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Notice of reimbursement arrangement (NORA) - Medicare Compensation Recovery 011-15030040



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 ...

Search for payment

  • If payment located:
    • enter ad-hoc payment amount, SAP document number, payment date and compensation payer unique account number
    • select Continue
  • If payment not located, locate compensation payer unique account number

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