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Patient claims processing in Medicare 011-43010000



Letters

Services Australia has endorsed these letters for use. They are the latest versions. Do not use locally produced letters.

Medicare claim needs more information (Z0828)

Your statement of Medicare benefits (Z2261)

Medicare public letters > Claims

Contact details

Assessing and Benefits

Cash Management section

Medicare claims helpdesk

Medicare EFT manual payments

Medicare and Aged Care - Local Peer Support (LPS)

Services Australia website

Multiple processing rules and adjacent statement of benefit reason (RSN) codes

Table 1

Reason Code (RSN)

Statement reason

Corresponding mainframe column

Mainframe reason codes

Mainframe rule applied

154

Diagnostic Imaging Multiple Service Rule (DIMSR) applied to service

DIMS

All DIMS

DIMSR has been applied

241

Total charge and benefit for multiple procedure

MO

A

MOP rule A has been applied

242

Service is part of a multiple procedure

MO

B or C

MOP rule B or MOP rule C has been applied

440

Multiple Echocardiogram Services rule applied

ME

All ME

MESR rule has been applied

441

Multiple Echocardiogram and DI Services rule apply

ME, DIMS

Any combination of ME and DIMS

MESR and DIMSR rules have been applied

512

Multiple Musculoskeletal MRI Service rule applied

MMRI

All MMRI

MMRISR rule has been applied

513

Multiple Musculoskeletal MRI and DI Services rule applied

MMRI, DIMS

Any combination of MMRI and DIMS

MMRISR and DIMSR rules have been applied

564

Multiple Vascular Ultrasound Service rule applied

VU

All VU

MVUSSR rule has been applied

565

Multiple DI and Vascular Ultrasound rules applied

DIMS, VU

Any combination of DIMS and VU

DIMSR and MVUSSR rules have been applied

Control lines for processing patient claims

Table 2: control lines for processing patient claims in Mainframe. Search the list using Ctrl+F.

Control line

Topic

Function

MQAI

Online PC or BB

Online patient claims or bulk bill claims lodged by the health professional

NABI

Patient claims electronic funds transfer (EFT) reversal

Returns all failed EFT payments with a status of REJECT:

  • NABI,cardnumber,DOP/ddmmyy
  • NABI,cardnumber,DOP/ddmmyy,time/hhmmss

NAOI

Same day adjustment

Used to do the same day reversal of claims. Returns up to 10 item lines processed on the day. SDL to delete SDR to reverse.

  • NAOI,cardnumber

NAQI

Cheque cancellation enquiry

Cheque reversal

NASI

Same day adjustment

Same day reversal supervisor screen

NCHI

History enquiry

Used to recall culled history lines

NDCI

Statement enquiry

Supervisor duplicate statement screen

NDFI

Statement of benefit

Request statement of benefit for same day claim

  • NDFI,cardnumber

NDSI

Statement enquiry

Duplicate statement screen. Issue duplicate statement. DDMMYY is DOP. P to request print, or M to print manually.

  • NDSI,cardnumber,ddmmy
  • NDSI,cardnumber,ddmmyy,<modifier>
    • PROV
    • CASH
    • CLAIMANT
    • HOSP
    • BANK
    • EFTPOS

NEBI

PC Electronic Pend

Browse mode

NEPI

PC Electronic Pend

Displays a claim according to the modifier:

  • NEPI,cardnumber,ddmmyy,mmhhss,seq no
  • NEPI,claim ID,seq no

NERI

PC Electronic same day reversal

Used with modifiers:

  • NERI,cardnumber - 1 record only
  • NERI,cardnumber,ddmmyy,mmhhss,seq no - More than 1 record
  • NERI,claim ID,seq no - More than 1 record

NESI

PC Electronic Pend

Payment claims supervisor access

NHCI

History enquiry

Supervisor restricted access

NHDI

Latter day adjustment

Same Day delete transaction

NHHI

Latter day adjustment

Suppress and transfer

NHOI

History enquiry

Used with modifier - up to the last 6 months

NHRI

Latter day adjustment

History recall transaction

NHSI

History enquiry

Supervisor access - up to 2 full years history

NPBI

Claims payments

EFT mode

NPDI

Pend

Delete pended claims or view operator that pended the claim.

  • NPDI,cardnumber

NPEI

Pend

Delete pend screen

NPFI

Claims payments

Full-format Medical claims payment screen

NPID

Pend

Re-pend by investigations

MPII

Pend

Returns a full-format screen for investigations

NPND

Pend

Pend claims according to the modifiers:

  • NPND,RSN - over key NPOC or NPFC with NPND and RSN, then press [Enter] to pend the entire claim with the reason code
  • NPND,cardnumber - over key NPOC or NPFC with NPND, then press [Enter] to pend the entire claims screen

NPOI

Claims payments

payment screen

  • NPOI,cardnumber

NPRI

Pend

Recalls item lines that have been pended.

  • NPRI,cardnumber
  • NPRI,cardnumber,<modifier>
    • OPER/NNNNN
    • DATE/DDMMYY
    • OPER/NNNNN,DATE/DDMMYY
    • CLNO/(1.9 ALPHANUM)
    • SORC/AAAA
    • BANK
    • CHQ
    • CASH
    • EFTPOS
    • DOL
    • DOP

NPSI

Claims payments/Statement enquiry

Full-format Medical claims payment screen - Supervisor only

NQAI

PC Electronic Claiming

Browse mode

NQEI

PC Electronic Claiming

Action mode

Review online claim

  • NQEI,Claim ID,Oper/Pnumber,DOP/DDMMYY

Review online claims - F11 on column to sort

  • NQEI,claim ID,SORC/sourcecode,paid

Same day reversal of Online claims

  • NQEI,claim id,cardnumber - (type R to select, then R. Claim ID is DA for Provider Online claims, HC for MOA claims and AC for APP claims)

N-R

Claims payments

Use R on the end of a control line after payment to recall the same card

NSCI

Substantiation

Substantiate patient contribution screen

NSQD

Cheque cancellation enquiry

Online transaction which produces an offline job

NSVI

Substantiation

Substantiation of claims - requested by Supervisor

Control lines for processing cheque enquiries

Table 3: control lines for processing cheque enquiries in Mainframe. Search the list using Ctrl+F.

Control line

Topic

Function

BATI

Cheque enquiry

Used to obtain Medicare number

  • BATI,NB?R,chequenumber

Replace ? With state of issue

BBCI

Cheque status enquiry

Cheque information screen – check status or STOP a cheque with S or lift a STOP with L (same day only)

  • BBCI,NB?R,chequenumber

Replace ? With state of issue

BBEI

Cheque enquiry

Cheque enquiry screen

  • BBEI,cardnumber

BILI

Stop Cheque Status

Check a STOP cheque status

  • BILI,NB?R,STOP

Replace ? With state of issue

Control lines for general processing and enquiries

Table 4: control lines for general processing and enquiries in Mainframe. Search the list using Ctrl+F.

Control line

Topic

Function

BRNA

EFT details

Check or change EFT details

CESN and CESF

Mainframe

Login/Logout

EPCI

Postcodes/locations

Returns locations with that postcode

  • EPCI,postcode

Returns locations with the postcode

  • EPCI,locale,state initial

FPGI

Provider enquiry

Shows all doctors for that provider group

FPRX

Provider exemption file

Updates and holds the details of providers eligible for either remove area or grandparent exemptions

FPVI

Provider enquiry

Shows provider details

FRSI

Source Office Enquiry

Used to define and display source office code details:

  • FRSI,sourcecode

INSERT

Mainframe

Use to insert into a control line

MCDS

Report

Online claims processing report

MQSI

Supervisor screen

Supervisor screen for online claims processing

OPOQ

Mainframe

Used to login to source office code

  • OPOQ,sourcecode

PAGE UP

Mainframe

Use to change screens on Mainframe

PHEB

Two way claim

Process a Two-way claim - F3 to transmit

QITH

Item enquiry

Medicare item history details

QITI

Item enquiry

Medicare item details

  • QITI,item,DOS

QPLI

Provider enquiry

Accesses the qualification file for provider classifications

QPRX

Provider exemption file

Provider exemption file enquiry screen

QPVI

Provider enquiry

Displays details for the provider requested. Can be used with search key if the provider number is not known

  • QPVI,State code 4 letters of last name First initial of name First three letters of the street name

QVRE

Provider enquiry

Vocationally registered provider enquiry screen

QVRL

Provider enquiry

Vocationally registered provider listing screen

RHMI

Header mode

Display in header mode:

  • RHMI,OFF - Exit from header mode
  • RHMI,ON - Access header mode

ROMI

Claims list

List all claims submitted that day

Control lines for common patient history searches

Table 5: control lines for common patient history searches in Mainframe. Search the list using Ctrl+F.

Control line

Topic

Function

NHSI,Card No,Patient Name

View history

View Claims History, F9 to obtain PIN number

NHSI,Card No,patient,DENT/ALL

CDBS

For all CDBS Items

NHSI,Card No,patient,DENT

CDBS Caps

Shows cap amount, benefit paid and remaining balance

NHSI,Card No,patient,DENT/YY

CDBS eligibility period

YY for year of enquiry, 2 years of eligibility period info

NHSI,Card No,PEND/ONLY

Pends

Lists all Pended claims under the Card

NHSI,Card No

Safety Net

F6 for EGSN and SHIFT F6 for MSN and shows verified/unverified amounts for individuals

NSCI,Card No,YY

Safety Net

Substantiation for current year

NSCI,Card No,to/3112YY

Safety Net

Substantiation for previous year

NLTI,Card No,YY

Safety Net

Individual Safety Net eligibility

Patient claim history (NHSI/NHOI) shortcut keys

Table 6

Key

Function

F1

Help screen

F2

Claim ID and operator number

SHIFT+F2

Claim type

  • PCM -Manual Claim
  • PCO - Online or Easyclaim lodged by provider
  • PCW - Webclaim
  • APP - Online claim through the APP
  • D* - Bulk Bill Claims
  • V* - Veterans’ claims
  • SB* - Simplified Billing claims
  • MOA - Online claim through MyGov

‘*’ will have additional letter e.g. ‘E’ for electronic claim

SHIFT+F1

Provider classification

F3/ESC Key

Exit/clear screen

F4

Schedule fee, Office source code

SHIFT+F4

Processing Rule applied

F6

Substantiation & EMSN details

SHIFT+F6

OMSN details

F7

Page backward

F8

Page forwards

F9

PIN number

F10

CHQ/EFT details

F11

Specimen Collection Point (SCP)

SHIFT+F11

Location specific practice number (LSPN)

F12

Cancel

GPO box capital city postcodes

Table 7

Postcode

City

State

0801

Darwin

NT

2001

Sydney

NSW

2601

Canberra

ACT

3001

Melbourne

VIC

4001

Brisbane

QLD

5001

Adelaide

SA

6000

Perth

WA

7001

Hobart

TAS

Date of service more than 2 years old

Table 8: when patient claims submitted for payment are over 2 years old from the date of services.

Patient claim…

Action

over 2 years old (less than 5 years old)

Medicare benefits less than $100 (paid for 1 claim for 1 Medicare card number)

Medicare benefit less than $100

Claim must be supported by an original or duplicate account/invoice or receipt for payment.

The claim can then be processed and paid without reference to culled history.

over 2 years old (less than 5 years old)

Medicare benefit more than $100 (paid for 1 claim for 1 Medicare card number)

Medicare benefit more than $100

Check the culled history for any duplicate payments. If:

  • there is no evidence of a duplicate payment on the culled history:
    • the claim can be processed and paid
  • if cannot be decided whether a previous payment exists:
    • If it is a manual paper claim, scan and email all the claim documents to MPS Assessing where it will be auto-uploaded to the electronic workflow (PaNDA) for assessment
    • If the work item is in the electronic workflow (PaNDA), then Proficiency Raise the claim for assessment

more than 5 years old

Service more than 5 years ago

All claims for services 5 years old or more and which:

  • were lodged manually at a Service Centre - the claim documents must be scanned and emailed to MPS Assessing, where they will be auto-uploaded to the electronic workflow (PaNDA) for assessment.
  • are in PaNDA- where the Service Officer cannot process the claim they should make sure that it is re-categorised to the Patient Claims over 5 years category for assessment

There is no charge incurred to Medicare for 5 year cull requests.

How to update vendor request spreadsheet for creation of MBS vendors

Table 9

Column ID

Name of Field

Details

A

VENDOR FIELD

Leave blank this will be completed by the Accounting Operations (AO) team

B

NAME 1

Key name of recipient

Maximum 35 characters (no titles for example Mr)

C

NAME 2

Leave blank

D

SEARCH TERM

Usually Medicare number

No spaces

Maximum 10 characters

E

SEARCH TERM 2

Leave blank

F

ADDRESS 1

Key address of recipient (symbols accepted)

Maximum 35 characters

Must contain number/name and type for example, Road, Crescent, Place

Abbreviations are accepted (for example Rd)

Include PO box if relevant

G

ADDRESS 2

Leave blank

H

POST CODE

Set column to Text

4 numbers only (include PO box if relevant)

I

CITY

Key suburb or town (include PO box if relevant)

No symbols (only name), maximum 35 characters

J

STATE

Key state in capitals

Maximum 3 characters

K

K -PO BOX

Leave blank

L

PO BOX POST CODE

Leave blank

M

PO BOX CITY

Leave blank

N

PO BOX STATE

Leave blank

O

EMAIL

Key if provided

Use @ symbol

Maximum 60 characters

P

COMMUNICATION METHOD

Leave blank

Q

1ST TELEPHONE

Set column to Text

Key area code and number

No spaces

Maximum 30 characters

Not compulsory

R

1ST FAX

Set column to Text

Key area code and number

No spaces

Maximum 30 characters

Not compulsory

S

AUTH GROUP

Leave blank

T

ABN

Set column to Text

Key ABN number if relevant

No spaces

Maximum 11 characters

U

BANK COUNTRY

Key 'AU.’

Two characters allowed

V

BSB

Set column to Text

Key 6 digit number only

No spaces

W

BANK A/C NUMBER

Set column to Text

key numbers only

Maximum 18 characters

No spaces

X

A/C NAME

Key name

No titles or symbols

Spaces allowed

Maximum 50 characters

Y

PMT TERMS

Set column to Text

Key '0001

4 numbers allowed

Z

PMT METHOD

Key 'J' (direct deposit only for upload payments)

One character allowed

AA

A/C GROUP

Key 'MBS'

AB

SHORT KEY HSE BANK

Key 'ADMIN'

AC

GL RECO A/C

Set column to Text

Key '21101’

10 characters allowed

AD

SORTING KEY

Key '001'

AE

PLANNING GROUP

Key 'VANSN'

All Remaining

Leave blank

How to update payment run request spreadsheet for creation of MBS payments

Table 10

Column ID

Name of Field

Details

A

VENDOR FIELD

Service Officer to include customer name

B

INV DATE

Date the template is being completed

Must be in the format DD.MM.YY

No hyphens or slashes

C

HEADER TEXT

Patient Claims: PC/SOURCE OFFICE CODE OPERATOR NUMBER EG PC/ABCD12345

Where ABCD is the office code and 12345 is the operator number (P from operator number is not needed

Bulk Bill Claims: BB/SOURCE OFFICE CODE OPERATOR NUMBER EG BB/ABCD12345

D

REFERENCE

MCAREBENEFITS

E

GL ACCOUNT

51201

F

COST CTR

Cost Centre allocated to the Service Officers state

  • NSW - N1511
  • VIC - V1511
  • QLD - Q1500
  • SA - S1511
  • WA - W0279

G

Leave blank

H

TAX CODE

Leave blank

Tax code not needed where GL account is 51201

I

ORDER

Leave blank

J

QTY

Leave blank

K

QTY UNIT

Leave blank

L

AMT

The total benefit amount to be paid to recipient, example 37.05

Only a full stop (.) can be used, no other symbols are accepted, for example, ($)

M

BLINE DATE

Leave blank

N

LINE ITEM TEXT

MEDICARE PCM for Patient Claims Payments

MEDICARE BB for Bulk Bill Payments

Medicare claims circulars (MCC) – historical details

Do not share the below attachments externally. See Freedom of Information - Information Publication Scheme.

Table 11: MCCs in order of newest to oldest. These provide details of historical system changes.

Circular

Topic

Issue date

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Introduction of warning message 8-ECLM PRV

11-Feb-11

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Medicare patient claims next business day EFT payments new warning message NAOI and NHDI

18-Apr-11

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Suppress ended and transferred members from claimant selection for manual patient claims and substantiation

21-Feb-11

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Pre-populate claimant details on  LDA screen NHRC

25-Oct-10

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Pre-populate claimant details on substantiation screen NSCI

28-Jun-10

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Amendment of the patient claims Latter Day Adjustment system to allow multiple adjustments

11-Jun-10

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Increase Approved Collection Centre numbers from 3 to 5 digits for simplified billing and bulk billing

22-Jun-10

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Increase Approved Collection Centre numbers from 3 to 5 digits

22-Jun-10

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Introduction of Extended Medicare Safety Net benefit cap

8-Dec-09

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Medicare Safety Net registration of same sex couples

Dec-08

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Processing screen improvements for Online Bulk Bill, Simplified Billing and Easyclaim

Nov-08

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Changes to the display of claimant details on claims processing screens

10-Jul-08

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Patient claim screen change to make sure claimant bank account details are used

10-Jul-08

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LSPN - Introduction of DI Accreditation Rule

9-May-08

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Medicare Dental Initiative claims processing and substantiation

1-Nov-07

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Dental Initiative patient history

1-Nov-07

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Provider payments within location start and end dates

2-May-08

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Allied Health claiming via Medicare Online and Easyclaim

11-Oct-07

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Medicare Easyclaim

12-Jun-07

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1 May 2007 MBS changes - Amendment to processing of derived fee item 61462

19-Apr-07

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EFT Consumer Project patient claims, cash, cheque, and EFT reversals

19-Mar-07

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EFT Consumer Project patient claims latter day adjustment transfer and suppress - replaces MCC150

19-Mar-07

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EFT Consumer Project patient claims latter day adjustment same card - replaces MCC146

19-Mar-07

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EFT Consumer Project patient history changes

19-Mar-07

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EFT Consumer Project Same day adjustment

19-Mar-07

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EFT Consumer Project patient claims substantiation

19-Mar-07

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EFT Consumer Project amendments to manual patient claims processing

Mar-07

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Two-way agency PHEB enhancements for Pathology

1-Dec-06

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Introduction of an action field on FCEI

2-Oct-06

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Two-way agency (PHEB) enhancements

27-Jul-06

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Specialist referral enhancements

30-Jun-06

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Reverse and repay substantiated claims in NAQI/NABI

27-Feb-06

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Removal of EPC referral form for Allied Health and Dental Care services checking

1-Nov-05

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Enable patient name change on bulk bill vouchers

27-Feb-06

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Enable additional benefits from NSCI to be paid by EFT

27-Feb-06

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Return claims screen after Same Day delete (SDR code)

1-Nov-05

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Two-way fund gap statement reprint on thermal roll (NDFI)

1-Nov-05

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Automatic substantiation of patient claims

1-Nov-05

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Two-way incorporation of ECLIPSE into PHEB

1-Nov-05

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Display all card members when processing patient cheque claims

1-Nov-05

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Add PBS daily totals to the daily ROTI screen

1-Nov-05

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Changes to OSS to reflect HIC Online and IBA Healthpoint

28-Jul-05

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Changes to cash balancing

4-Jul-05

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Thermal roll print for NDSI - Patient claims duplicate statement

22-Aug-05

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Display safety net details on patient claims screens

4-Jul-05

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New RSN codes for closed provider locations - HIC online

4-Jul-05

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Enhancements to patient episode coning claims processing

4-Jul-05

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End dated members and changes to Medicare safety net screens

23-Mar-05

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Display safety net totals on claims history screens

4-Apr-05

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Receipt or statement for non-swipe EFT claims

4-Apr-05

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Ad-hoc individual safety net letter requests

4-Apr-05

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Display Medicare number in safety net screens

4-Apr-05

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Changes to pend recall 2004

24-Jan-05

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Thermal print of unsubstantiated services

13-Dec-04

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New referral type for allied health and dental services

28-Oct-04

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Extended bulk bill incentive payments and introduction of RMAA codes A and B

1-Sep-04

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LSPN assessment of equipment types for DI and RO services

1-Nov-04

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Bulk billing replacement of RMDS reports

14-Aug-04

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MRI fee relativities phase 2

1-Nov-04

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Partially paid accounts

1-Apr-04

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Introduction of PF6 toggle between patient claims and the safety net registration system

25-Jan-05

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Introduction of allied health and dental items phase 1

1-Jul-04

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Implementation of Simplified Billing Latter Day Adjustment system

22-Aug-04

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Introduction of auto reject and validation checks for bulk bill additional payment items

1-Jul-04

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HIC online enquiry system

13-Jul-04

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Three new items and changes to QPLI to display RRMA details 1 May 2004

22-Apr-04

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Changes to NHOI screen and details on HIC online

8-Mar-04

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MedicarePlus Safety net effective 1 April 2004

12-Mar-04

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Practice nurse items and additional 5 dollar bulk bill items effective 1 February 2004

3-Feb-04

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Patient claims processing changes

12-Dec-03

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Implementation new bulk bill LDA transaction and overpayment procedure

16-Sep-03

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Implementation new patient claims LDA transaction

15-Sep-03

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Changes to existing bulk bill adjustments DLSI

8-Aug-03

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Introduction of the diagnostic imaging substituted service rule effective 1 July 2003

27-Jun-03

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Changes to patient claims adjustments NHRI and online patient history

5-May-03

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Introduction of MSN substantiation receipts

28-Mar-03

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Changes to claims assessment system automation of simple high volume errors and warnings for bulk bill electronic claims

Mar-03

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Location specific practice number LSPN claims phase 2 part 1, 1 July 2003

Mar-03

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Extending EFT payments to all bulk bill claims

3-Mar-03

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Cease REMReq for registered sites

20-Sep-02

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MBS Changes 1 November 2002 derived fee items and photodynamic therapy items

17-Oct-02

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Assessing changes for the multiple vascular ultrasound services site rule effective 1 November 2002

29-Oct-02

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Online history and assessment indicator changes

29-Oct-02

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Introduction of voluntary indigenous identifier

9-Jul-02

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Introduction of 10 new photodynamic therapy items

28-Jun-02

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Introduction of multiple vascular ultrasound services site rule

1-May-02

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Stage 1 changes to Medicare standardised addressing rules 2002

Jul-04

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Amendments to claim history and direct bill assessing screens 14 January 2002

Jul-04

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Pathology assessing changes effective 1 December 2001

19-Dec-00

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Introduction of relative value guide for Anaesthetics RVG 1 November 2001

9-Nov-01

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Electronic exchange of enrolment data from DIMA phase 2

25-Aug-00

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Enhancement to the ETSI and ETRI transactions

7-Jul-00

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Electronic exchange of two-way agency data pilot phase

15-Nov-99

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MBS Changes 1 November 1999 Public health DI services and pathology

15-Oct-99

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Electronic exchange of enrolment data from DIMA phase 1

25-Oct-99

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MBS Changes 1 March 1999 CT scans and pathology

17-Feb-99

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MBS Changes 1 November 1998 DI service and pathology

15-Oct-98

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Medicare Benefits Schedule changes

26-May-05

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Two-way agency stage 1

24-Jun-98

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Issuing EFT statements

1-Apr-05

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MBS changes July 1998

24-Jun-96

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Psychiatric consultations

4-Jun-98

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Operational statistics system

25-Mar-98

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Redirection of rejected EFT patient claims payment

2-Feb-98

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Enhancements to EFT patient claims and manual cheque claims

1-Apr-05

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Compensation advance payment option reconciliation

5-Jan-98

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MBS changes November 1997

3-Dec-97

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Revocation of s11 and 12 HIC act 1973

3-Sep-97

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Amendments to compensation case management system

15-Jul-97

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MBS changes June 1997 prolonged anaesthesia

19-Jun-97

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MBS changes May 1997 assistant anaesthetist

28-Apr-97

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Medicare EFT patient claims

1-Apr-05

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Diagnostic imaging services changes 20 January 1997

15-Jan-97

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New provider specialty codes

18-Dec-96

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Psychiatric consultation changes

10-Jan-97

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Diagnostic imaging service 1996

1-Nov-96

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MBS changes November 1996

1-Nov-96

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Processing specified services

9-Oct-96

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Limits for new providers in attracting Medicare benefits

14-Oct-96

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Compensation advance payment option

15-Jan-97

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EDI processing transaction

26-Jun-96

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Enhancements to substantiation NTSI transaction

19-Jul-96

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New Medicare cash transaction

12-Jun-96

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NCRI and NCCI screen changes

24-May-96

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Enrolment of compensation nursing home recipients

13-May-96

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New item fee file item history report

1-Apr-96

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Medicare card number recall

8-Feb-96

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New item fee file enquiry system

21-Feb-96

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Interim compensation arrangements

1-Feb-96

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Changes to processing of compensable services

24-Jan-96

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Patient claims telephone claiming

2-Jun-97

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Private health insurance fund claims

13-Nov-95

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Changes to processing DI derived fee items

14-Sep-95

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Changes to patient claims processing screens

8-Aug-95

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Patient episode coning PEC

19-Jul-95

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New sign-on procedures

3-May-95

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Medicare card replacement procedures

30-May-95

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New Medicare claim form

2-Mar-94

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Payment of benefits for RHCA visitors

30-Mar-94

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Direct bill pend delete transaction

3-Feb-94

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History scrolling facility

9-Dec-93

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Medicare operations statistics system

22-Oct-93

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Content-based and time-based items

20-Oct-93

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Changes to history transactions

26-Aug-93

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Processing procedures S4B3 and rule 3

5-Aug-93

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Compensation system stage 3

25-May-93

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Compensation changes to claims processing

25-May-93

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QPRX diagnostic imaging transaction

28-Jan-93

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Swap system

26-Mar-93

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Medicare compensation registration system

3-Feb-93

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QC system direct bill transact 1993

8-Jan-93

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Quality control direct bill 1993

8-Jan-93

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Family safety net crossover

15-Dec-92

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Enrolment changes copy transfer facility

8-Jan-93

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Rejection of old style Medicare cards

10-Dec-92

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Diagnostic imaging 1992

20-Oct-92

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Taxation statement 1992

27-Oct-92

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Quality control system enrolment transactions

20-Oct-92

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Quality control enrolments

20-Oct-92

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Extension of the quality control system cheque claims

9-Sep-92

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Quality control branch managers 1992

15-Sep-92

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Enrolment changes open ended PEPs

15-Sep-92

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Changes to pend processing patient claims

7-Sep-92

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Standardisation of the PF key

3-Aug-92

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Substantiation statements 1992

3-Aug-92

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC053

Changes to enrolment 1992

1-Jul-92

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC052

Readers guide to online 1992

23-Jun-92

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC051

Medicare claims history 1992

25-May-92

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC050

Medicare comprehensive claims

5-May-92

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC049

Quality control of cash 1992

4-May-92

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC048

DI changes and removal of YY 1992

27-Apr-92

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC047

Processing radiation oncology service

8-Apr-92

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC046

Medicare system enhancements

12-Mar-92

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC045

Removal of co-payment 1992

1-Mar-92

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC044

Budget changes 1992

31-Jan-92

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC043

Pathology changes Budget 1991

1-Feb-92

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC042

Medicare Safety Net confirmation

22-Jan-92

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC041

Family safety net claims 1992

14-Jan-92

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC040

Family safety net registration 1991

12-Dec-91

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC039

New schedule and 5 digit item

18-Nov-91

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC038

Medicare Safety Net

21-Nov-91

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC037

Transitional safety net 1991

1-Dec-91

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC036

Co-payment arrangements

1-Dec-91

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC035

Card resequencing and PF4 history

15-Oct-91

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC034

Productivity enhancements

2-Sep-91

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC033

Quality control procedures

28-Aug-91

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC032

Changes to GP attendances

23-Aug-91

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC031

Medicare card issue numbers

24-Jun-91

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC030

Processing specialist services

1-May-91

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC029

Processing diagnostic imaging services

23-Apr-91

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC028

Address standardisation and punctuation checking

18-Apr-91

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC027

Return card procedures

16-Apr-91

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC026

Medicare card reissue 1991

22-Apr-91

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC025

Changes to enrolment procedure

19-Mar-91

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC024

MBS changes 1 January 1991

1-Jan-91

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC023

Efficiency improvements

23-Nov-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC022

Medicare pended claims 1990

19-Nov-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC021

Provider scrolling facility 1990

13-Nov-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC020

MBS changes on 5 digit item numbers

26-Oct-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC019

Medicare card reissue

25-Oct-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC018

MBS changes on attendance items

1-Nov-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC017

Production of Medicare cheques

26-Sep-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC016

Enrolment of Chinese nationals

31-Jul-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC015

EDI Direct bill processing 1990

12-Jul-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC014

EDI direct bill processing exception statement

20-Jun-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC013

Hyperbaric treatment processing Item 9450

4-Jun-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC012

Departure date field on ENSI screen

23-May-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC011

Changes to MBAC processing

13-May-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC010

Report Management and Distribution System (RMDS)

10-May-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC009

Production of Medicare cheques

28-Apr-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC008

Medicare provider enquiry QPLI

28-Feb-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC007

Warning message 8-SHRT PND

28-Feb-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC006

Processing radiation oncology

9-Mar-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC005

Minor system changes on return messages

5-Mar-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC004

Warning message 8-CHK CMLT

19-Jan-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC003

MBS changes

28-Nov-89

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC002

Direct bill claims electronically

9-Feb-90

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMCC001

Vocational register of GPs

10-Nov-89

Forms

Provider registration for Electronic Funds Transfer payments form (HW029)

Do not share these attachments externally. See Freedom of Information - Information Publication Scheme.
Use 'Save As' workaround to download/use attachments.

\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngVG4 form
\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngAssessing and Benefits Team Escalation header
\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMedicare Claims Enquires Escalation form
\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngMedicare Claims File Fix Escalation form
\\INTERNAL.DEPT.LOCAL\Shared\NAT\SERDELEXCEL\WORKPRODIMP\Operation Blueprint Migration\RDT Release Icons\32w\icon-hidden-attachment.pngManual EFT payment request form