This document outlines details about actioning NORA for Medicare Compensation Recovery.
Action a NORA
This table follows on from Table 1 in Claim management - Medicare Compensation Recovery.
|
Step |
Action |
|
1 |
Evaluate - select document type + Read more ...
-
Select Notice of reimbursement arrangement from the Document type dropdown menu
-
Select the relevant buttons
-
Select Continue
Note:
|
|
2 |
Assign work item + Read more ...
-
A message displays
Are you sure you want to process a Notice of reimbursement arrangement? Would you like to continue?
-
Select Yes
|
|
3 |
Record details + Read more ...
Enter details of the NORA into the relevant fields.
Staff must add the below details:
-
Date of receipt - enter the date the NORA was received
-
Date of reimbursement arrangement - enter the reimbursement commencement date provided on the NORA form
Note: this date must be more than 6 months after the claim was lodged with the insurer to be notifiable
-
Date of injury or illness - this automatically populates
-
Date claim lodged with insurer - enter the date the claim for compensation was lodged. This date should be provided on the NORA form
-
Start date of liability period - enter the date of injury unless a specific period of liability is advised
-
End date of liability period - enter date of reimbursement arrangement unless a specific period of liability is advised
-
If applicable, select is this NORA a result of an ART review? button
-
Select Continue
The next workflow depends on the fields entered and the claim status. A message shows advising what action is needed:
-
Close claim on existing Notice of past benefits (NOPB), go to Step 4
-
Process Statement by claimant (SBC) to close the claim, see Table 1 > Step 9 in Process a Statement by claimant (SBC), then go to Step 6
-
Claim is 25(4), go to Step 5
-
Issue a Notice to claimant (NTC), go to Step 8
-
MCRS determines if the claim is not notifiable based on date validation. See Table 3 in Close, terminate or reopen a claim - Medicare Compensation Recovery
|
|
4 |
Close claim on an existing Notice of past benefits (NOPB) + Read more ...
The most recent NOPB shows.
To close the claim on the displayed notice:
-
select Close case on display notice
-
add a case note to document this process. See Table 6 in Claim management - Medicare Compensation Recovery
-
select Submit
-
go to Step 6
To not close the claim on the displayed notice and to issue an NTC:
-
Do not select the Close case on display notice button
-
select Continue
-
a screen shows the most recent NOPB and advises if valid at date of reimbursement arrangement, it can be used to close the claim
-
select Submit
-
See Issue a new NTC table in Notice of past benefits request and Notice to claimant (NTC) - Medicare Compensation Recovery
|
|
5 |
Claim is 25(4) + Read more ...
-
Message displays
S25(4) applies, thus issue NOC
-
Select Yes
|
|
6 |
Compensation Payer details in SAP + Read more ...
|
|
7 |
Notice of charge (NOC) summary + Read more ...
A table shows with the NOC summary. Review the summary and totals shown:
-
if the totals are incorrect, select:
-
the Back button to return to the Compensation payer details in SAP screen, and
-
the Back button again to return to the SBC Capture screen, if incorrect, re-capture correct services, and
-
Submit
-
if totals are correct, select Submit
The NOC will issue to the notifiable person, with a copy to the claimant/their authorised third party.
If payment has been received and a refund is required use the Referring a case to Compensation Finance email template. See Payments, refunds and debts.
Procedure ends here.
|
|
8 |
Issue Notice to claimant (NTC) + Read more ...
If MCRS determines a notice to the claimant is required, a message shows No Notice of past benefits (NOPB) exist, a new Notice to claimant will be created for the case:
-
Add a case note to document this process. See Table 6 in Claim management - Medicare Compensation Recovery
-
Select Submit
-
A message displays Are you sure you want to request a Notice to claimant?
-
Select Yes
-
See Issue a new NTC table in Notice of past benefits request and Notice to claimant (NTC) - Medicare Compensation Recovery
-
Procedure ends here
|