FOI 24/25-0830 | DOCUMENT 6

Accept a case from the eligibility reassessment queue and complete procedural fairness check

SGP KP Publishing

Exported on 2025-02-28 01:04:36

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SGP KP Publishing – Accept a case from the eligibility reassessment queue and complete procedural fairness check

1 Before you start …………………………………………………………………………………………………….. 4

2 Accept an eligibility reassessment case ………………………………………………………………… 5

3 Understand PACE procedural fairness checks ………………………………………………………. 6

4 Complete the procedural fairness checklist …………………………………………………………… 7

5 Next steps …………………………………………………………………………………………………………….. 8

Table of Contents – 2

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SGP KP Publishing – Accept a case from the eligibility reassessment queue and complete procedural fairness check

This article provides guidance for an access assessor to:

assign an eligibility reassessment case from the queue
understand automatic PACE procedural fairness checks
complete the procedural fairness checklist.

Before you start – 3

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SGP KP Publishing – Accept a case from the eligibility reassessment queue and complete procedural fairness check

1 Before you start

You have read:

about eligibility in Our Guideline – Applying to the NDIS
about checking eligibility in Our Guideline – Leaving the NDIS
article Understand eligibility reassessment requirements.

Before you start – 4

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SGP KP Publishing – Accept a case from the eligibility reassessment queue and complete procedural fairness check

2 Accept an eligibility reassessment case

Before commencing the case review, you must update your status to available.

To update your status:

from the omni-channel panel, click the down arrow next to offline
select available
a list of all open eligibility reassessment cases will appear. Click the tick to accept the case.
once accepted eligibility reassessment case will automatically open.

Accept an eligibility reassessment case – 5

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SGP KP Publishing – Accept a case from the eligibility reassessment queue and complete procedural fairness check

3 Understand PACE procedural fairness checks

Procedural fairness is the first step in the eligibility check workflow. PACE will automatically complete some procedural fairness checks including:

who progressed the case and who created the referral
the referral is for a YPIRAC or remote or very remote area (MM6 and MM7) participant, unless you are an assessor with the right skill tag.

If any of the above criteria is met, the case will not be visible to you from the eligibility reassessment case queue.

When completing the first stage of the procedural fairness check, the above fields will be auto filled and non-editable. The next step is to check if you approved the participant’s access. At the prompt, if required, click Yes. Once selected, click save and the case will automatically be routed back to the eligibility reassessment queue.

An eligibility reassessment case may automatically be routed to reassessment if:

if a participant has not had 12 months support
if it looks like we recorded the wrong eligibility decision.

Understand PACE procedural fairness checks – 6

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SGP KP Publishing – Accept a case from the eligibility reassessment queue and complete procedural fairness check

4 Complete the procedural fairness checklist

To commence the eligibility check assessment, select the eligibility check tab and follow the guided steps.

To complete the procedural fairness checklist for access decisions created in PACE, complete the following questions:

Have you made an access decision for the participant linked to the ER? Select Yes or No.
consider Have you approved any plan (old or active) for the participant linked to the ER? Select Yes or No.
consider Do you have any conflicts of interest? Select Yes or No.
click Next.

Complete the procedural fairness checklist – 7

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SGP KP Publishing – Accept a case from the eligibility reassessment queue and complete procedural fairness check

5 Next steps

If Yes was pre-populated, or selected by you, for any question:

The case will automatically move back to eligibility reassessment queue.
A different access assessor will draw down the referral from the queue.

If No was pre-populated and selected by you for all questions:

You will continue the eligibility check by considering the participant’s impairment and eligibility.

Next steps – 8

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