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Service Improvement Initiative

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ARCHIVED - Literature Review on Service Standards

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Australia - Service Standards for Health Insurance Commission

The Health Insurance Commission won a 'platinum' Award for Excellence in Customer Service in 1999 for the development and implementation of service charters to improve Medicare access.^[48] The prize was awarded on the strengths identified in HIC's efforts to target and recognize rural and non-metropolitan customers, including improved access for Aboriginal and Torres Strait Islanders to Medicare and the Pharmaceutical Benefits Scheme. The Commission was awarded for the following strengths:

A proactive approach in seeking out what the customers require;
Effectiveness of material on staff evaluation, in relation to awareness of the Service Charter;
Targeting and recognition of rural and non-metropolitan customers;
Linkages back into the business operations of the organization;
Commitment to addressing language, cultural, religious and racial barriers between the Commonwealth Government and the Australian community.

Australia - Health Insurance Commission

Our service standards for public customers^[49]

Important Note: Claims payment standards relate to the time it takes us to issue a payment. For electronic funds transfer (EFT) claims, please allow 3 working days for bank processing. For cheque claims, please allow 2-6 working days for postal delivery.

Medicare

For claims made manually (via Medicare office, mail, fax, etc)

paid accounts will be reimbursed by cash on the day at a Medicare office (daily limits apply)
alternatively, paid accounts will be reimbursed by EFT to your nominated bank account, usually within 3 days of processing, or by cheque posted to you, usually within 10 days of lodgement
claims for unpaid General Practitioner (GP) accounts will be reimbursed by cheque made out to the doctor. The cheque will be posted to you usually 16 days after lodgement
claims for other unpaid medical provider accounts will be reimbursed by cheque made out to the provider. The cheque will be posted to you usually 18 days after lodgement

For claims made electronically (including via a doctor's surgery)

paid accounts will be reimbursed by EFT to your nominated bank account, usually within 3 days of lodgement, or by cheque posted to you, usually within 10 days of lodgement
claims for unpaid GP accounts will be reimbursed by cheque made out to the doctor and posted to you usually 14 days after lodgement
claims for other unpaid medical provider accounts will be reimbursed by cheque made out to the provider. The cheque will be posted to you usually 15 days after lodgement

Childhood Immunization

immunization history statements will be sent when your child turns one, two and five years of age

Compensation

Medicare History Statements will be issued within 28 days of receipt of a Request for a Notice of Past Benefits
A Notice of Past Benefits will be issued within 28 days of receipt of the returned Medicare History Statement
Refunds from an advance payment option will be made within 3 months of the HIC receiving both the Notice of Judgement/Settlement and the advance payment amount

Paying claims

We will process your claim promptly
Our payments can be made in cash, by cheque or electronic deposit into your bank account
Claims for accounts not paid will be reimbursed by cheque made payable to the doctor and sent to the claimant
Cash claims within a specified limit will be reimbursed immediately
Cheque and EFT claims will be paid within legislated or approved times

Enrolling for Medicare

In most cases
- when you enroll in person, your Medicare number will be allocated the same day and you will receive the card within 3 weeks
- when you mail your application, you will receive your card within 3 weeks of processing your application