Contracted Service Provider Notice
2018 Compliance Monitoring Program
(CSPN - 2017/10)
To assist you to comply with the program requirements, we will undertake the following compliance monitoring activities during 2017-18.
Compliance Monitoring Focus for 2017-18
Our approach to compliance monitoring is risk-based, focusing on client safety, program integrity and financial risks to the program and to clients.
- Risk-based Provider Audits – providers are selected for audit based on analysis of claiming patterns, information obtained from referrals, complaints, contract issues and outcomes of the annual provider self-assessment process.
- Service Management Systems Audits – providers who did not complete the 2017 SAT will be selected to participate in a Service Management Systems and Claims Audit.
- Limited Scope Audits focusing on
- MHLT fittings
- partially subsidised device fittings
- PPB Membership
- duplicate claiming
- refitting and replacements
- maintenance claims, including relocated maintenance.
- Claims Audits - clients are selected across multiple providers and a full claims history review will be undertaken.
- Random Provider Audits - provide quality assurance of our risk profiling/compliance monitoring program.
We continually monitor compliance and may implement additional compliance activities, if required, at any time.
Providers will be notified in advance of an audit. For claims audits, providers will only be contacted if there are issues found or further information is needed. You can find out more about how we monitor compliance on our website.
10 November 2017
Download this CSPN 2018 Compliance Monitoring Program