Tier 2 Classification query review panel
The Tier 2 Classification Query review panel manages queries of mapping difficult and complex cases to the current classification system.
In 2013 the Non-Admitted Care Advisory Working Group (NACAWG) endorsed the creation of the Tier 2 Classification Query Review Panel (Query Review Panel) and approved the Terms of Operation.
Although processes for classification review exist at a jurisdictional level; on occasion, complex unresolved queries are escalated to IHACPA for resolution. The Query Review Panel manages these queries, seeking to resolve them in a timely manner, and enabling a clear and consistent approach is taken to mapping difficult and complex cases to the current classification system.
The panel has representatives from jurisdictions, and is chaired by an IHACPA representative.
Governance
Unresolved Tier 2 Classification queries are escalated for resolution as follows:
Level 0 queries
It is anticipated that Level 0 queries are managed through existing classification query review processes established within existing hospital and Local Health or Hospital Network (or equivalent) procedures.
Level 1 queries
Level 1 queries have been considered by the hospital and remain unresolved.
These queries should be considered by jurisdictions in accordance with their own classification query review process. Should the issue remain unresolved, the query should be referred to the jurisdictional Tier 2 classification query review panellist who may recommend escalation of the query to the Query Review Panel.
Level 2 queries
Level 2 queries are queries which have been considered by the jurisdiction and remain unresolved. Level 2 queries may be submitted to the Query Review Panel by jurisdictions.
Prior to any query being considered by Query Review Panel, jurisdictions should ensure the following steps have been taken.
- Consult reference texts
- Seek advice from peers
- Seek input from clinicians
- Perform a web search
- Review the IHACPA website for previous similar classification queries and accompanying decisions
- Seek a decision at jurisdictional level
Jurisdictions submitting queries must formulate the query in the style of a recommendation for endorsement or options for consideration by the Query Review Panel. The jurisdictions must use the Query Review Submission form that is available below. Panellists are encouraged to liaise directly with the area raising the query to collaboratively develop a recommendation for panel endorsement prior to submitting the query to the panel.
IHACPA will review the query for compliance, and formulate an initial response to the query which will be included in the material circulated to the Query Review Panel for comment.
Recommendations are supported on a consensus basis. The Chair will consider the views put forward by members of the Query Review Panel in determining whether consensus has been reached or not.
If the Chair determines that consensus is not reached, the query will be escalated to NACAWG (Level 3).
Queries at Level 3 and above
These queries are matters which have been considered by the Query Review Panel, but have been unable to achieve consensus agreement on the recommendation or options for consideration put forward by the jurisdiction raising the query, or any alternative recommendations put forward by other panellists in response to the query. In short, queries where there are strong divergent views are escalated to Non-Admitted Care Advisory Working Group, Activity Based Funding Technical Advisory Committee, Jurisdictional Advisory Committee, and the Pricing Authority respectively until consensus agreement is reached.
IHACPA at its discretion may elect to escalate a query immediately to Level 3 or above if it considers that a faster resolution is warranted.