2 General Enquiries

2.1General Principles

-              the majority of general claim and account enquiries will be able to be resolved by the National Call Centre

-              where an enquiry requires a fuller or specialist explanation, the call will be referred to the appropriate Claims Management, Customer Service or Corporate Centres

-              the National Call Centre will operate between 8am and 6pm (Eastern Standard Time)

-              OHS notification and enquiries will be referred to the State based OHS staff

-              no caller should be transferred or put on hold more than twice, if possible

-              transferring and referring telephone enquiries should appear seamless to the caller, and not reflect geographical spread of the organisation or its functions.

2.2National Call Centre

National Call Centre will respond to the following enquiries:

-              general coverage under SRC Act

-              claimant rights and obligations, including right of appeal

-              lodging a claim, and evidence required

-              decision making process and time frames

-              return to work model and employer responsibilities

-              benefits payable under the SRC Act

-              what has been paid against a claim (according to PRACSYS)

-              claiming for treatment outside the liability review date, and evidence required

-lodging a claim with a health fund/Medicare pre and post determination of liability (except where enquiry relates to HOSC Act)

-what States medical rates we accept and how Comcare determines its rate of reimbursement

-              what to do if an overpayment or duplicate cheque is received

-              changes to Comcare's claims management arrangements (as per the Staff Quick Reference Sheet).

The National Call Centre will also respond to requests for RTW and Compensation forms and information (Employees Guide to Workers' Compensation, Guide to the Assessment of Permanent Impairment, customer circulars etc).

The National Call Centre will not advise claimants of adverse decisions in relation to their claim.  The claims manager will manage this communication (see Section 4 Communicating Claims Decisions).

The National Call Centre should be advised if an office is to be unattended for any period of time.  This advice should note the time and/or date when the office will be attended and include the name and number of an officer to be contacted in case of an emergency.  The telephones in the unattended office are to be diverted to the General Claims Line.

2.3Reasons for transferring a call

A claim or account enquiry will be transferred from the National Call Centre to the Claims Management, Service or Corporate Centres if:

-              there is insufficient information on PRACSYS to answer the enquiry

-              there is a comment on PRACSYS asking that all enquiries for this claim number be referred to a specified contact officer

-              PRACSYS shows an adverse decision, of which the claimant has not been advised

-              the enquiry is from a Member of Parliament, the Office of the Ombudsman, Human Rights and Equal Opportunity Commission, Privacy Commission and/or the media.

2.4Identifying the appropriate Centre

-              referral will be guided by the nature of the enquiry, and information recorded on PRACSYS (in particular file location or “FLOC” screen)

-each Centre will be responsible for ensuring that the Virtual Phone Book is kept up to date

-as a general rule, calls should be referred to

:Corporate Centre if the enquiry is from a Member of Parliament (or their staff) or from the Office of the Ombudsman, Human Rights and Equal Opportunity Commission, Privacy Commission and/or the media, refer to Corporate Policy.  Enquiries about SRC Commission matters, or complaints from claimants of licensed authorities should also be referred to Corporate Policy

:National Claims Helpline (1800 150 555) if the caller is not a Member of Parliament (or their staff) or from the Office of the Ombudsman, and wishes to complain about Comcare's service

:Service Centre in the caller's State when the enquiry relates to a matter before the Administrative Appeals Tribunal (AAT), customer training, case management services or advice, and occupational health and safety

:Canberra Claims Management Centre if the enquiry relates to a claim with a date of injury after 1 July 1996, and according to the FLOC screen on PRACSYS, the file has been moved to the ACT office

:Melbourne Claims Management Centre if the enquiry relates to a claim with a date of injury before 1 July 1996 and according to the FLOC screen on PRACSYS, the file has been moved to VIC office.