Document Assessment – Medicare Compensation Recovery 011-15010000

Question

Answer

A valid MO022/MO026/MO027 is received and there is no claim registered. Should the claim be registered?

Yes. Due to arrival of correspondence, the claim needs to be registered and the NTC issued.

An invalid MO022/MO026/MO027 is received and there is no claim registered. What steps should be taken?

Claim is to be registered as a “provisional claim” and issue a letter requesting the missing information.

An MO026 (notice of past benefits request) is received for an existing claim. There are no funds on SAP and no notifications of a settlement or reimbursement. Should a notice to claimant be issued?

Yes, when the previous NOPB has expired Service Officers can issue a new notice to claimant.

An invalid MO026 is received and there is an existing claim. Should a letter be issued?

Yes, issue a Z2802.

An MO026 & MO021 are received, and there is an existing claim and authority on file. What action is to be taken?

If the authority named on the new valid form is different to the one on the record, contact the sender to ensure that the previous authority is no longer acting for the injured person on the claim. Once confirmed, update. If the claim has had a previous notice of past benefits issued which has expired, process the request and issue an updated NTC to the new third party authority.

An MO026 is received and there is evidence of a settlement or reimbursement arrangement. What action is required?

If the NOJS or NORA has been processed, an NTC should have already been processed; a new one is not needed. The new MO026 can be added to the claim as a ‘Notice of past benefits request’ document when processing the enquiry case. MCRS will recognise it is not needed and a pop up will announce that no further action is required at this time.