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Hospital Circular 02/2008

Date Issued: 19 March 2008

Distribution: Chief Executive Officers; Chief Medical Officers; Chief Finance Officers; Hospital Booking Clerks

Subject: Non emergency patient transport to and from appointments at non admitted clinics at health services receiving the VACS Specified Grant – Ambulance Outpatient Clinic Charges

Purpose: To outline the authorisation process and payment for ambulance transports to and from appointments at non admitted clinics at those health services receiving the VACS Specified Grant – Ambulance Outpatient Clinic Charges.

Context

Specialised non-emergency patient transport may be required by some people in order for them to be able to attend appointments at non admitted patient clinics.

These transports, which may be either for stretcher transport or clinic car transport can be provided by the ambulance services (the Metropolitan Ambulance Services, MAS, or Rural Ambulance Victoria, RAV) or health services may enter into arrangements with non-emergency patient transport (NEPT) services.

In 1993 funding and responsibility for meeting the cost of transports to and from hospital outpatient appointments was transferred to hospitals through the VACS Specified Grant – Ambulance Outpatient Clinic Charges.

Eligibility for Transport Services

Non-emergency specialised patient transports need to be medically authorised. In authorising the transport, medical practitioners should consider whether there is a demonstrated medical requirement for specialised transport on the grounds that:

• The patient requires the use of the specialised equipment contained within the vehicle.
• The patient requires the skill levels and qualifications of staff on either an ambulance vehicle or on a non-emergency patient transport vehicle.
• A patient has an illness or a disability that makes it impractical to use any other form of transport, for example, severe immobility or disorientation.

Responsibility for Authorisation and Payment for Transport Services

Following a recent review, new authorisation of transport and payment arrangements have been determined:

• Health services will authorise the use of specialised transports for all new and review patients attending non admitted patient clinics.
• Patients are responsible for payment for ambulance transport except in the following circumstances:
  • TAC, WorkCover and DVA patients will be covered by their respective schemes;
  • Pensioner and concession card holders where the cost of ambulance transports will be met by MAS/RAV for transport of new patients and by health services for the transport of patients to review appointments. Health services will need to invoice MAS/RAV at the end of each financial year for the cost of transports involving patients’ initial attendance.
  • Ambulance membership subscribers will be covered by the Ambulance Subscription Scheme.

Patients being transported to MBS funded non admitted patient clinics will be treated the same way as state funded non admitted patient clinics.

These arrangements are only applicable to health services that receive the VACS Specified grant – Ambulance Outpatient Clinic Charges.

Where the ambulance services receive outpatient transport booking requests from General Practitioners or other non-health service personnel, the call-taker will redirect the caller to the relevant health service to determine whether authorisation should be given.

The Ambulance Charging Guidelines have been updated to reflect this policy on responsibility and authorisation of fees. The Guidelines can be found at (www.health.vic.gov.au/ambulance/index.htm).

Lance Wallace
Executive Director
Metropolitan Health & Aged Care Services