COMCARE OPERATION ADVICE NO. 22
PAYMENT OF MEDICAL ACCOUNTS FROM OVERSEAS
Branch Heads
State Commissioners
Majors
1.This advice outlines the procedure to be used to deal with accounts for medical treatment that are not in Australian dollars.
2.The account should be registered and processed as a 'subsequent' claim rather than as a 'medical' claim. As a result the cheque will be manually produced by the Benefits Payment Team in Central Office and this will ensure that:
.the envelope in which the cheque is sent carries the correct postcode; many countries have postcodes that have more characters than COMPENSE will accept;
.the envelope is labelled 'AIR MAIL' and receives the correct postage.
3.All overseas medical accounts will be paid in Australian dollars. On the date an account is being determined, the selling exchange rate for the currency concerned should be obtained from the Commonwealth Bank and used to calculate the amount in Australian dollars payable.
4.To compensate the claimant or doctor concerned for the expense of exchanging the money, an amount of $4.00 should be added to the cost of the account before it is processed. When writing to the claimant/doctor explaining that payment of the claim has been approved, it should also be explained that:‑
(a)a cheque in Australia dollars will be sent shortly; and
(b)$4.00 (in Australian dollars) has been added to the account before payment, to cover exchange expenses; (Australian banks currently charge $4.00 per cheque number irrespective of the currency or amount).
SUE HAMILTON
First Assistant Commissioner
Program Implementation
10 April 1989
5. MEDICAL/TRAVEL CLAIMS
5.1. REGISTRATION
The aim of Registration is to get all claims on to the system. No time should be wasted on 'processing' these items at this stage. Decisions on whether a claim is a duplicate or is payable are up to the delegate who will process the claim, therefore ALL items should be registered if possible. Accounts rendered may not have enough information to enable registration and should be passed on to your Team Leader for a decision on what to do with them.
After opening and sorting mail go to the program REGISTER ALL CLAIMSICORRO.
For those items with a Claim No. use the Claim No. path to identify:
Determination Status (from List Conditions screen),
File Location (use PF1 from List Conditions screen).
For those items without a Claim No. use the Surname path to identify:
Claim No. (from List Conditions screen),
Determination Status (from List Conditions screen),
File Location (use PF1 from List Conditions screen).
Write these details on to the account in a prominent place.
Then go to either:
The Add Medical screen (PF11 from List Conditions screen), OR
The Add Travel screen (PF12 from List Conditions screen),
and register the claim details.
NOTE: 1)Expenses which are payable under Section 57 of the Act (ie where COMCARE has required a medical examination or report) should not be registered here. These costs are not dependent on liability being accepted for the Initial Claim and, therefore, may be rejected by the system for determination and payment. To overcome this problem Section 57 claims will probably be treated as a separate group under the next Release of COMPENSE. At present these costs should be registered under subsequent claims and will be paid manually by the Benefits Payment Team in Head Office. A Determination Status of P can be used when the costs are for an undetermined Initial Claim.
2)In cases where travel expenses are to be paid to someone other than the employee they too should be registered under subsequent claims.
Those who provide treatment have been divided into two groups ‑ Providers and Organizations. If Dr John Brown has provided treatment you should be able to find him on the Provider list or add him to that list. If Bellvue X‑Ray Clinic has provided a service they should be found on the Organization list or added to that list. The main difference between these groups is whether the Provider is an individual or a company. If Dr Brown wishes to be addressed as Dr J Brown Pty Ltd he should be placed on the Organization list.
3)Accounts in any currency other than Australian dollars should not be registered as 'Medical/Travel' claims. Rather they should be treated as 'Subsequent' claims.
7. SUBSEQUENT CLAIMS
7.1 REGISTRATION
The aim of Registration is to get all claims on to the system. No time should be wasted on `processing' these items at this stage. Decisions on whether a claim is a duplicate or is payable are up to the delegate who will process the claim, therefore ALL items should be registered if possible.
Subsequent claims are those that do not fall into the Medical/Travel or Incapacity categories but require some type of payment. At present, Section 57 expenses (ie where COMCARE has required a medical examination or report) are included under Subsequent claims.
Another group of claims which fall into this category are those travel claims where someone other than the Employee has to be reimbursed eg. an airline or bus company.
Also included as 'Subsequent' claims are medical accounts in any currency other than Australian dollars.
After opening and sorting mail go to the program REGISTER ALL CLAIMS/CORRO.
For those items with a Claim No. use the Claim No. path to identify:
Determination Status (from List Conditions screen),
File Location (use PF1 from List Conditions screen).
For those items without a Claim No. use the Surname path to identify:
Claim No. (from List Conditions screen),
Determination Status (from List Conditions screen),
File Location (use PF1 from List Conditions screen).
Then go to:
The Add Subsequent screen (PF13 from List Conditions screen)
and register the claim details.
Names and addresses should be entered without full stops and commas.
Addresses should be entered in the format:
123 High Street
TRAINING ACT
Subsequent claims should be sent off file to F.O.L. sort.
MINUTE
______________________________________________________________
Sue Hamilton
PAYMENT OF MEDICAL ACCOUNTS FROM OVERSEAS
Danny Cartledge from our Adelaide Office rang and advised they had received unpaid accounts from a doctor in England, and asked how these could be paid.
2.After discussion with various officers here, Danny was advised that the best solution was to treat the claim as a 'subsequent' claim, so that it would be paid via a manually produced cheque issued by the Benefits Payment Team (BPT).
3.The BPT would ensure that:
.the envelope in which the cheque is sent includes the correct postcode; many countries have postcodes that have more characters than COMPENSE will accept;
.the envelope is labelled 'Air Mail' and receives the correct postage; if the claim is processed in the same way as other Medical/Travel claims (ie via HIC's computer) the envelope will not receive the correct postage, and therefore, probably go via surface mail.
4.I do not consider it worthwhile arranging for a cheque to be raised in the relevant currency. This would be an expensive, cumbersome and time‑consuming procedure. Rather, when a delegate in the State Office writes to the claimant or doctor concerned explaining that payment of the claim has been approved he/she should explain that:‑
(a)payment of the account has been approved;
(b)a cheque in Australia dollars will be sent shortly; and
(c)$4.00 has been added to the account before payment, to cover exchange expenses; (Australian banks currently charge $4.00 per cheque number irrespective of the currency or amount).
6.I believe these methods will be the most cost‑efficient way of processing overseas accounts. If you agree, I suggest the following comcare operational advice be sent to all state offices, and we will also arrange for the compense clerical procedures manual to be amended as per the attached photocopies.
ROBERT KNAPP
Assistant Commissioner
Premiums and Budgets Branch
4 April 1989