Commonwealth Numbered Regulations

HUMAN SERVICES (MEDICARE) REGULATIONS 2017 (F2017L01008) - REG 29

             (1)  If a declaration under section 21 of the Hearing Services Administration Act 1997 is in force specifying that the Chief Executive Medicare is the claims acceptance body for the purposes of that section, then it is a prescribed function of the Chief Executive Medicare to act as the claims acceptance body for the purposes of that section.

             (2)  If a declaration under section 21 of the Hearing Services Administration Act 1997 is in force specifying that the Chief Executive Medicare is the claims payment body for the purposes of that section, then it is a prescribed function of the Chief Executive Medicare to act as the claims payment body for the purposes of that section.

             (3)  The Chief Executive Medicare's functions prescribed by subsections (1) and (2) include:

                     (a)  on behalf of the Commonwealth, recovering a service provider debt under section 24 of the Hearing Services Administration Act 1997 if:

                              (i)  the debt is apparent from the records of the Chief Executive Medicare; or

                             (ii)  the Health Department notifies the Chief Executive Medicare of the debt; and

                     (b)  disclosing the following information to the Health Department about a claim accepted, paid or rejected by the Chief Executive Medicare:

                              (i)  client number;

                             (ii)  voucher number;

                            (iii)  date on which the claim was submitted;

                            (iv)  date on which the claim was accepted, paid or rejected;

                             (v)  date of the service to which the claim relates;

                            (vi)  provider number;

                           (vii)  practitioner number;

                          (viii)  site identification;

                            (ix)  item number;

                             (x)  hearing loss details for right and left ears;

                            (xi)  details of the device fitted to the client, whether fitted to the left or right ear, and fitting configuration;

                           (xii)  date on which the device was fitted;

                          (xiii)  details of top-up devices;

                          (xiv)  contracted service provider's certification details;

                           (xv)  client certification details;

                          (xvi)  cost to the client;

                         (xvii)  payment details;

                        (xviii)  if the claim is rejected--a code showing the reason the claim or an element of the claim was rejected;

                          (xix)  any other details about the processing of the claim.