ‘Other – specify’ field in question 7
• not ticked temporary or permanent in question 6, even if all other details are provided in questions 6 and 7
• added a lab test date in question 8, but no antigen details
• ticked either:
• significant immunocompromised of short duration (live attenuated vaccines only), or
• the individual is pregnant (live attenuated vaccines only) and
• any vaccines listed under the Non-live heading have been selected

Service Officers must make one attempt to contact the provider if any of the above apply

If contact with the provider is successful:

• Tell the provider why the form cannot be processed and request they resubmit a correct and completed form
• Return the IM011 form to the provider with a standard letter
• Record a comment on AIR Mainframe and PaNDA:

’New MEDE received on (PaNDA lodgement date) from provider (provider number), form returned to provider due to being altered and/or not completed correctly’

• Finalise the document as per WLM processing guidelines

If contact is not successful:

• Return the IM011 form with a standard letter
• select the option the form has been altered and not completed correctly
• record a comment on AIR Mainframe and PaNDA: ‘New MEDE received on (PaNDA lodgement date) from provider (provider number), form returned to provider due to being altered and/or not completed correctly’
• Finalise the document as per WLM processing guidelines

Procedure ends here.

When a temporary medical exemption is received for COVID-19 vaccines and has an end date of more than 6 months, staff must make one attempt to contact the provider/practice.

If contact is successful, advise the practice/provider:

• the form will be processed, however we will process the COVID-19 vaccines for 6 months only, as per ATAGI guidance, and any other vaccines selected will be processed as per the date certified by the provider on the form
• the revised end date for the COVID-19 exemption, and
• to update their records and let the patient/individual know

Process the form:

• record the COVID-19 exemption for 6 months only;
• process any other exemptions as per the date certified by the provider,
• record a comment on AIR Mainframe and PaNDA:

’New MEDE received on (PaNDA lodgement date) from provider (provider number). Form was processed for a maximum duration of 6 months for the COVID-19 vaccines.

• Finalise the document as per WLM processing guidelines

If contact is unsuccessful

Process the form:

• record the COVID-19 exemption for a maximum of 6 months only;
• process any other exemptions as per the date certified by the provider, and
• prepare the Z2935 letter, attach a copy of the IM011 form and send it via post or HPOS (depending on how the form was received)
• send back via HPOS:
• select Open in HPOS in top right corner of PaNDA work item
• select Reply
• prepare the Z2935 letter
• save the letter as a PDF file (ensure to rename the letter – do not leave the letter name) to your desktop (or a file path of your choice)
• select Choose file and navigate to where the letter was saved
• select Open – file can be seen next to choose file
• select Add File – make sure the correct file is attached
• if not – select Remove and search again
• add the following in the message text field (Z2936):

Dear <Provider name>

Please read the attached letter about the Australian Immunisation Register form you submitted.

Yours sincerely

Director

The Australian Immunisation Register

• finalise HPOS message:
• check correct file is attached
• if not – select Cancel then Confirm cancellation and start again
• if correct – select Send
• upload the letter in PaNDA
• record a comment on AIR Mainframe and PaNDA:

‘New MEDE received on (PaNDA lodgement date) from provider (provider number). Form was processed with a maximum duration of 6 months for the COVID-19 vaccines.

Log on to AIR mainframe, then:

• key ‘YCUI’
• press [Enter]

The YCUI – Registration Amendment Search screen displays.

Key search criteria using Medicare number (if available), or key:

• surname
• given name
• date of birth
• postcode (optional)

Press [Enter]

If there is:

• no match found, use different search criteria or:
• key ‘YCAI’
• create individual
• only one match, the YCUA – Amendment Registration screen displays
• more than one record that meets search criteria:
• a list is displayed
• select (/) appropriate individual
• press [Enter]. The YCUA – amendment registration screen displays

To record an exemption due to a:

• medical contraindication, go to Step 4
• natural immunity, go to Step 5

To record an exemption due to a medical contraindication:

• Press [PF17 – CONTRA-IN]. The YCAM – Medical contraindication information screen displays
• Update any vaccines the provider selected on section 7 from the completed IM011 form
• Key the exemption information. Press [Tab] to move across fields:
• 2 digit vaccine code (press [PF1] for a list of codes) Note: for influenza use F1 (FLUMC)
• if the exemption is permanent or temporary
• reason code
• provider number
• start date (provider signature date or date form received if signature date missing)
• end date (for temporary exemptions)
• previous anaphylaxis date (if applicable)
• Press Enter and check the information is correct before pressing [PF9 – UPDATE]. The message ‘Update successful’ displays
• Finalise the document as per WLM processing guidelines. Only use the below approved comment on AIR Mainframe for a successfully updated record:

’New MEDE received (PaNDA lodgement date) from eligible provider (provider number). This has been processed’

Note: if the screen is full and the Service Officer needs to enter more vaccines, press [PF8] to page forward to the next screen to continue.

Procedure ends here.

To record an exemption due to natural immunity:

• Press [PF20 – NAT IMM]. The YCAN – Natural immunity information screen displays
• Key the exemption details. Press [Tab] to move across fields:
• 3 digit antigen (disease) code (press [PF1] for a list of codes)
• provider number
• notification date (provider signature date or date form received if signature date missing)
• laboratory test date or physician based clinical diagnosis date
• Press [Enter] and check the information is correct before pressing [PF9 – UPDATE]. The message ‘Update successful' displays
• Finalise the document as per WLM processing guidelines. Only use the below approved comment on AIR Mainframe for a successfully updated record:
• ’New MEDE received (PaNDA lodgement date) from eligible provider (provider number). This has been processed’

Note: if the screen is full and the Service Officer needs to enter more vaccines, press [PF8] to page forward to the next screen to continue.

Finalise the document as per WLM processing guidelines.

Procedure ends here.

If the customer has a general enquiry, answer their enquiry if appropriate or direct them to self-service.

Details about self-service options are on the Services Australia website.

General enquiry examples:

• How to have a medical exemption recorded on the AIR
• How to show proof of a current medical exemption
• Other general query about information recorded on the AIR

If staff are unable to help the customer with their enquiry, refer them to their:

• vaccination provider, or
• state or territory health department

If the enquiry requires access to a record, go to Step 2.

Confirm the identity of the customer by performing an AIR security check.

Has the customer been authenticated?

• Yes, go to Step 3
• No, if the customer is:
• a recognised vaccination provider or their staff, refer them to their state or territory health department, if appropriate. Procedure ends here
• an individual or their representative, refer them to their vaccination provider, if appropriate. Procedure ends here

Access the individual’s record via Mainframe and search for previously recorded:

• medical contraindication, or
• natural immunity

Medical Contraindication

• From the YCUA screen press [PF17] CONTRA-IN, the YCAM - Medical Contraindication Information screen displays
• Press [PF5] CON HIST, the YCAH screen displays
• View history

Natural Immunity

• From the YCUA screen, press [PF20] NAT IMM, the YCAN – Natural immunity information History screen displays
• View history

or

• From the YCUA screen, press [PF16], the YCEJ - Registration History screen displays
• Check Description column for previous medical exemptions
• to view the previous amendment to the registration, key [/] in the Selection (Sel) column and press [Enter]
• Note: to check previous amendments change the From date, for example. date of birth

Use the [PF7] and [PF8] keys to move backwards and forwards through the pages.

If the request is for an amendment to the medical exemption recorded on the AIR, go to Step 4.

If the medical exemption amendment request relates to:

• Additional vaccines/antigens to be added, go to Step 5
• Medical exemption information advised in error, go to Step 6
• Changes to the start or end date of a medical exemption, go to Step 7
• Correction required due to Services Australia error, go to Step 8

Tell the caller that an eligible provider can:

• upload the additional vaccines/antigens using the AIR Site, or
• complete a new IM011 form with the new vaccines/antigens

Procedure ends here.

Medical exemption information recorded on the AIR may contain errors.

Errors can include incorrect:

• vaccines/antigens
• antigen date
• provider number
• patient
• medical contraindication, or
• natural immunity

Tell the caller that an eligible provider is required to submit an amendment request in writing through HPOS messages, with the required details.

The Resources page contains details required for medical exemption amendment requests.

For requests of this nature, it is preferable (but not necessary) that amendment requests are submitted by the:

• provider who originally recorded the exemption, or
• individual's general practitioner

If the request is to amend the start date and/or end date to a later date:

• tell the caller that an eligible provider can:
• upload a new medical exemption using the AIR Site, or
• complete IM011 form with the new medical exemption information
• procedure ends here

If request is to amend the start date and/or end date to an earlier date:

• Tell the caller that an eligible provider is required to submit the amendment request in writing through HPOS messages, with the required details

The Resources page contains the details required for medical exemption amendment requests.

For requests of this nature, it is preferable (but not necessary) that amendment requests are submitted by the:

• provider who originally recorded the exemption, or
• individual’s general practitioner

If an error is identified by a provider, patient and/or Services Australia staff member, escalate the error to AIR Local Peer Support (LPS), LPS will complete the actions outlined in Table 7.

Procedure ends here.

Check the Source Location for the amendment request. If received via:

• HPOS messages, go to Step 2
• insecure email, fax or posted letter, go to Step 3

If received via HPOS, check details in Text to see who sent the request:

• Doctor - doctor's name shows in Sent by
• Delegate - shows as Sent for doctor's name, by delegate's name

If the amendment request is sent by a doctor or delegate and includes the required details, go to Step 4.

If the amendment request is not sent by a doctor or delegate, and/or the amendment request is missing the required details. Make an outbound call to the provider to tell them about:

• the secure channel requirements for amendment requests, and/or
• details required for inclusion. Procedure ends here

The Resources page contains details required for medical exemption amendment requests.

If received through:

• insecure email, reply with a standard email template to the customer
• fax or posted letter, return the correspondence with a standard letter

Procedure ends here.

Escalate amendment requests to AIR LPS. Leave a standard comment in Mainframe. See Resources for details to be included in comments.

Procedure ends here.

If the amendment request includes all the required details, and is sent from:

• Individual or their representative, go to Step 2
• Original eligible provider at same or different location, go to Step 3
• Other eligible provider at same or different location, go to Step 3

The Resources page contains details required for medical exemption amendment requests.

Investigate the amendment request to determine if change is required due to:

• Services Australia error, go to Step 3
• Provider error, contact the individual and advise they need to speak to an eligible provider
• Procedure ends here

Note: it is preferable (but not necessary) that amendment requests are submitted by the provider who originally recorded the exemption, or by the individual’s general practitioner.

Investigate the request and determine if change is required:

• Required, escalate the details to the AIR helpdesk. Once a response is received from AIR helpdesk, go to Step 4. See Resources page for contact details
• Not required, tell the provider and/or individual amendment is not required. Leave a standard comment. Procedure ends here

The Resources page contains details to include in comments.

Once a response is received from the AIR helpdesk:

• Record a comment in Mainframe documenting the changes and response provided by AIR helpdesk
• Record a comment in PaNDA (if applicable)
• Tell the Provider and/or individual about the outcome
• If the amendment was due to a Services Australia error, provide feedback to the staff member using the Staff Feedback Tool (if applicable)

Procedure ends here.