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Evidence Guide: PSPINM001 - Process claims

Student: __________________________________________________

Signature: _________________________________________________

Tips for gathering evidence to demonstrate your skills

The important thing to remember when gathering evidence is that the more evidence the better - that is, the more evidence you gather to demonstrate your skills, the more confident an assessor can be that you have learned the skills not just at one point in time, but are continuing to apply and develop those skills (as opposed to just learning for the test!). Furthermore, one piece of evidence that you collect will not usualy demonstrate all the required criteria for a unit of competency, whereas multiple overlapping pieces of evidence will usually do the trick!

From the Wiki University

 

PSPINM001 - Process claims

What evidence can you provide to prove your understanding of each of the following citeria?

Confirm details

  1. Complete documents, and obtain authorisation/s for claims.
  2. Assess the reasonableness of accounts to ensure accounts that are paid are relevant to disability.
  3. Record account details.
  4. Notify relevant personnel when accounts are rejected.
Complete documents, and obtain authorisation/s for claims.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess the reasonableness of accounts to ensure accounts that are paid are relevant to disability.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Record account details.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Notify relevant personnel when accounts are rejected.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Process payments

  1. Produce and post cheques or process electronic transfer of funds.
  2. Batch accounts where required for traceability.
  3. Confirm authorisations for periodic payments to avoid overpayments.
  4. Process claims within time limits.
Produce and post cheques or process electronic transfer of funds.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Batch accounts where required for traceability.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Confirm authorisations for periodic payments to avoid overpayments.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Process claims within time limits.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Maintain files

  1. Maintain records.
  2. Document all contacts.
  3. Maintain evidence of file management for audit purposes.
Maintain records.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Document all contacts.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Maintain evidence of file management for audit purposes.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Confirm details

  1. Complete documents, and obtain authorisation/s for claims.
  2. Assess the reasonableness of accounts to ensure accounts that are paid are relevant to disability.
  3. Record account details.
  4. Notify relevant personnel when accounts are rejected.
Complete documents, and obtain authorisation/s for claims.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assess the reasonableness of accounts to ensure accounts that are paid are relevant to disability.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Record account details.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Notify relevant personnel when accounts are rejected.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Process payments

  1. Produce and post cheques or process electronic transfer of funds.
  2. Batch accounts where required for traceability.
  3. Confirm authorisations for periodic payments to avoid overpayments.
  4. Process claims within time limits.
Produce and post cheques or process electronic transfer of funds.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Batch accounts where required for traceability.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Confirm authorisations for periodic payments to avoid overpayments.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Process claims within time limits.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Maintain files

  1. Maintain records.
  2. Document all contacts.
  3. Maintain evidence of file management for audit purposes.
Maintain records.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Document all contacts.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Maintain evidence of file management for audit purposes.

Completed
Date:

Teacher:		 Evidence:

 

 

 

 

 

 

 

Assessed

Teacher: ___________________________________ Date: _________

Signature: ________________________________________________

Comments:

 

 

 

 

 

 

 

 

Instructions to Assessors

Evidence Guide

ELEMENTS

PERFORMANCE CRITERIA

Elements describe the essential outcomes

Performance criteria describe the performance needed to demonstrate achievement of the element. Where bold italicised text is used, further information is detailed in the range of conditions section.

1. Confirm details

1.1 Complete documents, and obtain authorisation/s for claims.

1.2 Assess the reasonableness of accounts to ensure accounts that are paid are relevant to disability.

1.3 Record account details.

1.4 Notify relevant personnel when accounts are rejected.

2. Process payments

2.1 Produce and post cheques or process electronic transfer of funds.

2.2 Batch accounts where required for traceability.

2.3 Confirm authorisations for periodic payments to avoid overpayments.

2.4 Process claims within time limits.

3. Maintain files

3.1 Maintain records.

3.2 Document all contacts.

3.3 Maintain evidence of file management for audit purposes.

Required Skills and Knowledge

ELEMENTS

PERFORMANCE CRITERIA

Elements describe the essential outcomes

Performance criteria describe the performance needed to demonstrate achievement of the element. Where bold italicised text is used, further information is detailed in the range of conditions section.

1. Confirm details

1.1 Complete documents, and obtain authorisation/s for claims.

1.2 Assess the reasonableness of accounts to ensure accounts that are paid are relevant to disability.

1.3 Record account details.

1.4 Notify relevant personnel when accounts are rejected.

2. Process payments

2.1 Produce and post cheques or process electronic transfer of funds.

2.2 Batch accounts where required for traceability.

2.3 Confirm authorisations for periodic payments to avoid overpayments.

2.4 Process claims within time limits.

3. Maintain files

3.1 Maintain records.

3.2 Document all contacts.

3.3 Maintain evidence of file management for audit purposes.

Evidence required to demonstrate competence must satisfy all of the requirements of the elements and performance criteria. If not otherwise specified the candidate must demonstrate evidence of performance of the following on at least one occasion.

applying legislation, regulations and policies relating to processing of claims

recording and reporting of transactions

reading and interpreting claims information

checking the accuracy of calculations and reconciliations

assessing reasonableness of accounts

using communication including reporting of irregularities and errors

Evidence required to demonstrate competence must satisfy all of the requirements of the elements and performance criteria. If not otherwise specified the depth of knowledge demonstrated must be appropriate to the job context of the candidate.

public sector legislation, including work health and safety and environment

regulations, and guidelines relating to injury management and processing claims

privacy legislation

procedures to ensure confidentiality and security of information

procedures for cash and non-cash handling

injury management claims relating to diverse disabilities

methods and techniques for simple numerical calculations

equal employment opportunity, equity and diversity principles