Diaries Matrix

DIARY NAME

PTY

CAT

WHAT YOU WILL SEE IN 'TEXT'

WHAT TO DO

MOST COMMON DIARIES:

AMEND CHEQUE STATUS

Nine

ACCT

The requested status change has been made to this cheque.

INFORMATION

The cheque has been stopped or cancelled.  You will need to go into the relevant invoice and reverse line items that were incorrect.  Rather than 'paid', they will show as 'waiting', allowing you to make adjustments and repay only the correct items.

CANNOT AUTOMATICALLY UPDATE

Two

CPROC

The automatic update program has failed to update this record.

INFORMATION

Where you have altered a Normal Weekly Earnings or superannuation figure, an automatic process will normally update any period of incapacity that is affected by the new rate change.  If the process has not succeeded, usually as a result of not being able to update a record that was manually calculated, this diary will specify which period did not update, advising you to manually perform the function.

FILE LOCATION REMINDER

One

CMGT

Pulled from 'COMMENTS' in the 'FLOC' function.

INFORMATION

Initially entered from the File Location function on the Claims Management menu, this diary provides you with a reminder ('resubmit') that further specific action is required in relation to the claim on the date the diary is generated.

RTWP CLOSURE MONITORING

Seven

REHAB

It is 3 weeks since the end date of the RTWP. Follow up a RTW Closure or Amendment form for input.

ACTION

A RTWP has been left open even though the end date of the plan has expired.  The diary is reminding you to follow up with the Case Manager about whether a closure or amendment to the plan will be provided.  The diary will not be able to be deleted until you either enter a plan closure or amendment.  As this is an 'action' diary, you will be taken directly to the 'Close RTWP' function in the Claims Management menu to enter details.

RTWP REQUESTED

Six

REHAB

Case Manager letter was sent 2 weeks back but RTWP hasn't been received. Time to follow up.

ACTION

No plan has yet been registered on PRACSYS, even though a letter has automatically been generated (in most cases), where it has been identified by the system that the claim is in the Risk Type 2 category.  This diary is reminding you to follow up with the Case Manager about whether a plan is going to be provided.  The diary is able to be deleted once a plan is either registered, or you have identified as the Claims Manager that a plan will not be required.  As this is an 'action' diary, you will be taken directly to the 'Create RTWP' function in the Claims Management menu to enter details.

UNVERIFIED CLAIM INVOICE

Seven

CPROC

ACTION

An important diary that indicates to you that accounts have been determined but due to being more complex types of invoices (either by cost or category of account), they have a 'waiting' status, and will not be paid until you have confirmed they are okay to be processed.  You will need to action the diary by being taken to the 'Invoice Verification' function in the Claims Management menu and agreeing that the accounts can be paid.

OTHER DIARIES:

CLAIMS MANAGEMENT

Claim has reached 80% of its goal cost

One

One of the costs attached to this claim is now at 80% of the goal cost. You might like to review claim management now.

INFORMATION

As the text describes, the claim's actual cost or duration, associated with either invoices, incapacity or rehabilitation, has reached 80% of the goal figure that Comcare Australia would like to see as the maximum length of time or amount for this type of claim.  You will need to look in 'View Claim Goals' in the Claims Management menu, to see where you might be able to improve the claim's performance.

Customer claim disagreement reasons

Three

Awaiting customer's reasons for objecting to liability. Delete the diary by entering reasons or finding liability.

ACTION

The text explains what to do in relation to this diary.  You will be taken to 'Amend Claim' and will need to either enter reasons why the Customer disagrees with the case, or alternatively, change the 'Customer agree' flag from 'N'o to 'Y'es.  Once you have done this, the diary will disappear.  This diary is a form of 'resubmit', reminding you that the Customer has not yet provided a statement why they don't support the claim.

Case Manager invalid on claim

Five

Following amendments to the case manager/cost centre links, the claim currently has invalid case manager details.

ACTION

This diary is generated when a claim has an invalid Case Manager recorded.  The diary is easily actioned by either blanking out the Case Manager field or entering correct Case Manager details in 'Amend Claim'.

Follow up Tax File Number with employee

Four

No tax file number has been supplied for this claim. Either follow up with employee or set TFN to be supplied to 'N'.

ACTION

This is a reminder for you to follow up with the employee about their tax file number.  To delete the diary you will need to either enter the number or change the 'TFN to be supplied' flag to 'N'o.

INVOICES

Held claim invoice

Four

This invoice was manually held from payment. Verification of payment is required.

ACTION

This diary is reminding you that there is an invoice determined on the system, but with a 'hold' rather than 'verified' status.  The 'hold' status is usually determined where you expect Customer intervention to the decision to make payment.  The diary has been designed to ensure that you don't forget the account is yet to be paid, and also is a prompt for you to follow up with the Customer on any reasons they wish to provide contrary to your decision to make payment.  As an 'action' diary, you will be taken directly to the 'Invoice verification' function in the Claims Management menu.

Unverified invoice for rejected claim

Seven

INFORMATION

Sometimes when a claim has been rejected, accounts can have been registered but then forgotten to be determined.  This diary reminds you that there are outstanding accounts waiting for action.

INCAPACITY

Determination reminder

Three

The period of approved incapacity for this DOF payee will expire in 2 weeks.

INFORMATION

This diary is important to ensure the continuity of payment to long term compensation recipients.  Rather than having to enter a reminder into the system yourself so you can ensure follow up action near to when a payee's incapacity certificate is due to expire, this diary automatically recognises the long term status and does it all for you!  You will need to then look at whether or not to extend the incapacity payment.

Review Dependant

Five

This dependant's eligibility is due for review as payments will cease in 6 weeks.

INFORMATION

A review of dependant's entitlements to compensation need to be carried out when they are due to turn 16 and again periodically up to the age of 25 where they continue their schooling.  This diary prompts you to review the entitlement without you having to enter your own reminder into the system.

Unsuccessful NWE update

Two

An NWE adjustment is required for this claimant, as the system was unable to correctly process the update.

INFORMATION

This diary lets you know that PRACSYS has failed to correctly update a Normal Weekly Earnings figure.  As the text indicates, you will need to manually enter details for the particular case.

Recurring payment not produced

Two

INFORMATION

The incapacity function on PRACSYS allows you to make 'once off' or 'recurring' payments to payees.  In some cases, the system may be unable to correctly accept the data you have entered.  The purpose of this diary is to let you know that the determination has not been successful, and you will need to look at the period in question and correct any errors manually.

Undetermined incapacity

One

ACTION

This diary ensures that you do not leave any incapacity determinations unregistered on the system after a given time.  In this way, you won't forget that the incapacity is yet to be completed.  It is a useful diary for Team Leaders, to indicate statistically how many outstanding incapacity determinations are yet to be processed.  As an 'action' diary, you will be taken directly to the 'Amend Incapacity Determination' function in the Claims Management menu, so you can either accept or reject the period not yet determined.

Unverified incapacity

Two

ACTION

In some instances, incapacity payments need to be verified.  This diary ensures that no unverified incapacity determinations are left on the system after a given time.  You will be taken to the 'Incapacity Verification' function in the Claims Management menu to complete the process and delete the diary.

RETURN TO WORK

RTWP acknowledgement request

One

This RTWP or Amendment was entered by a non-authorised user and needs to be viewed and acknowledged by the Claims Mgr.

ACTION

This diary is sent to the Claims Manager when another user has registered a RTWP or amendment, and they are not authorised to agree to the plan.  As an 'action' diary, you will be taken to the 'Amend RTWP' function in the Claims Management menu, where you will need to go to the final screen, agree to the plan and send a letter of acknowledgement to the Case Manager, where applicable.

RTWP/Claim monitoring

Nine

This RTWP to be reviewed every 2 months for duration of the plan as there are no interim goals for measuring progress.

INFORMATION

In cases where no interim goals are entered for a RTWP, and only a final goal is registered, this diary is a reminder for you to remember to monitor the employee's progress periodically during the life of the plan.

RTWP return to work monitoring

Two

This RTWP needs reviewing. See if it has been achieved and update the record.

INFORMATION

This diary reminds you to check the progress of an employee's return to work, including whether it has been achieved and is likely to continue.  Updating the claim record may include the addition of comments in the 'Amend RTWP' screen, or more efficiently, through the 'Create' or 'Amend Claim Comments' function in the Claims Management menu.

Claim type parameter exceeded

Five

This claim has exceeded Risk Type 1 parameters.

INFORMATION

On occasion, a Type 1 claim will become a Type 2, or more expensive and complex case.  This diary provides the Claims Manager with a prompt that this has occurred.  You should commence rehabilitation action as with other Type 2 claims, where appropriate.

Claim type parameter exceeded (Type 1)

Three

Claim has exceeded Risk Type 1 parameters, but the Claims Manager doesn't have authority to manage Type 2 claims.

INFORMATION

This diary differs from the one above, where the system recognises that the Claims Manager attached to a claim that has turned from a Type 1 to Type 2 case does not have the authority to make decisions for more expensive and complex claims.  You will receive this diary as a Team Leader and will need to redistribute the claim to a more experienced manager.

Incapacity follow up

Six

The current incapacity period extends beyond the RTWP end date. Check to find out why and overcome any problems.

INFORMATION

Sometimes incapacity is determined for a claim which does not coincide with when a RTWP is due to be completed.  This diary alerts you to the likelihood of a further need for rehabilitation.  You will probably need to talk to the Case Manager and discuss proposed follow up action taking into account ongoing incapacity.

RTWP amount exceeded

Four

The total RTWP estimated cost is insufficient to support the verification of all rehab payments. Increase RTWP ceiling.

ACTION

When a RTWP is entered on the system, estimated costs for the plan are included, covering services supplied by a Rehabilitation Provider.  This diary is issued when those estimated costs are exceeded by what has been registered in the 'Create Claim Invoice' function.  As an 'action' diary, you will be taken directly to the 'Amend RTWP' function to reasonably adjust the estimated cost, and allow for any outstanding accounts to be processed.

End of plan monitor

Eight

In 2 weeks the expected end date of this RTWP will be reached. It requires a closure or amendment.

INFORMATION

This diary is an alert for the Claims Manager, indicating that a RTWP is due to be completed.  Rather than waiting for a closure or amendment to the plan to be provided, you should contact the Case Manager to ensure that they are aware that the plan is due to finish, and they need to send either closure or amendment details by the time the plan date has expired.

RTWP/Claim monitoring (1 month)

Nine

A month has elapsed since the estimated start date of this RTWP. Follow up progress.

INFORMATION

As an ongoing management guide for a RTWP, this familiar diary reminds you to check the progress of the current plan, to ensure that goals are being met.  You could do this by discussing the claim with the Case Manager and checking PRACSYS for the current status of incapacity and invoice payments.

Follow up N or R status RTWP

Two

This RTWP has a status of 'R' or 'N'. A month has elapsed since registration. F/u to enter details or close it.

INFORMATION

This diary reminds you that, where you have made a RTWP non compliant or have rejected it, you will need to follow up with the Case Manager regarding their intention with the plan.  They may choose to refine the plan so it is compliant, or may prefer to provide a closure, to you can finalise activity on the record.

DIRPAY

Overpayment for DOF payee

Five

This DOF payee has an overpayment which has not been recovered.

INFORMATION

This is an important diary sent to Claims Managers that is issued where an overpayment has occurred with a DOF payee's incapacity entitlement.  While it is an information diary, if you do not set up recovery of the overpayment, it will result in an action diary being issued to you within the next month.  Your office will have specific procedures in relation to how to deal with overpayment recovery.

DOF payee authorisation required

Two

There has been a change to the payroll details for this payee which requires authorisation.

ACTION

This is another important diary which must be actioned prior to the end of a pay cycle, to ensure that DOF compensation recipients are paid.  The diary is automatically generated where the system recognises there have been changes made to either the payee's name and address and/or bank details.  Authorisation of such changes must be completed before any payment will be made.  As an 'action' diary, you will be taken directly to the 'DOF' payee record to authorise changes.  Take care to ensure that you check both page 1 and 2 of the screen, as often authorisation is required for both address (page 1) and bank detail (page 2) changes.

DOF payee previous financial year payment

Six

A payment has been produced for this payee which requires a supporting statement for the ATO.

INFORMATION

A general information diary, this indicates that a payee has received payment this year for an entitlement in the previous financial year.  This will affect the payee's past tax record, and means that the payee will require a statement for the Australian Taxation Office by the end of the current financial year.

RISK MANAGEMENT

Rehab/Claim alert

Six

An incident has been reported and should be reviewed with regard to early rehabilitation intervention.

INFORMATION

This diary is sent to State Account Managers and National Business Managers, and relates to an Occurrence Report being registered which will probably result in a compensation claim.  As a proactive measure, the diary alerts you to contact the Customer and discuss options for early intervention.

Interstate alert

One

Incident report for your region has been processed at another office.

INFORMATION

If an incident report has been received and input in another state office, this diary will generate to the Account Manager.  The diary is simply an alert to let you know that another office has entered the details.

ACCOUNTING

Inactive recovery account reminder

Six

This is a reminder that the recovery account has been inactive for a month or more.

ACTION

This diary is generated to Team Leaders if no action is taken to commence recovery of an overpayment.  It will also appear after a specified time if you have deferred taking action to recover, to remind you that this action still needs to be completed.  As an 'action' diary, you will be taken directly to the 'Recoveries' function within the Application (first) menu.