26Functions in relation to hearing services

26 Functions in relation to hearing services

(1) The following are prescribed functions: (a) acting as the claims acceptance body for section 21 of the Hearing Services Administration Act 1997; (b) acting as the claims payment body for that section. (2) Subregulation (1) has effect only when a declaration that the Chief Executive Medicare is the claims acceptance body or the claims payment body for the purposes of section 21 of the Hearing Services Administration Act 1997 is in force. (3) Each of the functions in subregulation (1) includes: (a) recovering a service provider debt under section 24 of the Hearing Services Administration Act 1997 if: (i) the debt is apparent from the records of the Chief Executive Medicare; or (ii) the Health Department notifies the Chief Executive Officer of the debt; and (b) disclosing the following information to the Health Department about a claim accepted or paid by the Chief Executive Medicare: (i) client number; (ii) voucher number; (iii) date on which the claim was submitted; (iv) date on which the claim was processed; (v) date of the service to which the claim relates; (vi) provider number; (vii) practitioner number; (viii) site identification; (ix) item number; (x) hearing loss details for right and left ears; (xi) details of the device fitted to the client, whether fitted to the left or right ear, and fitting configuration; (xii) date on which the device was fitted; (xiii) details of top‑up devices; (xiv) contracted service provider’s certification details; (xv) client certification details; (xvi) cost to the client; (xvii) payment details; (xviii) a code showing the reason a claim or an element of a claim was rejected; (xix) any other details about the processing of the claim. (4) In this regulation:

client means a person who received a hearing service for which a claim has been made.

contracted service provider has the meaning given by section 4 of the Hearing Services Administration Act 1997.

hearing services has the meaning given by section 4 of the Hearing Services Administration Act 1997.

voucher has the meaning given by section 4 of the Hearing Services Administration Act 1997.