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 MO021/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.

See Process Correspondence

A valid MO026 (notice of past benefits request) is received with an invalid MO021 (Third party authority). What steps should be taken?

• If no claim is registered and the MO026 was signed by the injured person/claimant, the claim can be registered as an active standard claim and the NTC issued directly to the injured person/claimant. Contact to be made with the sender of the documents advising that the MO021 form was invalid.
• If no claim is registered, claim is to be registered as a provisional claim and issue a z2802 letter requesting the missing information. When a valid MO021 is received re-declared (that is re-signed and re-dated) copy of the MO026 is not required to be received with the updated MO021 form. The claim can proceed using the initial valid MO026 and the updated valid MO021.
• If there is an existing claim with an existing valid MO021 on the claim from the same authorised third party, proceed as per normal processing of NTC issue.

An MO026 is received for an existing claim. There is no indication of a 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 . A NTC should not be issued until a valid MO026 is received.

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

If the authorised third party (ATP) named on the new documents match the existing claim, proceed as normal and issue a NTC if the previous NOPB has expired.

If the ATP named on the new valid form is different to the one on the record, contact the injured person to confirm that the previous ATP is no longer acting for the injured person on the claim. Once confirmed, update the record to add the new authority. 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 ATP.

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.

Example

Accept

Reject

First and last name provided on MO022 with signature and signature date.

X

Deed of Release contains full name (John Smith) and signature of notifiable person that matches the MO022 declaration.

X

First name and initial of last name provided on MO022 with signature and signature date.

For example, John S.

Email page sent from notifiable person’s business email address contains full name in email address

For example, John.Smith@notifiable.com.au OR

J.Smith@notifiable.com.au

X

MO022 has the name of notifiable business in name field with signature provided and signature date.

X

First name, initial of last name provided on MO022 with signature and signature date.

For example, John S

Contact person's full name provided at Q23 and matches the shortened name on declaration.

X

Business name of notifiable person provided on MO022 with signature of representative, for example John S, and signature date.

Contact person's name (may only be first name and last initial) provided at Q23

Email page sent from notifiable person’s business email address contains name in email address

For example, John.S@notifiable.com.au.

X

Signature provided on MO022 using electronic signature software, such as DocuSign. The electronic signature shows the full name. Full name not provided separately in box above signature.

X

First initial, initial instead of last name provided on MO022 with signature.

For example, J S

This cannot be confidently matched to any supporting document.

X