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Fees and Charges for Acute Health Services in Victoria
 
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Section A: Admitted Patients
Section B: Non-Admitted Patients
Section C: Other Services
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Section A: Fees for Admitted Patients

7. TAC Patients

7.1 Invoicing TAC for Activity

Funding arrangements for TAC patients are detailed annually in Part 2 Health Operation of the Victorian Health Policy and Funding Guidelines

The arrangements for the provision and payment of a range of public hospital services for TAC patients are outlined below.

There are no major changes to the payment processes in moving from the original to the renewed arrangements. DH continues to receive funding directly from the TAC for WIES funded separations. DH in turn continues to cash flow hospitals accordingly. Separate uncapped TAC WIES targets have been incorporated into hospital budgets, based on prior year throughput reported in the VAED. All other payments are reimbursed directly by TAC.

For more information, please visit the Transport Accident Commission (TAC) website.

To discuss TAC issues, contact David Seinfeld (david.seinfeld@dhhs.vic.gov.au)

7.2 How the payment process works

For DH to receive payment from TAC, TAC must accept the claim and issue a claim number. The patient information reported by the hospitals to DH via PRS/2 must match exactly those held by the TAC for each admitted patient separation. Details of the new data elements required to assist in this process are published in the Specifications for Revision to PRS/2 and to the VAED as updated at Health Data Standards & Systems (HDSS)

The department will pay a rate applicable for all accepted TAC patients matched with TAC records (as reported in the VAED) including numbers in excess of the published target. If hospitals do not achieve the TAC target, any funding which has been cash flowed will be recalled at the full TAC rate. It is imperative that hospitals ensure that their own records are complete, comprehensive and timely.

Hospitals should only accrue revenue for accepted TAC records. Any rejected records will be automatically funded as public in the prior year adjustment (PYA) process, up to the agreed public or private WIES target.

Hospitals should ensure that TAC records are updated in the PRS/2 with monthly information fed back by the Department.  This will ensure that updated records will be accepted by TAC and therefore minimise delays in reconciling activity and payment for records with TAC.

Errors that are not accurately corrected by health services, such as a patient’s data of birth, continuously cycle through both the DH and TAC databases and remain unmatched and as a result unfunded. This causes additional review, reconciliation and problem solving by the TAC and DH. Hospitals are required to ensure that information is keyed in with a high level of accuracy to prevent future errors and be proactive in identifying and remedying anomalies prior to sending data to the DH.

First Service is a TAC initiative which enables hospitals to directly submit claim forms to the TAC on behalf of patients who have been treated or admitted to hospital as a result of a transport accident. All relevant information is collected at the time of lodgement so TAC can make a decision on the claim more quickly.

Further information on First Service is available in the attachment; hospitals can also contact the TAC directly to seek information or to enquire about specific TAC clients claims.

Note: First Service has developed a streamlined hospital claim form. Commencing in January 2014, this claim form is now available to all public hospitals. This is available on the TAC web site.

For hospitals who are not yet engaged with First Service, hospitals and/or patients can continue under the existing arrangements and are encouraged to contact the TAC for claim lodgement by calling 1300 654 329. Hospitals should make themselves aware of the form’s specific requirements. Where hospital data does not exactly match the details a patient has entered on a TAC claim form this may impact payment timelines and the reconciliation process for both TAC and DH.

Monthly status reports to hospitals include:

  • A monthly report which includes all NEW claims and any claims with a status change since the previous month
  • A year-to-date update report on all outstanding claims, including those held and/or denied.

The reporting format includes the WIES value for the agreed claim and the amount paid by DH on this basis. DH remuneration rates per WIES are shown in Table 1. All hospital payments by DH will be reconciled with the actual WIES as agreed by TAC. Reports also include the following headers.

Microsoft Excel icon TAC Status Codes Ready Reckoner (MS Excel File 52kb)

Status     refers to the remittance advice code provided by TAC, which will appear in reports from DH to hospitals.
Description on Remittance is a description of the status code.
Business Explanation is a more detailed explanation as to what has occurred to produce the reported status.
Account Action    indicates the action to be taken.

For records where claims are not accepted by TAC, either:

  • Additional information is required to be transmitted by hospitals to allow the claim to be accepted, or
  • Hospitals retrospectively reclassify these patients to reflect any changes in Care Type and the preferences indicated by the patient on the form of election for admission.

Hospitals are expected to review rejected claims promptly and revise and resubmit claims if further information is required. Where there is no further recourse to the TAC these records will be designated as denied on the monthly report. Hospitals should recode these separation records as public.

As TAC claimants have 12 months to lodge a claim with the TAC, following the end of each financial year, any resulting hospital funding adjustments will be undertaken through the PYA process. This will generally only apply to hospitals that are over target, since hospitals below target will automatically be funded up to target for outstanding records, as public WIES.

Ultimately, care in data entry will significantly improve and streamline the reconciliation process.

To assist hospitals in understanding the data exchange and payment process a process map has been prepared and made available for downloading:

For issues regarding rejection or hold-up of claims contact:

David Seinfeld: email david.seinfeld@dhhs.vic.gov.au

7.3 TAC Payment Overview

WIES funding for TAC admitted patients in public hospitals and separate trauma related specified payments continue to apply. TAC WIES throughput is uncapped. All admitted and non-admitted prices will be adjusted annually

Reference Circular No 4/2008

Hospitals will continue to receive payments for WIES throughput and trauma specific payments for TAC patients from DH. Hospitals, however, will need to continue to charge TAC directly for the specialist medical and imaging costs associated with these admitted patient episodes, rehabilitation and non-admitted patient services.

WIES will be paid at the TAC specific payment rate shown in Table 1.

The rehabilitation 1 and rehabilitation 2 rates will be paid at the TAC specific payment rate shown in Table 3. All other admitted patient services will be paid at the public rate.

Patients may only be coded to rehabilitation care types in accordance with the Department's Victorian Admitted Episodes dataset (VAED) specifications as set out in the VAED Manual (also refer to specification changes to the manual; see Victorian Admitted Episodes Data Set (VAED).

Trauma Appropriateness Payments (TAP) ceases from 2013-14. Funding has been redistributed to relevant Health Services through their emergency department or urgent care centre funding streams based on average Trauma Appropriateness Payment activity over the past three years. Funding will also be used to improve trauma education across the State.

The following are published in the Victorian Health Policy & Funding Guidelines

  • Definitions for inliers and outliers for TAC admitted patients
  • Cost weights and related parameters for TAC admitted patients.

7.4 TAC Patient Types

7.4.1 Acute admitted patients

TAC compensable patients should only be admitted to hospital in accordance with the Minimum Criteria for Admission as specified in the current DH Hospital Admission Policy.

New Admission Policy

Fees for TAC compensable separations (Table 1) are based on AN-DRGs with Victorian modifications (VICDRG) and the Victorian DH cost weights.

The formula for calculating weighted inlier equivalent separations is the same as the general hospital casemix funding formula set out in Victorian Health Policy & Funding Guidelines (Volume 2).

For acute episodes of care, the payment rate for TAC separations is per Weighted Inlier Equivalent Separation (WIES).

7.4.2 Emergency Department (ED) only attendance fee

With the Victorian Health funding model moving towards the National ABF model, from 2012-13 admissions will no longer be permitted within the Emergency Department(ED).

TAC patients attended to in the ED only in 2015-16 will be charged an attendance per attendance (Note: This is inclusive of the facility fee).

During 2015, the Department of Health and Human Services worked closely with TAC to negotiate a new fee which better reflects the actual cost of providing services. The new attendance fee is $419, and can be charged for all emergency department attendances from 1 February 2016.

TAC should continue to be billed separately for diagnostic and medical services.

7.4.3 Rehabilitation patients

Fees may be raised for TAC compensable patients admitted for same-day rehabilitation for the  provision of same day treatment. Criteria for admission as a same day admitted patient are that the patient:

  • Attends a rehabilitation program designated for payment purposes by the Department, and
  • Attends for two or more therapy interventions, and
  • Receives treatment for a period of four hours or more.

Where these criteria are not met, the fees raised for attendance for rehabilitation would be in accordance with the appropriate non-admitted patient fee rate.

Fees for patients separated from Designated Rehabilitation Programs are paid at the rate specified in Section A. The Department’s VAED Manual lists Designated Rehabilitation Programs for the purpose of Care Type 6. Also refer to specification changes to the manual; see Victorian Admitted Episodes Data Set (VAED).

The TAC rehabilitation rate is per bedday.

7.4.4 Other Admitted Patients

Fees for other separated patients are paid at the rate published in the Policy and Funding Guidelines. Payment rates for other admitted patients are summarised in Section B.

7.4.5 Other TAC Patient Types

Payment rates for non-admitted patients in specialty clinics and mental health, diagnostic imaging and medical reports are shown in Section B.

Payment rates for medical and allied health services in outpatients, casualty and accident and emergency are shown in Section A, under the heading TAC Patients.

7.5 Payment Rates

Table 1 WIES Payment Rates

Base Fee

1 July 2016 - 30 June 2017 per WIES

All health services $4,136

Table 2 ED only attendance fee

Base Fee

1 July 2015 - 30 June 2016
per attendance

1 July 2016 - 30 June 2017
per attendance
ED only attendance fee $419 $429

Table 3 Rehabilitation Payment Rates

Rehabilitation Care Type 1 July 2015 - 30 June 2016
per bedday
1 July 2016 - 30 June 2017
per bedday
Level 1 2 $789 $809
Level 2 6 $651 $667
Level 3 7 $651 $667
Level 1 Spinal $1,186 $1,215
Level 2 Spinal $1,008 $1,033
Paediatric
  $1,184 $1,214

Table 4 Other Inpatient Fees

Grouping Other Inpatient Fees Metro/Rural 1 July 2015 - 30 June 2016
per bedday
1 July 2016 - 30 June 2017
per bedday
  Geriatric Evaluation and Management   $607 $623
  Nursing Home Type - Patient/Day   $239 $245
  Palliative Care - Admitted Metro $620 $636
Rural $626 $642
Mental Health Clinical Inpatient – Adult Acute Metro $643 $659
Rural $647 $663
Clinical Inpatient – Aged Acute Metro $587 $602
Rural $590 $605
Clinical inpatient – Acute Specialist Metro $772 $791
Rural $775 $794
CAMHS Acute Metro $699 $716
Rural $702 $719
  Extended Care Adult Metro $559 $573
Rural $562 $576
Specialty Clinics Pain Management Inpatient   $651 $667
  Rehabilitation in the Home – Inpatient Equivalent   $457 $469

Table 5 Non-Admitted Patient Fees

Grouping TAC Non-Admitted Patients Specifics 1 July 2015 - 30 June 2016
per bedday
1 July 2016 - 30 June 2017
per bedday
Specialty Clinics Pain management  

Compensable non-admitted patient fees for outpatients

Pain education program Refer policy $1,008 per program
Continence   $104 $106
Gait analysis RCH $1,932 $1,980
Kingston - 1 Assessment $1, 431 $1,467
Kingston - 2 Assessments $2, 147 $2, 201
  Rehab in the home   Compensable non-admitted patient fees for outpatients
  PAC   $34 $35
Mental Health Clinical Community Care  Per Visit Group: $146 per visit Individual: $249 per visit Group: $150 per visit Individual: $255 per visit

Table 6 Diagnostic Imaging Fees

Report Type

Amount TAC will reimburse hospital

Details

MRI

As listed in the TAC fee schedule for

Medical Practitioner Services The rates payable depend on the MBS item billed in relation to the MRI procedure undertaken.

Access the TAC fee schedule for Medical Practitioner Services.

Other diagnostic imagining services

Table 7 Medical Reports Fees

Report Type

Amount TAC will reimburse hospital

Conditions/Details

Standard Discharge Report

$0

Hospitals may not bill TAC for standard discharge reports.

Medical Report

The treating medical practitioner does prepare the medical report.

As listed in the TAC Fee Schedule titled: Maximum 'Reimbursements for Medical Reports'.

See TAC fee schedules for details

The fees in this schedule can only be considered for payment where the treating medical practitioner raises the charges under his own private practice provider number.

This report is prepared by a Public Hospital's Medical Officer as opposed to the treating medical practitioner.

$391

This rate is based on an average report preparation time of 1.5 hours.

Hospitals billing the TAC for a medical report must include item number THR010 on the invoice. This is an all inclusive fee - includes GST (10%).

Hospital Report

The report is prepared by clerical staff on behalf of the Public Hospital's Medical Officer and provides a summary of the medical record.

$235

 Hospitals billing the TAC for a medical report must Include item number 9163 on the invoice. This is an all inclusive fee - includes GST (10%).

FOI Request from TAC to Access Medial Reports

Reasonable costs incurred.

Public Hospital may charge the TAC for the reasonable costs incurred in making those arrangements as prescribed in the FOI Act and the Freedom of Information Access Charges Regulations 2004 (Regulations).

Pain Education Program (Non-admitted)

The fee for TAC’s Pain Education Program is $1,008 per program effective 1/10/16. Pain Education Programs are 8-10 hour multi-disciplinary group education programs. To deliver this service, TAC must approve the provider and their pain education program. TAC's current approved providers (as at 1/10/16) are Austin Health, Barwon Health and St Vincent's Hospital.

7.6 Hospital resource section on the TAC website

The TAC has developed a Hospital Resource section for all hospital staff working with TAC clients, so that allows easy access to information regarding:

  • Clinical justification
  • Commonly used outcome measures, guides to selecting and using outcome measures, case examples
  • TAC claim lodgement
  • Discharge planning
  • Form downloads
  • TAC policies
  • Fee schedules

To access this resource go to the Hospital Resources section on the TAC website.

7.6.1 Prior Approval

The TAC must approve a range of hospital services before they commence. And equipment items before they are supplied. The approvals relate to:

  • Outpatient Rehabilitation Plans (ORPs)
  • Rehabilitation in the Home
  • Hospital in the Home
  • Attendance at pain management clinics
  • Gait clinics and the provision of highly customised equipment
  • Highly customised equipment (refer to section 7.14 .5
  • Attendant care
  • Overnight leave
  • Approval for surgery; especially surgery post the patients’ initial inpatient stay.

The patient’s TAC claim number should be quoted on all correspondence (including invoices). Written requests will be assessed by a TAC Claims Officer.

An Early Support Coordinator (ESC) will manage claims for TAC patients who sustain a severe injury. The ESC will also work with the patient and hospital to plan for the client’s future needs. Please note that a ‘severe injury’ is defined by TAC, and is considered to be conditions such as a significant acquired brain injury, paraplegia, quadriplegia, amputation of the limb, permanent blindness, burns the cause severe disfigurement, and a brachial plexus injury that results in the loss of the use of a limb.

7.6.2 TAC Claim Lodgement

The TAC Hospital Claim Form can be found online at the Hospital Claim Form section on the TAC website.

With permission from the patient, a hospital representative can help the patient complete the TAC Hospital Claim Form and submit it directly to the TAC by secure email or by fax to number (03) 9656 9437. By completing the Hospital Claim Form, the patient is submitting a claim to the TAC to assess their entitlements.

Patients who do not want to complete the Hospital Claim Form can lodge a claim at a later date by telephoning the TAC on 1300 654 329. The TAC will then make a decision about the claim and notify the patient. The patient will receive a TAC claim number if their claim is accepted.

To access this resource go to www.tac.vic.gov.au, select “Provider Resources” and then the “Hospital Resources” tab on the website. It contains links to relevant TAC policies and the TAC’s expectations in regard to the provision of hospital based services.

7.7 Admitted Patient Services

7.7.1 Acute Services

The Weighted Inlier Equivalent Separation (WIES) price for TAC patients are published in the Policy and Funding Guidelines as amended and available at Victorian Policy and Funding Guidelines.

For acute episodes of care, the WEIS payment includes all admitted patient services and items provided to an admitted patient, and excludes medical treatment provided by a medical practitioner with the right of private practice, imaging and diagnostic services.

TAC WIES are included in the Statement of Priorities. Payments are included in fortnightly cash flow to hospitals. Reconciliation and prior year adjustments as calculated based on accepted TAC records only. TAC records that are not accepted by the TAC will be treated as public WIES for reconciliation purposes. The TAC will reimburse hospitals directly for payments for other services.

7.7.2 Rehabilitation Services

The admitted patient bed rates include all admitted patient services and items provided to a TAC patient.

The exception is medical treatment and diagnostic services provided by a medical practitioner with the right of private practice.

TAC patients receiving "rehabilitation in the home" are regarded as Admitted Patients and continue to have the same rights and responsibilities as other hospital admitted and non-admitted patients.  In these circumstances, the following conditions apply;

  • Hospitals should contact a TAC claims officer to arrange any necessary Rehabilitation in the Home for a TAC patient and to seek prior approval for the provision of this Service
  • Payment for any home based outpatient or inpatient rehabilitation treatment provided as a substitute for hospital based care for suitable TAC patients can only be made where prior written approval for Rehabilitation in the Home has been obtained from the TAC
  • Rehabilitation in the Home (inpatient) will be paid at the Per Diem rate set out in the fee schedule
  • Rehabilitation in the Home (outpatient) will be paid according to the fee schedule for Compensable Non-admitted Patient Services.

The criteria for admission as a same-day rehabilitation patient are that the TAC patient:

  • Attends a rehabilitation program at a public hospital or extended care centre designated by the Department of Human Services as a provider of rehabilitation services
  • Attends two or more therapy intervention; and
  • Receives treatment for a period of 4 hours or more in a single day.

When a TAC patient does not meet the criteria for a same-day admission patient, the TAC will pay for the patient on a fee-for-services basis in accordance with the Fee schedule for compensable Non Admitted Patient Services.

7.8 Other Admitted Patient Services

7.8.1 Mental Health

All mental health treatment and services provided to a TAC admitted patient are included in the bed day rate. This is with the exception of medical treatment provided by a medical practitioner with the right of private practice including imaging and diagnostic services. The admitted patient bed day rates exclude personal services.

7.8.2 Specialty Clinics

Medical treatment, including diagnostic and imaging services, may be charged separately for TAC patients who receive treatment from a medical practitioner with the right of private practice.

7.8.3 Pain Management

Following an eligibility assessment, the Pain Management Program provider must submit the TAC Pain Management Program (PMP) Request Form to the TAC for consideration and approval. The PMP form should include an outline of the specific program that has been recommended. The TAC will then determine its liability to fund the requested program.

The inpatient PMP form can be downloaded at the TAC website.

The outpatient PMP form can be downloaded at the TAC website.

 7.9 Overnight bed leave

Public hospitals must notify the TAC when a patient takes overnight or weekend leave.

The patient must have prior approval for the TAC to provide support services needed by the patient on overnight or weekend leave. The TAC is not liable for any charge by a public hospital for bed holding fees for patients on overnight or weekend bed leave.

The TAC can consider paying for the necessary transport directly to and from home for approved hospital overnight leave.

7.10 Hospital Subcontracted Services

If a public hospital sub-contracts or outsources the services of allied health professionals, the costs of those services are included in the agreed rates and are the responsibility and liability of the hospital. To prevent incorrect invoicing, public hospitals that contract or outsource any services are required to make known (to the contracted party) the arrangements in place with the TAC for funding of public hospital services.

7.11 Services not covered by the TAC

The TAC is not responsible for any costs associated with a TAC patient’s telephone, facsimile and communication services use or for purchase of personal items such as toiletries or services such as hairdressing and television hire.

7.12 Patient Discharge

7.12.1 Discharge planning

Public hospitals have a responsibility to facilitate the safe and effective discharge of TAC patients. The TAC will work with hospitals to ensure this happens. This process can be streamlined with early notification of a patient’s expected discharge date, patient assessment, clear communication with the TAC and external parties about discharge needs, and a copy of the discharge summary (where the patient has provided their consent).

7.12.2 Post-Acute Care (PAC)

Post-Acute Care (PAC) programs are hospital-initiated services funded by the TAC and provided through the department. PAC programs are delivered at the discretion of the hospital and provide short-term home-based services, such as home help and personal care, to patients requiring short-term support to facilitate recuperation following discharge from an acute or sub-acute hospital. Plans to use PAC are preferably made in collaboration with the TAC.

PAC providers work collaboratively with hospitals to ensure public hospital patients referred to PAC are assessed and the required short-term services are arranged for all patients discharged from acute or sub-acute hospitals across Victoria.

Where the TAC accepts liability for the patient's claim, the PAC provider will be reimbursed for coordinating and arranging services at a daily rate. The PAC provider should complete a PAC Closure Summary to notify the TAC of the start and end date of the program, including a summary of the supports provided. The provider should also make recommendations for further service requirements two weeks before to the PAC program ends to enable the TAC to arrange alternative services.

7.12.3 Post Acute Services (PAS)

Post-Acute Services (PAS) are TAC-arranged services which can be performed after PAC services have finished, or, in the absence of PAC services.

The TAC requires the following information in writing to consider funding PAS for patients:

  • Type of services (e.g. home services, gardening, personal care, attendant care, taxi transport, childcare)
  • Frequency of services (e.g. daily, weekly)
  • Number of hours requested for each service
  • Duration of services (e.g. one month).

The TAC will review each request to determine the patient’s eligibility for the requested service(s) as well as the number of hours that can be approved. The TAC will then contact the patient to arrange the services.

7.12.4 Return to Work

The TAC can provide help for patients to return to work. The completed Certificate of Capacity provides a patient’s employer with details about suitable duties. The Certificate of Capacity form is available online at the TAC website.

The TAC can also provide income support to patients. A patient needs to supply the TAC with completed Certificates of Capacity and evidence of their pre-accident earnings for the TAC to determine their entitlement to income support. For employees, this is usually in the form of a payroll report for the 12 months before the accident. Self-employed patients should call the TAC to discuss what information they need to provide.

7.12.5 Referrals for Community Therapy

Copies of all referrals made to community therapy providers must be sent to the TAC. If direct referrals are not made and the TAC patient requires therapy in the community, this information must be sent in writing to the TAC.

7.12.6 Discharge summary

Public hospitals should provide a copy of the discharge summary within five days of receiving a request from the TAC. The TAC will include a copy of the TAC patient's consent to release medical information with the request if it requests a discharge summary. A charge cannot be raised by a public hospital for a standard discharge summary.

7.13 Aids and Equipment

Bed fees paid in Victorian public hospitals (i.e. acute, sub-acute, or rehabilitation patients) includes the aids and equipment (e.g. a walking frame) provided while an inpatient.

7.13.1 The First 30 Days Post Discharge

Victorian public hospitals are responsible for the provision of aids, equipment and domiciliary oxygen free of charge (no deposits or hire fees) to facilitate a safe and effective discharge for 30 days post discharge following an acute, sub-acute or rehabilitation admission see Section C. If necessary, the equipment item can be ordered via the Hospital Direct Equipment Order Form (available at the TAC website) and sent directly to TAC's contracted equipment suppliers.

7.13.2 After 30 Days Post Discharge

Following the initial 30 days after discharge, the TAC is responsible for providing aids and equipment once the claim is accepted. Victorian public hospitals must contact the TAC to ensure that appropriate arrangements are made to extend the hire of necessary aids and equipment beyond the initial 30 day period.

7.13.3 Continence Equipment

The TAC can fund continence products such as catheters, consumables and other related products required by a TAC patient on discharge.

Public hospital staff are required to complete a Continence Equipment Request and Order Form and refer to the accompanying Continence Equipment Request and Order Form Notes, before a patient's discharge to ensure the TAC orders the appropriate products. If a hospital supplies continence items to a patient when they are discharged, a full description of the item(s) is to be included on the hospital invoice when billing the TAC.

7.13.4 Surgical Supplies

The TAC can fund surgical supply products, such as wound care dressings, required by a TAC patient on discharge.

7.13.5 Highly Customised Equipment

The TAC will fund highly customised equipment needed by TAC patients with a certifiable permanent or long-term disability for long-term use beyond 30 days post discharge. This includes a power wheelchair, prosthetic equipment (artificial limbs), including interim and definitive limbs.

The TAC expects public hospitals to request prior approval for this equipment. For further information, refer to the Equipment (Medical) - Prosthetic Equipment and the Equipment policies.

Where a patient is in receipt of aids or equipment from the TAC prior to admission, the TAC will continue to provide those aids and equipment upon discharge, if required.

7.14 Non-admitted Patient Services

Non-admitted patient programs will be billed for services in accordance with the Compensable Non-admitted Patient Fee schedule. An Outpatient Rehabilitation Plan must be submitted by the hospital and approved by TAC before outpatient rehabilitation treatment can commence.

The form for this plan can be downloaded from the TAC website.

7.14.1 Specialty Clinics

Medical treatment for TAC patients provided by a medical practitioner with the right of private practice may be charged separately to this payment as well as diagnostic and imaging services. Travel time to a patient’s home and to outreach services is included in the TAC rate.

7.14.2 Mental Health: Clinical Community Care

A public hospital salaried psychiatrist may be involved in a patient’s treatment when required. This will result in a separate charge being raised for any associated medical treatment received from the psychiatrist overseeing the patient in psychiatric clinical community care.

7.14.3 Interpreter Services

The TAC does not have an in house TAC interpreter service.

When a therapist requires an interpreter to engage with a TAC patient in the community, the therapist can:

  • Book through on call interpreters and on call interpreters can invoice the TAC directly, or
  • Request interpreter service as part of the Outpatient Plan and book the interpreter service your hospital uses.

7.15 Family Support

7.15.1 Visiting expenses for the members of the immediate family

The TAC can pay the reasonable travelling and accommodation costs incurred by members of the immediate family to visit an injured patient when:

  • The TAC patient is injured and admitted as an inpatient in a hospital as a result of a transport accident
  • The hospital is located at least 100 km from the normal residence of the member of the immediate family, and
  • Members of the immediate family incur reasonable travelling or accommodation expenses by reason of visiting the TAC patient.

More information can be found at the TAC website.

7.15.2 Family Counselling

The TAC can pay the reasonable costs of family counselling for any member of the immediate family of the person who dies or who is severely injured in a transport accident. Family counselling is paid as part of the claim of the person who is severely injured or dies.

7.16 MEDICAL REPORTS PROVIDED BY PUBLIC HOSPITALS

7.16.1 Hospital Report

This is a report prepared by clerical staff on behalf of the public hospital’s medical officer and provides a summary of the medical record.

7.16.2 Medical Officer’s Report

This is a report which is prepared by the public hospital’s medical officer.

7.16.3 Treating Medical Officer Reports

Where the treating medical officer completes the medical report, payment is in accordance with TAC’s Fee Schedule titled 'TAC Reimbursements for Medical Reports'. If the treating medical officer fees are to be raised under a hospital provider number this should be discussed with the TAC before any charges are raised.

It is expected that all medical reports prepared by a public hospital, should include (where possible) the following information:

  • A relevant history of the transport accident;
  • A list of injuries sustained and relevant diagnosis;
  • Details of any known previous relevant medical history including previous attendances and medications;
  • Details of any investigations performed and a copy of such reports;
  • A discharge treatment plan including medications;
  • A summary of relevant review appointments and treatment, and
  • Details of any surgical procedures performed and a copy of the operation notes.

All fees payable by the TAC for reports are inclusive of GST.

7.16.4 Medico-legal Reports

The TAC advises that under the Transport Accident Act 1986, a legal firm can make a request for reimbursement of costs for medical and hospital reports obtained in support of their client’s claim for compensation.

The TAC has formally communicated this advice to the legal profession and asked legal firms to state in their application that the patient is a TAC client, in order to facilitate the billing process.

7.17 Freedom of Information requests

Where the TAC makes a request under the Freedom of Information Act 1982 (Vic) (FOI Act) for Medical Records of a TAC client, a public hospital may charge the TAC:

  • The initial FOI application fee required by section 20(1)(b) of the FOI Act.  This fee is set annually (and increases at the beginning of each financial year under the Monetary Units Act 2004); and
  • the reasonable costs incurred in processing the FOI request (for searching, copying and making a decision about the request) under the Freedom of Information Access Charges Regulations 2004 (Vic).

All FOI requests made by the TAC to public hospitals should contain a TAC client authority consenting for the public hospital to release the patient’s documents to the TAC.

Further Information

For more information about TAC policies, contact the TAC on 1300 654 329 or visit the TAC website.

Public hospital specific information can also be found at the TAC website

More information about public hospital fees can be found in the Public Admitted Patients section.

 

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Last updated: 28 September, 2016

For information relating to this site, contact: Peter Lewis Ph: (03) 9096 9050

This website is managed and authorised by the Finance, Policy and Operations Unit, Chief Finance Officer Branch of the Finance and Corporate Services Division of the Department of Health, Victorian State Government, Australia

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