EmailHospital Circular 19/2003
Date Issued: 24 July 2003
Publication: 19/2003
Distribution: Public Hospitals
Enquiries: Mignonne de Witt/ Head Office
Subject:
- Transport Accident Commission (TAC) – Changes in Department of Human Services (DHS) status Reports for Admitted Patients
- Fees Updates
- Emergency Department costs - Streamlined procedure for claims.
1. Changes to DHS Reports to hospitals on status of TAC claims
There were significant changes in the funding arrangements for TAC patients on 1 July 2002, detailed in circular 13/2002. This circular provides advice on changes to reporting arrangements from 1 July 2003.
1.1 Monthly status reports have been provided to nominated staff in hospitals since the new TAC funding arrangements commenced in July 2002. These reports provide information on new claims and the change in status of any other claims since the previous month and also show the amount billed and paid by TAC.
Following discussion of the most useful format for these reports, the monthly reports provided to hospitals on the status of TAC claims will change from July 2003:
- Two monthly status reports will now be provided; one which will show all NEW claims and any claims with a status change since the previous month and the other, a year-to-date update report on all outstanding claims (that is, those held and/or denied).
- The new reporting format will show (i) the WIES value for the agreed claim and (ii) the amount paid by DHS on this basis. DHS remuneration per WIES is shown below in Section 2. All Hospital payments by DHS will be reconciled with the actual WIES as agreed by TAC
1.2 TAC Codes for Claims status: a list of TAC codes for claims status, including denial reasons and the appropriate action required is now available in the DHS Fees and Guidelines under the TAC section. (See link below)
1.3 Process for claims after VAED cut-off: The final date for reporting claims on VAED for the 2002-03 financial year will be 17th September 2003. When remittance is finalised after this date, DHS will provide a report on outstanding claims year-to-date for 2002-03. Hospitals are encouraged to submit claims by this date.
After this date, any update to TAC claims (such as the provision of TAC Claim numbers) or new claims relating to 2002-2003 admitted patient activity must be advised to DHS contacts directly to enable these updates to be forwarded to TAC for processing. Following the receipt in October 2003 of reports relating to the final VAED 2002-2003 activity, hospitals should alert DHS of any queries they have about new denials reported.
1.4 Prior Year Adjustments: While TAC patients have a maximum of 12 months following an accident in which to lodge a claim, in practice, DHS processes for finalisation of “prior year adjustment” take place before the end of the following financial year. Therefore, following the finalisation of the prior year adjustment process, hospitals will no longer have budgets adjusted for any new TAC claims for patients in the previous financial year on the basis that hospitals have claimed these patients already as public patients prior to finalisation of their statutory accounts.
2. Fees Manual Updates
The fees manual has been updated to reflect correct TAC payments per WIES to hospitals for 2002-03 claims as shown below:
| Major Metro hospitals: Rural B1 Rural B2 Rural C Rural D&E MPS |
$2,058 $2,088 $2,124 $2,155 $2,187 $2,310 |
For these and other amendments to fees and processing, please refer to "Fees and Charges for Acute Health Services in Victoria - A Handbook for Public Hospitals".
Specifically, changes have been made in the following sections.
Section 7.3: Description of Fees (for TAC Admitted Patients) – Base fees
3. Emergency Department costs – Streamlined claims procedure.
The TAC, as part of its new phone lodgement process has introduced an "Emergency Expenses Claim". This new type of claim allows for faster lodging and payment of accounts where the injured client only requires funding for ambulance transport and/or treatment in the emergency department of a hospital.
Clients involved in a transport accident should be encouraged
to contact the TAC on
1300 654 329 and lodgement of the claim can be done by phone. The
TAC will then assist the client to determine whether an Emergency
Expenses Claim lodgement or a full lodgement by phone is most appropriate.
If Hospitals require more information, or need additional blue TAC phone number cards or posters, please call 1300 654 329
Contacts:
For Metropolitan hospitals: Mignonne de Witt (Phone 9616 8092)
For Rural hospitals: Teresa Guerrieri (phone 03-96161441)
| Shane Solomon Executive Director Metropolitan Health and Aged Care Services |
Dr C W Brook Executive Director Rural Health and Aged Care Services |
