8473.11.11 Practice Nurse Incentive Program online user guide
Contents
1. Australian Government Department of Human Services External User Guide Practice Nurse Incentive Program PNIP Online 4 x Jj 10 November 2011 Document Version Number 1 00 Definitions and acronyms ACCHS Aboriginal Community Controlled Health Service AGPAL Australian General Practice Accreditation Ltd AHP Allied health professional AHW Aboriginal Health Worker 5 Aboriginal Medical Service ASGC RA Australian Standard Geographical Classification Remoteness Area DoHA Department of Health and Ageing DVA Department of Veterans Affairs EN Enrolled nurse Full Time Equivalent GP General practice GPAPlus GPA Accreditation Plus HPOS Health Professional Online Services MBS Medicare Benefits Schedule PIP Practice Incentive Program PKI Public Key Infrastructure PNIP Practice Nurse Incentive Program RACGP Royal Australian College of General Practitioners RN Registered nurse UAWS Urban area of workforce shortage Contents Application screen flow overview 4 Step ANP OMNIS soo eooococoncsoccsooneo 5 450 22 InstrUctions aasoococccocsoccoconsos 6 Step 3 Eligibility Check 7 Step 4 Practice Details 13 Step 5 Payment Details 15 Step 6 Additional Locations 17 Stepi7 Incentivess eee TEE 19 Step 8 Practice Ownership2. 31 January 2011 1 February 2011 30 April 2011 1 May 2011 31 July 2011 1 August 2011 31 October 2011 Copy Peso T Tzz x o 20 Registered Nurse 20 20 Enrolled Nurse HHHH MM HHHH mm HHHH Mm Aboriginal Health Worker HHHH MM HHHH HHHH jMM Allied Health Professional jo 10005 oo Declaration 1 declare that the practice meets all of the PNIP eligibility requirements Yes O No Do you agree to collect and supply evidence specified 1 in the Program Guidlines j Status Initial Incentive 1 A Practice Nurse is a Registered Nurse or Enrolled Nurse A Health Professional is an Aboriginal Health Worker or Allied Health Professional You will need to calculate the TOTAL hours per week for all Registered Nurses Enrolled Nurses Aboriginal Health Workers and Allied Health Professionals currently working at the practice e g if you Practice Nurse Incentive Program Online Step 8 Practice Ownership PIP consenting practices Review the information in the sections Ownership Type 2 Practice Ownership Details 3 Ownership Address Information 4 Owners Partners Associates Note if the details displayed are incorrect you will need to logout from PNIP Online and logon to PIP and GPII Online from the link in the HPOS Main Menu and update your practice details before continuing with your PNIP applica
3. 21 Step 9 GP Details Summary 23 Step 10 Associated Documents 25 Step 11 Application Summary 26 Step 12 Application Submitted 27 Appendix A Individual GP Details 28 This user guide is designed to help you step through the process of applying for PNIP payments Application screen flow overview Application Screen Flow External PNIP Online Home Page Practice Screen x Screen Screen y Screens Payment Additional Incentive Screens Screen Screens Screens Screens Practice GP Details Associated Application Application Ownership Summary Documents Summary Submitted Screen Individual a Ai ae HPOS GP Details a 22 Paper based form GP T External t Medicare Note screen shots in this guide may slightly vary to the PNIP Online screens Practice Nurse Incentive Program Online Step 1 PNIP Online All practices If the practice is a new applicant select Apply Now to start a new application If the practice is currently registered for PNIP select Update then select an approved practice to update details If the practice has an application in progress select Continue to continue an existing initial application or view a printable version of a submitted application Select Logout to close the current session and go to the Health Professional Online Se
4. Aepicanon Sre maea _ Practice Nurse Incentive Program Online Step 7 Incentives All practices Note practices are not eligible for an incentive under the PNIP if they are supported to employ or retain the services of a practice nurse Aboriginal Health Worker or allied health professional through Australian State or Territory Government funding other private funding or incentive programs for example the Mental Health Nurse Incentive Program This restriction doesn t apply where the funding for health professionals has been provided by the Office for Aboriginal and Torres Strait Islander Health In the Incentive Payments section enter the Standard Weekly Contracted Hours details for 1 Registered Nurse 2 Enrolled Nurse 3 Aboriginal Health Worker 4 Allied Health Professional In the Historical Period section enter the Standard Weekly Contracted Hours details for each quarter for Registered Nurse 2 Enrolled Nurse 3 Aboriginal Health Worker 4 Allied Health Professional Note if the details entered in the first Historical Quarter are the same for the remaining quarters you can select Copy Previous at the top of each remaining quarter In the Declaration section answer the mandatory questions 1 PNIP eligibility requirements 2 Collect and supply evidence Note refer to the PNIP guidelines for more information on the requirement for collecting maintaining and providing evidence When all
5. information has been entered or answered select Previous to return to the previous screen without saving entries Nextto continue to Practice Ownership Resetto reset the screen unprotected fields only and go to the start of Incentives View Application Summary to display the Application Summary Save and Exit to save your application and go to the PNIP Online home page or Close to close the current session and go to the PNIP Online home page External user guide 19 E712 rins Incentive Microsoft internerExplorer PNIP Online Application Number A001124 Practice Name Smmv have two Registered Nurses currently working at the practice for 30 hours each per week and four Registered Nurses working at an additional practice branch for a total of 20 hours each per week your TOTAL Registered Nurse hours per week is to be recorded as 140 hours per week The TOTAL hours per week shall be the standard agreed weekly hours e g as set out in the employment contract The standard weekly contracted hours input format is defined as HHHH MM where HHHH for number of hours MM for number of minutes Incentive Payments Current Health Professionals Standard Weekly Contracted Hours Registered Nurse Enrolled Nurse Aboriginal Health Worker Allied Health Professional Ence Historical Period Previous Health Professionals Standard Weekly Contracted Hours Health Professional Nurse Type 1 November 2010
6. person to whom all correspondence is addressed Only 5 authorised contact persons are allowed Denotes mandatory fields Remove authorised contact First Name Last Name Primary Contact RA Number 4 ubwop mi E ME Hera Ic il i 4 Sele e J 1 Ir E Phone Number Facsimile Number Email Address Re enter Email Address Postal Address Is the practice postal address the same as the main location address sie Yes No Address Line 1 1 Address Line 2 Locality State NSM pooR Postcode 1 Communication with Medicare Would you like to receive electronic notification for the following via your HPOS Email facility Payment Advices and News Update 9 Access Online Receive printed copy via mail Quaterly Confirmation Statements Access Online Receive printed copy via mail General Correspondence 9 Access Online O Receive printed copy via mail Practice Nurse Incentive Program Online Step 5 Payment Details PIP consenting practices In the Bank Account Details section answer the mandatory question 1 Consent to use PIP banking details If you answered No go to Non PIP or non consenting PIP practices If you provided consent to use PIP data for PNIP review the practice information in the PIP Bank Account Details for 1 Account Name full account name 2 BSB only the last three digits are displayed 3 Account Number only the last three digits are displayed Note if the details displayed ar
7. 0 0 0 0 S Is the practice registered for PIP Yes No Main Practice Location i If the practice has multiple locations the main practice location should be the practice location that provides the highest number of services per annum Select one a Insurance Does your practice have public liability insurance Yes O No Do all practice GPs have current professional indemnity insurance Yes No Accreditation Details Is your practice currently accredited O Yes PNIP Employment Details Select the Health Professional Type employed at your practice Registered Nurse Enrolled Nurse 0 Aboriginal Health Worker 0 Allied Health Professional Did your practice render services for MBS items 10993 10994 10995 10997 10998 and or 10999 Yes eck PNIP Eligibility Shange Eligibility Information 4 8 Y Local intranet External user guide Registered PIP practices If you are a PIP registered practice complete the mandatory field and question in the Practice Details section 1 PIP Practice ID 2 Do you give consent to use PIP Data for PNIP Note the screen will refresh based on your answers If you do not consent for the use of PIP data for PNIP go to Non PIP or Non Consenting PIP Practice SVU me lalollit check D Medicare Australia Health Professional Online Services PNIP Online Eligibility Check Practice Details Practi
8. 11 2011 16 51 13 PM EST If you have any queries regarding this application contact PNIP on 1800 222 032 for assistance and quote the application number Print Save your completed application You can print or save your submitted application to keep a copy for your records The PDF and RFT versions are also available to print or save on the PNIP homepage until the application is approved B View PDF View RIF External user guide 27 28 Appendix A Individual GP Details In the GP Details section review the pre filled details for 1 Title First Name Last Name Provider Number Start Date End Date if relevant Ov UL d UA Note if any details are incorrect contact the PNIP for more information by email pnip humanservices gov au or call 1800 222 032 call charges may apply between 8 50 am and 5 00 pm Monday to Friday Australian Central Standard Time ACST In the Consent and Indemnity Insurance section answer the mandatory questions 1 Consent for Medicare to use your service data for the PNIP 2 Do you have current Professional Indemnity cover In the Provider Declaration section answer the mandatory question 1 Provider declaration section You need to repeat this process for each provider number you have associated with the practice When all information has been reviewed or entered select Submit to save the information you should print this screen for future reference if needed Reset to res
9. A check intenet olores PNIP Online Eligibility Check Practice Detalls Practice Name My Practice _ m 7 m _ _ 1 If you are not a General Practice Aboriginal Medical Service or Aboriginal Community Controlled Health Service select the General Practice option This will ensure you are able to complete the relevant questions on the application form Practice Type Is the practice registered for PIP Main Practice Location 4 General Practice Yes O No 1 If the practice has multiple locations the main practice location should be the practice location that provides the highest number of services per annum Address Line 1 Address Line 2 Locality State Postcode Insurance Does your practice have public liability insurance Do all practice GPs have current professional indemnity cover Accreditation Details Is your practice currently accredited Start Date End Date Accreditation Body Accreditation Number PNIP Employment Details Select the Health Professional Type employed at your a practice If the practice employs an Allied Health Professional specify the Allied Health Professional types Did your practice render services for MBS items 10993 10994 10995 10997 10998 and or 10999 1 Something St Yes Yes Yes 21112011 AGPAL a 5468 O Enrolled Nurse Aboriginal Health Worker v Allied Hea
10. Exit to save your application go to the PNIP Online home page or Close to close the current session and go to the PNIP Online home page External user guide 25 EVV Penns 9 Details Summary MicrosottintemnetExplorer E dee Australian Government Medicare Australia PNIP Online PNIP Online Application Number A001124 Practice Name Smmv Status Initial GP Details Summary 1 Select Yes on the Current field if the provider is currently working at one or more locations at the practice If the provider is not currently working at any location select No Enter the details for each provider if the provider works worked at more than one practice location then make sure to add the provider number for each location Denotes mandatory fields Provider Details Current Yes First Name 1 Last Name T E Will the provider be completing the GP Details form online Yes No RA Number 1 1 Each provider you must complete the Individual GP Details form online va HPOS Remove Provider Number Provider Number Location GP Details Status Mar vos a L J wl Li a Bi REMOVE Q ADD ANNE Vis piston Summam El Done Practice Nurse Incentive Program Online Step 10 Associated Documents All Practices In the Upload Document section enter the required information 1 T
11. P Online Eligibility Check Practice Details Practice Name Ifyou are not a General Practice Aboriginal Medical Service or Aboriginal Community Controlled Health Service select the General Practice option This will ensure you are able to complete the relevant questions on the application form Practice Type General Practice Is the practice registered for PIP Yes 9 No Main Practice Location 1 If the practice has multiple locations the main practice location should be the practice location that provides the highest number of services per annum Address Line 1 10 Somthing St Address Line 2 ci Locality Mytown State nsw E Postcode 12222 Insurance Does your practice have public liability insurance Yes O No Do all practice GPs have current professional indemnity insurance Yes No Accreditation Details Is your practice currently accredited Yes No ert Tats 17 11 2011 ge End Date 11112018 B Accreditation Body AGPAL Accreditation Number z 2222 et ganr stats El E Done B Localintranet Practice Nurse Incentive Program Online All practices In the PNIP Employment Details section complete the mandatory details and questions 1 Health professional type Note if you select allied health professional the screen will refresh and you will need to select the allied health professional types 2 MBS items APPO
12. PIP or non consenting PIP practices In the Provider Details section enter mandatory and or optional details for 1 Current Title First Name Last Name GP to complete online declaration Provider Number Location Start Date mandatory if GP is current Q mx O9 U B End Date mandatory if GP is not current You need to add all GPs working at the main location and at each practice location by selecting Add Another Provider Number All practices GPs that have HPOS access and the practice indicates will respond online will receive an email with a link for each provider number associated with the practice The GP must follow the link and complete the details on the Individual GP Details screen refer Appendix A Individual GP Details All other GPs will need to complete the PNIP Individual GP form available from medicare gov au The form s can be uploaded during the application process as an associated document The form s can also be sent through HPOS email as an attachment by fax or by mail to PNIP Fax 1300 587 696 Mail Practice Nurse Incentive Program GPO Box 2572 ADELAIDE SA 5001 When all information has been reviewed or entered select Previous to return to previous screen without saving entries Nextto continue to Associated Documents Reset to reset the screen unprotected fields only and go to the start of the GP Details Summary View Application Summary to displays the Application Summary Save and
13. ce Name Smmv i If you are not a General Practice Aboriginal Medical Service or Aboriginal Community Controlled Health Service select the General Practice option This will ensure you are able to complete the relevant questions on the application form Practice Type General Practice a Is the practice registered for PIP Yes O No PIP Practice Details PIP Practice 1D E Do you give consent to use PIP data for PNIP Yes Main Practice Location i If the practice has multiple locations the main practice location should be the practice location that provides the highest number of services per annum Address Line 1 Address Line 2 m T 4 Select a Postcode i Insurance Does your practice have public liability insurance O Yes Do all practice GPs have current professional indemnity insurance Yes Accreditation Details A ees oO Is your practice currently accredited O Yes PNIP Employment Details Select the Health Professional Type employed at your Registered Nurse 7 Enrolled Nurse Aboriginal Health Worker Allied Health Professional Did your practice render services for MBS items 10993 10994 10995 10997 10998 and or 10999 O Yes bility Information Previous Next Reset View Application Summary Save and Exit Practice Nurse Incentive Program Online PIP conse
14. ch additional location 1 Address Line 1 Address Line 2 optional Locality State Postcode Is the additional practice location accredited registered for accreditation or not accredited Start Date if the location is accredited registered Donny End Date if the location is accredited registered 9 Accrediting Body if the location is accredited registered 10 Accreditation Number if the location is accredited registered 11 Public liability insurance 12 Medical practitioner professional indemnity When all information has been reviewed or entered select Previous to return to the previous screen without saving entries Nextto continue to Practice Ownership Resetto reset the screen unprotected fields only and go to the start of Additional Location View Application Summary to display the Application Summary Save and Exit to save your application and go the PNIP Online home page or Close to close the current session and go to the PNIP Online home page External user guide 17 18 PNIP Online Application Number A123456 Practice Name XYZ Practice Status Initial Additional Location En Denotes mandatory fields Does your practice have more than one location O Yes O No If your practice has more than one location do or Yes O No more GPs from the main practice location also practice at the additional pracitice location Current Locations Locatio
15. e incorrect you will need to logout from PNIP Online and logon to PIP and GPII Online from the link in the HPOS Main Menu and update your practice details before continuing with your PNIP application Non PIP or non consenting PIP practices In the PNIP Bank Account Details section enter mandatory details 1 Account Name 2 BSB 3 Account Number Note when all information has been reviewed or entered select Previous to return to previous screen without saving entries Next to continue to Additional Locations e Reset to reset the screen unprotected fields only and go to the start of Payment Details View Application Summary to display the Application Summary Save and Exit to save your application and go to the PNIP Online home page or Exit to close the current session and go to the PNIP Online home page External user guide 15 16 Derails Microsoft E Medicare Ansirala PNIP Online PNIP Online Application Number A001124 Practice Name Smmy Status Initial Payment Details i All payments are made through Electronic Funds Transfer only The correct BSB number is important If you are unsure check with your bank Denotes mandatory fields Bank account details Do you wish to use PIP s bank details for PNIP Yes No PIP Bank Account Details Account Name Australian Government PNIP Online Applica
16. een At any time you can view the progress of your Application on the Application Summary screen to navigate to the Application Summary screen select the View Application Summary button You can reset any screen to the values on entry by selecting the Reset button You can use Close or Save and Exit to leave the Application at any time To save a screen it must be completed successfully The standard buttons displayed in your browser should not be used as this can cause information to be lost You can refer to the PNIP Online Users Guide for more information on the Application process or contact PNIP for assistance Practice Nurse Incentive Program Online Step 3 Eligibility Check All practices In the Practice Details section complete the mandatory fields and questions 1 Practice Name 2 Practice Type 3 15 the practice registered for PIP Note the screen will refresh based on your answers If you are not a PIP registered practice go to Non PIP or Non Consenting PIP Practice APPO ne ibi check Microsottinternetia ore A Australian Government Medicare Australia Health Professional Online Services PNIP Online Eligibility Check Practice Details 1 If you are not a General Practice Aboriginal Medical Service or Aboriginal Community Controlled Health Service select the General Practice option This will ensure you are able to complete the relevant questions on the application form Practice Type General Practice 8
17. elds only and start again 2 Select Exit or Close to close the current session and return to the PNIP Online home page or 3 Contact PNIP for more information at pnip humanservices gov au or 1800 222 032 call charges may apply between 8 30 am and 5 00 pm Monday to Friday Australian Central Standard Time ACST If your practice is eligible to apply you can select Previous to return to previous screen without saving entries e Next to continue to Practice Details Change Eligibility Information to update the screen unprotected fields only and redo the Eligibility Check View Application Summary to display the Application Summary Save and Exit to save your application entries and go to the PNIP Online home page or Exit to close the current session and go to the PNIP Online home page Practice Nurse Incentive Program Online Step 4 Practice Details PIP consenting practices Review the details in the Authorised Contact section for 1 Upto five authorised contact persons for the practice including the primary contact 2 Practice phone number 3 Practice fax number 4 Practice email address Note if the details displayed are incorrect you will need to logout from PNIP Online and logon to PIP and GPII Online from the link in the HPOS main menu and update your practice details before continuing with your PNIP application If the details are correct go to Communication Non PIP or non consenting PIP practices In the Authorised C
18. et the screen unprotected fields only and go to the start of Individual GP Details e Exit to close the current window or Close to close the current session and go to the PNIP Online home page Practice Nurse Incentive Program Online Application Number A123456 Practice Name XYZ Practice Application Type PNIP ASGCRA 1 Individual GP Details i Thus deciaration form must be completed by all GPs so that the practice can participate in You must enter all information and complete the declaration Once all information is completed select Submit to submit this form Many of the below information is not correct you must contact PMI Once the form is submitted to update any of your information you can contact GP detaiis Title tbe First Name gt Last Nome ast name Provider Number prowder number Start Date dd mmiyy End Date dd mmiyy Consent and indemnity insurance that ali practice GPs have current professional indemnity cover 1 consent to the use of my Medicare and Department of Yes Ho Veterans Affairs service data when calculating the practicos PNIP payment s Do you have current Professional Indemnity cover O Yes O Mo Privacy Note Information provided on this form will be used to assess entitiement to payment under the and required by Medicare Austraba to perform functions under serico arrangements made under subsection 7 2 of the Medica
19. ew or Edit GP Details Summary Complete View or Edit Associated Documents View or Edit 1 Once the Application has been completed the practice is required to submit supporting documentation using the PNIP Associated Documents screen The information can also be sent to Medicare Australia using HPOS email mail or fax For list of the supporting documentation refer to the PNIP Program Guidelines for more information Submit Application Cancel Application Ex dicare Australia 2009 Practice Nurse Incentive Program Online Step 12 Application Submitted All practices This screen is confirmation that your application has been successfully submitted You should print this screen or record your application number for future reference if you need to contact the PNIP Select View PDF version or View RTF version to print and or save a copy of the successfully submitted application You can also select e Exit to close the current session and go to the PNIP Online home page or Close to close the current session and go to the PNIP Online home page e To tins Applicaton submitted Microsoft Interise x9 orsr 16 CLOSE o ee Australian Government Medicare Australia PNIP Online PNIP Online Application Submitted The practice application has been submitted to Medicare Australia for processing Application Source Online Application Number A001124 Practice Name Smmv Date Time of Lodgement 21
20. gements All changes must be signed by the authorised contact person or the practice owner s Privacy Note The information on this form will be used to assess the practice s eligibility to receive payments under the Practice Nurse Incentive Program The collection of this information is authorised by the Medicare Australia Act 1973 This information may be disclosed to the Department of Health and Ageing other relevant agencies or as authonsed or required by law False or Misleading Information Penalties exist under law for giving false and or misleading information Medicare Australia may suspend payments and or recover any resulting overpayments that result from inaccurate information that is provided in the application or the applicant fails to notify Medicare Australia of any relevant changes in circumstances Note Refer to the Change of details section above for examples of relevant changes in circumstances and the time in which practices are required to notify Medicare Australia changes Medicare Australia may suspend payments and or recover any overpayments that result from the provision of incomplete or inaccurate information or delays in advising Medicare Australia of changes to practice details Navigating through the Application To move to the Next screen in the Application select the Next button at the bottom of the screen To move to the Previous screen in the Application select the Previous buttons at the bottom of the scr
21. ine Instructions About this application This form can be used to submit a new application for the Practice Nurse Incentives Program PNIP For the purposes of the General Practitioners GPs include Fellows of the Royal Australian College of General Practitioners RACGP Fellows of the Australian College of Rural and Remote Medicine vocationally registered GPs and medical practitioners undertaking approval training GPs will also include non specialist medical practitioners known as other medical practitioners who provide non referred services and are not technically GPs Enquiries Practice Nurse Incentives Program Email pnip humanserices gov au Phone 1800 222 032 Hours of operation are 8 30 am 5 00 pm Australian Central Standard Time Call charges apply from mobile and pay phones only Program Guidelines To make sure that your practice meets all of the ongoing eligibility requirements you must read the Practice Nurse Incentive Program Guidelines You can view the Practice Nurse Incentive Guidelines in PDF or RTF format Accreditation Requirements To be eligible to receive the PNIP Incentive payment Accreditation Assistance or Top up payment practices must be accredited or registered for accreditation against the Royal Australian College of General Practitioners RACGP Standards for general practices Accreditation is assessed by the following organisati
22. ives of the corporation e g company director and company secretary State or Territory Government or Other Public Body Declaration to be completed by an authorised representative of the practice Practice Ownership type Which arrangement best describes your practice Associateship Practice Ownership details Company Name Trading Name mgesa Ownership Address Information Address Line 1 1 Address Line 2 Locality State Postcode Owners Partners Associates Remove Owner Partner Associate Title First Name Practice Nurse Incentive Program Online Step 9 GP Details Summary PIP consenting practices For your practice to be fully assessed for financial disadvantage for top up payment and grandparenting payment all GPs who worked at your practice during the historical period of 1 August 2010 to 30 July 2011 need to provide their consent for Medicare to access full MBS billing data It is important that all GPs currently working at your practice provide their consent in case your practice withdraws or is withdrawn from the PIP In the Provider Details section review the current practice details for all GPs Note if the details displayed are incorrect you will need to logout from PNIP Online and logon to PIP and GPII Online from the link in the HPOS Main Menu and update your practice details before continuing with your PNIP application Non
23. lth Professional O Audiologists Chiropractors 0 Diabetes Educators 7 Dieticians Nutritionists O Exercise Physiologists 7 Occupational Therapists Orthoptists 7 Orthotists Prosthetists O Osteopaths 0 Physiotherapists 2 Podiatrists Psychologists 0 Social Workers 0 Speech Pathologists Yes O No Check PNIP Eligibility hange Eligibility Information View Application Summary External user guide dl 12 Note the Reset button unprotected fields only will be enabled until you select the Check Eligibility button Select Check Eligibility Note the Check Eligibility button will not be enabled until you answer all the mandatory questions For example your practice is not eligible for the PNIP if it does not employ a health professional Note professional nursing standards require an enrolled nurse to be supervised by a registered nurse Supervision may be direct or indirect but appropriate supervisory arrangements must be in place The eligibility check will return with one of the following determinations 1 Based on the information provided your practice is eligible for PNIP To continue with your application select Next to go to Practice Details 2 Basedon the information provided your practice is not eligible for PNIP because of the following reasons your reason s will be listed You can review your answers and Select Change Eligibility Information to clear unprotected fi
24. ment Name Description Type File size Added By MNAE Copyright O Medicare Australia 2009 External user guide 25 26 Step 11 Application Summary All practices In the Application Summary section you can view or edit any section of the application by selecting View or Edit When all Application Summary sections status is Complete the Submit Application button will be enabled to complete the PNIP application You can also select Cancel Application to cancel all applications and go to the PNIP Online home page e Exit to save your applications and go to the PNIP Online home page or Close to close the current session and go to the PNIP Online home page eT Application AIT JH SEDES Et EST Australian Government Medicare Australia PNIP Online PNIP Online Application Number A001124 Practice Name Smmv Status Initial Application Summary 1 The following table shows which sections of the application are complete incomplete You may View or Edit any completed sections or fix any errors for incomplete sections On selection this link will take you back to the section specified To return to this screen select the View Application Summary option Section Status Actions Eligibility Check Complete vi cE li Practice Details Complete Vi E Payment Details Complete View or Edi Additional Locations Complete Vi Incentives Complete View or Edit Practice Ownership Details Complete i
25. n Number Type Locality State Postcode Accreditation Status 0t Main PROSPECT ACT 1234 Accreditated in own right 02 Additional TUGGERANONG ACT 2600 Accreditated in own right 03 Additional WODEN ACT 2200 Not accredited Additional DICKSONWODEN ACT 2600 Not accredited 05 Additional HOLT ACT 2700 Not accredited lt Previous Ell 21 3 5 5 8 7 we Add Practice Location Information Location Number Address Line 1 Address Line 2 Locality State Postcode 1 i Additional practice locations are known as practice branches Practice branches providing 3 000 or more services per annum need to be accredited or registered for accreditation in their own right for the services of that branch to be included in the calculation of the practices payments For further information refer to the Practice Incentives Program Guidelines Documentary evidence of accreditation status accreditation or registration certificate must be supplied for each practice branch wishing to participate in the Is the additional practice location Select One v If the branch is accredited or registered for accreditation enter the following Start Date B End Date pa Accrediting Body Select One g Accreditation Number Does your practice have public liability insurance Yes O No Do all medical practioners at the practice have current Yes O No professional indemnity cover Que Fese C Viem
26. nting practices If you provided consent to use PIP data for PNIP review the practice information in the following sections 1 Main Practice Location 2 Insurance 3 Accreditation Details z ee Australian Government Medicare Australia PNIP PNIP Online Eligibility Check Practice Details Practice Name Smmv 1 If you are not a General Practice Aboriginal Medical Service or Aboriginal Community Controlled Health Service select the General Practice option This will ensure you are able to complete relevant questions on the application form Practice Type General Practice v Is the practice registered for PIP Yes PIP Practice Details PIP Practice 1D 45596 _ Do you give consent to use PIP data for PNIP Yes No 9065 PIP consent is successful Main Practice Location 1 If the practice has multiple locations the main practice location should be the practice location that provides the highest number of services per annum Address Line 1 1 Address Line 2 Locality di INTLEYS POINT State Postcode Insurance Does your practice have public liability insurance Yes Do all practice GPs have current professional indemnity cover 090 Yes No Accreditation Details Is your practice currently accredited Yes No Start Date v 18 102 on JS End Date 08 05 2013 __ Fa Accreditation Body Accreditation Number PNIP Employment Details Select the Health Profe
27. ons Australian General Practice Accreditation Ltd AGPAL Enquiries number 1300 362 111 www agpal com au GPA Accreditation plus Enquiries number 1800 188 088 www gpa net au Change of Details Changes to practice arrangements can impact on your practice s eligibility to participate in the PNIP and or the calculation of incentive payments The practice must advise Medicare Australia in writing of any changes to practice arrangements by the relevant point in time date or within 14 calendar days whichever date is earliest Relevant changes include but are not limited to a GP leaving or starting at a practice e achange in the practice s authorised contact person change in banking details a change in the practice s accreditation status e change in eligibility for any of the individual payments a change in the number of Practice Nurses Aboriginal Health Workers and or Allied Health Professionals within the practice change in practice location ownership or structure change in the practice s public liability insurance or an individual GP s professional indemnity cover change the practice s public liability insurance arrangements for Practice Nurses Aboriginal Health Workers and Allied Health Professionals All correspondence will be sent to the primary authonsed contact person provided in this application The authorised contact person is responsible for notifying PNIP of any changes in practice arran
28. ontact section enter the mandatory optional details 1 Upto five authorised contact persons for the practice including the primary contact 2 Practice phone number 5 Practice fax number optional 4 Practice email address optional In the Postal Address section enter the mandatory details 1 Postal address same as main address a If Yes review pre populated fields if incorrect select No b If No enter postal address All practices In the Communication section enter the mandatory details 1 Payment advices 2 Quarterly confirmation statements 3 General correspondence When all information has been reviewed or entered select Previous to return to previous screen without saving entries e Next to continue to Payment Details Resetto reset the screen unprotected fields only and go to the start of Practice Details View Application Summary to display the Application Summary Save and Exit to save your application and go to the PNIP Online home page or Exit to close the current session and return to the PNIP Online home page External user guide 15 14 E Y ori Online Practice Derails MicrosoftintenetExp lores Australian Government Medicare Australia PNIP Online PNIP Online Application Number A001124 Practice Name Smmv Status Initial Practice Details Authorised Contact d The primary authorised contact person will be the
29. re Australia Act 1973 consent to Medicare Australia accessing information including personal information held by itself or the Department of Veterans Affairs about medical services provided by me for the purposes of calculating PNIP payment s and disclosing information including personal information pronded in this form to the Department of Health and Ageing for statistical research and policy development purposes Medicare Australia s Use of this information I understand that Medicare Australia may access information regarding serices provided by me for the purpose of calculating payments and provide reports regarding information on this application and provided by me to the authorised contact person s nominated on thes form and provide information which may include identifying information relating to this application to the Department of Health and Ageing for statistical research and policy development purposes Provider Deciaration Provider declaration selection O Accepted Not Accepted Mock up only External user guide 29 humanservices gov au 8473 11 11
30. rvice home page LocouT Health Professional Online Services Main menu You are here Rome PNIP Online PIP and GPII Apply for the Practice Nurse Incentives Program PNIP PNIP Forms Mail Centre 0 Apply Now New applicants must fill out the application form and supply the required supporting documentation Current Practices Practice ID Practice Name Action 005596 Smrnv Update In Progress Applications Practice Name Status Action Smmv Initial Continue What is PNIP The Practice Nurse Incentive Program aims to support an expanded role for practice nurses in primary health care particularly in prevention and chronic disease management as well as improve access to general practice services in the community The PNIP is administered by Medicare Australia on behalf of the Australian Government Department of Health and Ageing Eg For more information see the Practice Nurse Incentive Program Guidelines You can view the Practice Nurse Incentive Guidelines in PDF or RTE format Copyright Medicare Australia 2009 Your Privacy l Done A Y Local intranet External user guide Step 2 Instructions All practices Read the instructions and select Next to continue to the Eligi y Check screen Exit to return to the PNIP Online homepage APNPOnineInseucions Microsoft lioness Australian Government Medicare Australia Health Professional Online Services PNIP Onl
31. sion and go to the PNIP Online home page External user guide 21 22 Onine bristles Oymerstip Details Microsoftintenetplorer Australian Government Medicare Australia PNIP Online PNIP Online Application Number A001124 Practice Name Smmv Status Initial Practice Ownership Details 1 signed declaration must be forwarded with this application You must download and complete the Practice Ownership Declaration and forward this to Medicare Australia as an attachment to a HPOS email by fax or by mail You can provide the RA Number for each Owner Partner Associate for the practice If you provide the RA Number the Owner Partner Associate will be able to view and edit the practice information online if this application is approved The RA Number is located on the Owners Partners Associates Key or Smartcard Denotes mandatory field Depending on the practice arrangement that applies complete the Ownership Declaration as specified Individual Proprietor Declaration to be completed by the proprietor Partnership Declaration to be completed by the partners of the practice You must obtain all partners signatures e Associateship Application to be completed by all associates who are owners of the practice Do not include the signatures of practice associates who are not owners of the practice Body Corporate Declaration to be completed by at least two authorised representat
32. ssional Type employed at your practice O Registered Nurse Enrolled Nurse C Aboriginal Health Worker Allied Health Professional Did your practice render services for MBS items 10993 10994 10995 10997 10998 and or 10999 Yes No ligibilit hange Eligibility Informat Note if the details displayed are incorrect you will need to logout from PNIP Online and logon to PIP and GPII Online from the link in the HPOS Main Menu and update your practice details before continuing with your PNIP application If the details are correct go to PNIP Employment Details External user guide Non PIP or non consenting PIP practice In the Main Practice Location section enter the mandatory and or optional details 1 Address Line 1 2 Address Line 2 optional 3 Locality 4 State 5 Postcode In the Insurance section answer the mandatory questions 1 Public liability insurance 2 Medical practitioner professional indemnity In the Accreditation Details section complete the mandatory details and questions 1 Currently accredited or registered for accreditation Note if you answer Yes the screen will refresh to answer 2 5 below otherwise go to PNIP Employment Details Accreditation start date Accreditation end date Accrediting body 2 3 4 5 check Explorer Accreditation number Australian Government Medicare Australia Health Professional Online Services PNI
33. tion Non PIP or non consenting PIP practices You need to add all owners of the practice In the Ownership Type section select an entry from the mandatory drop down list In the Practice Ownership Details section enter the optional details 1 Company Name 2 Trading Name In the Ownership Address Information section enter the mandatory and or optional details 1 Address Line 1 2 Address Line 2 optional 3 Locality 4 State 5 Postcode In the Owners Partners Associates section enter the mandatory and or optional details 1 Title 2 First Name 5 Last Name 4 RA Number optional All Practices Provide a signed Ownership Declaration form available from medicare gov au or by selecting Practice Ownership Declaration on this screen The declaration can be uploaded during the application process as an associated document The declaration can also be sent through HPOS email as an attachment by fax or by mail to PNIP Fax 1300 587 696 Mail Practice Nurse Incentive Program GPO Box 2572 ADELAIDE SA 5001 When all information has been reviewed or entered select Previous to return to the previous screen without saving entries e Next to continue to GP Details Summary Resetto reset the screen unprotected fields only and go to the start of Practice Ownership View Application Summary to display the Application Summary Save and Exit to save your application and go to the PNIP Online home page or Close to close the current ses
34. tion lumber AUS 1124 Practice Name Sanw Sana Payment Details payments ace made thorugh Electronic funds Transiter only The conect BSS number ig f you are Check with your banie Denotes mandatory feids Bank account oetans Do you wish to use PIP s bank details for O Ye O Mo Bank Account Detass Account Di 958 Account Number 4 Mo Jl vm rn hm ce ETE TII nthe Practice Nurse Incentive Program Online Step 6 Additional Locations PIP consenting practices Review the details in the Current Locations section where there are additional locations Note if the details displayed are incorrect you will need to logout from PNIP Online and logon to PIP and GPII Online from the link in the HPOS Main Menu and update your practice details before continuing with your PNIP application Non PIP or non consenting PIP practices In the Additional Location section answer the mandatory question Does your practice have more than one location If you answered Yes answer the mandatory question If your practice has more than one location do one or more GPs from the main practice location also practice at the additional practice location Note for an additional location to be added one or more GPs from the main practice location must also work at the additional location If you answered Yes to the above questions enter or answer the mandatory and or optional details for ea
35. ype 2 Document Name 3 Description 4 Choose file by selecting Browse to locate a file on your computer When all information has been entered select Upload to save the document to your application Repeat this process for all documents to be uploaded Note refer to the PNIP Guidelines for a list of documents that need to be submitted with your application Copies of all required documents can be sent through HPOS email as an attachment by fax or by mail to PNIP Fax 1300 587 696 Mail Practice Nurse Incentive Program GPO Box 2572 ADELAIDE SA 5001 When all the documents have been uploaded select Previous to return to previous screen without saving entries Next to continue to the Application Summary View Application Summary to display the Application Summary Save and Exit to save your application and go to the PNIP Online home page or Close to close the current session and go to the PNIP Online home page PHP Oline Associated Documents Explorert Australian Government Medicare Australia PNIP Online PNIP Online Application Number A001124 Practice Name Smmv Status Initial Associated Documents 1 Denotes mandatory field Upload Document Type Select one Document Name Accreditation Certificate Description AGPAL Certificate Choose file ell External GuidesiScre Browse Upload Available Documents Filter Criteria Type All Reference Number v Date Added Docu
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