Receive and Input Manual Claim :: New claim lodgement
with no claim form v14.0
Outputs
3.0
Complete claim lodgement
2.0
Input claim data
riggers & Inputs
T
1.0
Receive claim
Administrator
Lodgement
ACC > Claims Management > Manage Claim Registration and Cover Decision > Register Claim > Receive and Input Manual Claim :: New claim lodgement with no claim form
Uncontrolled Copy Only : Version 14.0 : Last Edited Friday, 26 February 2021 11:13 AM : Printed Monday, 16 October 2023 1:15 PM
Page 1 of 3
Receive and Input Manual Claim :: New claim lodgement
with no claim form v14.0
NOTE What information do I need to register the
Summary
claim?
A request for a new claim must contain all of the
Objective
following information relating to the client:
To capture new claims requested by internal staff into Eos and
• Person ID
file the relevant information
• First name of client
• Surname of client
Background
• Date of birth of client
In certain circumstances it’s necessary to create a new claim In
• NHI number of client
these cases, there will be no standard ACC claim form so the
• Fund code of new claim
information must be provided another way
• Accident description of new claim
[Out of Scope]
• Date new injury identified
Global
• Provider name
Process
• ACC provider number
Owner
• Full name of the person submitting the request
Global
for a new claim
Process
• Title of the person submitting the request for
Expert
the new claim
• Date the request for a new claim was submitted
Variation
• The name of the ACC business unit submitting
Expert
the request for a new claim
• The ACC45 number of the original claim, if
Procedure
there is one
• The name of the staff member if the new claim
1.0 Receive claim
needs to be transferred to a specific person
Lodgement Administrator
• At least one of the following for the new claim:
o read code
a Open the Registration Email Inbox and access the new
o injury description
claim request.
o injury diagnosis
b Read the email content and any attachment(s).
• A copy of at least one of the following:
o Document where the injury is recorded
NOTE What if the email doesn't have all the infor-
o Clinical notes with the relevant page number
mation I need?
noted
Reply to the email and request the information
o Instruction from the Technical Services team
from the sender.
o Medical Advisor comment
c Confirm that the request meets the criteria for a new
NOTE A request for a new claim may be on the
claim to be lodged
Referral for new claim lodgement form
NOTE What’s the criteria for a new claim to be
lodged?
Referral for New Claim Lodgement
A new claim may be lodged only if all of the fol-
lowing are true:
NOTE What if the email doesn't have all the infor-
• The client has consented to the new claim
mation I need?
being lodged via any of the following methods:
Reply to the email and request the information
o verbally
from the sender.
o in writing
• and at least one of the following is true:
o the date of accident of the new claim is dif-
ferent from the date of accident of the claim that
the client is currently being treated for
o the accident description of the new claim is dif-
ferent from the accident description of the claim
that the client is currently being treated
o the claim contains at least one of the following
types of claim:
complicated claim
non-complicated claim
Non-complicated claim definition
Complicated claim definition
NOTE What if the claim doesn’t meet the criteria for
a new claim?
Return the request to the requestor for them to
gather more information or cancel the request
d Confirm that you have all the information you need to
register a new claim
ACC > Claims Management > Manage Claim Registration and Cover Decision > Register Claim > Receive and Input Manual Claim :: New claim lodgement with no claim form
Uncontrolled Copy Only : Version 14.0 : Last Edited Friday, 26 February 2021 11:13 AM : Printed Monday, 16 October 2023 1:15 PM
Page 2 of 3
NOTE What if the email is from MFAT (Ministry of
NOTE What document type should I use in Eos?
Foreign Affairs & Trade) or an Embassy?
- Miscellaneous claims: VCF011 Internal docu-
If the email is from a staff member posted over-
ment
seas, we still need to register their claim.
- Sensitive claims: SC VCF011
We will also register claims on behalf of their
NOTE What information should I include when I'm
family members – usually the email will still come
uploading and where?
from the MFAT staff member
- Contact details: Referral for new claim lodge-
- Lodge the claim using a dummy number
ment
- Status: Received
- If there is insufficient information on the email
- Direction: Internal
from the client regarding their personal details
- Reason: Contact with Internal Party
(eg. Date of birth, Middle name etc.), Please re-
- Description: Referral for new claim lodgement
spond to the email and get clarifying details.
k Confirm cover status
- If meant to be Held, then transfer to relevant person or
If the client has not attached enough information
team.
about the accident – please clarify this, this could
- If meant to be Accept, then amend cover status to
be done by requesting a medical certificate or
Accept and suppress auto accept letter.
doctors notes to show they have sought treat-
ment.
l Open the client's party record and turn notifications on.
m Confirm to the requestor that you've created the new
If the client has supplied an address, then please
claim and advise of any changes or default info you had
update their details otherwise leave all infor-
to use.
mation as it is.
- Let the claim stream to Cover Triage for
3.0 Complete claim lodgement
assessment and suppress the letters
Lodgement Administrator
a Close out of the Eos screen and any related documents.
2.0 Input claim data
b Move email into Completed [current year] sub-folder in
Lodgement Administrator
the Registration Email Inbox.
a In Eos, open the client's party record. See the Client
Searches guide below.
Client searches
b Turn off notifications.
Stop notifications
c Request a Dummy ACC45 number using the Request
Dummy 45 tool.
Request Dummy 45 spreadsheet
d In the reason for request box in the Request Dummy 45
tool, type: 'Referral for new claim lodgement'
e In Eos, enter the new claim information into the relevant
fields.
NOTE What if it's been identified that it's a work re-
lated gradual process, disease or injury?
Add 'WRGP' to Additional Injury Comments to
ensure that it streams to the Gradual Process
team.
f In Part E, enter the default provider number (J99966) so
that the claim receives a Held cover status.
g Click NEXT on the claim intake form to save the changes.
h Reopen the new claim and action any information
requirements.
i Once the claim has a 'Registration Complete' status,
remove the default provider and replace with the actual
provider from the ACC45.
NOTE What if the claim has been streamed to a spe-
cialist department?
Transfer the claim to your queue (or contact the
relevant department to ask for it to be transferred
to your queue if you're not able to transfer it
yourself).
j In Eos, upload any documents that came with the request
to the claim.
File an inbound email
ACC > Claims Management > Manage Claim Registration and Cover Decision > Register Claim > Receive and Input Manual Claim :: New claim lodgement with no claim form
Uncontrolled Copy Only : Version 14.0 : Last Edited Friday, 26 February 2021 11:13 AM : Printed Monday, 16 October 2023 1:15 PM
Page 3 of 3
