Retention, transfer and availability of claim forms
Provider Obligations Concerning Record Keeping
Providers are reminded that they must:
- maintain records that support and substantiate all claims submitted to the department (as per clause 12.1.3(a) of the Service Provider Contract (Contract)).
- ensure claim forms are complete, accurate and certified by an authorised person before a claim is submitted (as per clause 12.1.4(c) of the Contract)
- retain original claim forms in accordance with program and contractual requirements
- provide copies of claim forms when transferring client files (section 35(5)(c) of the Hearing Services Program (Voucher) Instrument 2019 (Instrument)
- retain original claim forms for relocated clients for at least seven years after the date of service (section 35(5)(d) of the Instrument).
Claims forms as Tax Invoices
Providers should be aware that the Australian Taxation Office may request copies of tax invoices from a provider for GST payments it has received, or from the department for GST payments it has made.
Please be aware that, under clause 14.1.4 of the Contract, the claim form is the tax invoice. If the claim form is not fully completed or is not available, it is not a valid tax invoice. Where a valid tax invoice cannot be provided for a submitted claim, the department will require reimbursement of the payment or payments made for breach of the above contract clauses.
Electronic Records and Changing Software Systems
Providers must ensure their software systems automatically populate the relevant areas of the claim form with the correct information and the signature of the staff member submitting the claim. Alternatively, claim forms must be printed and manually signed. Providers should check with their software provider if they are unsure whether their system can automatically complete claim forms.
Providers remain responsible for compliance with program requirements irrespective of the software system they use. Reliance on third-party software does not remove a provider's obligation to retain, access, transfer and produce complete claim forms when required.
Providers should check with their software providers that claim forms can be correctly exported and included with client files, provided to the department if requested, and fully transferred to a new software system if the provider chooses to change systems. If a software system cannot do this, the provider may be unable to meet program requirements and may be liable for any required reimbursements.
Providers planning to migrate to a new records management or practice management system should undertake appropriate testing before implementation to ensure all claim forms and supporting records can be successfully exported, transferred and retrieved.
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