The TAC can pay the reasonable cost of ambulance services for a client who has sustained an injury as a result of a transport accident. Ambulance services may provide transportation of a person (within Australia) by any reasonable means.
Ambulance services may be provided to a TAC client:
- for the purpose of receiving medical or hospital services
- to a person's place of residence after receiving medical or hospital services.
Transport Accident Act 1986 reference: s.3 'ambulance service' and s.60
In this policy:
- Ambulance services refers to any public or privately owned ambulance or car fleet used to provide emergency and non-emergency patient transport for TAC clients.
- Out-patient driver services refers to any privately owned car fleet staffed by qualified patient transport officers that is used to provide transportation for TAC clients to and from out-patient appointments, including appointments at hospitals.
What ambulance services can the TAC pay for?
The TAC can pay for ambulance services when medically required under the following circumstances:
- From the scene of the accident to the hospital
- From the hospital to the person's residence on the day of the accident after receiving treatment
- From one hospital to another
- From the hospital to the person's residence after a stay in hospital as an in-patient.
What documentation does the TAC require in regard to ambulance services?
Prior written approval is not required from the TAC when transferring a TAC client from the scene of the transport accident to the hospital.
Subsequent ambulance services to the doctor's room or to a hospital must be supported by a request from a medical practitioner which states why an ambulance is the only suitable means of transport.
When can a TAC client use out-patient driver services?
The TAC can pay for out-patient driver services when medically required under the following circumstances:
- The service is required as a result of the client's transport accident injuries
- The service is required to provide physical assistance for a client to access, enter or be positioned in a vehicle and the physical assistance required is greater than that expected to be provided by a taxi driver
- The client does not require supervision for behavioural management
- A carer or family member is not available to provide assistance.
To expedite payment of accounts and to ensure the most appropriate services are provided to the client, the TAC encourages prior approval to be sought by the client's treating registered medical practitioner or the Director of Nursing of the treating hospital.
Where a client requires supervision by a carer or family member, the TAC can pay for the use of a private vehicle, public transport or taxi. See also the Travel and Accommodation Expenses policy.
What documentation does the TAC require in regard to out-patient driver services?
The request for out-patient driver services must be supported by medical documentation outlining:
- the clinical reasons why the use of out-patient driver services is the only suitable means of transport for the client
- the period the client will require the outpatient driver services.
Can the TAC pay for 'waiting time' for an out-patient driver service?
The TAC can pay for active 'waiting time' for an outpatient driver service upon request by the hospital or facility under exceptional circumstances, where there is a clinical need for the client to be actively managed or supervised. Active waiting time will be paid for the time the outpatient driver has provided active supervision and assistance for the client.
A maximum of 1 hour of passive waiting time can be paid for where the outpatient driver service has been instructed by a referring hospital to wait in the vehicle for the client to make a return trip. If the time taken for an appointment exceeds, or is expected to exceed 1 hour then a new booking should be made.
It is expected that the usage of 'waiting time' is managed by the hospital in a cost-effective manner.
Can the TAC pay for non-attendance fees for out-patient driver services?
The TAC cannot pay for non-attendance fees or cancellation fees for out-patient driver services.
In relation to ambulance and out-patient driver services, what will the TAC not pay for?
The TAC will not pay for:
- treatment or services for a person other than the injured client
- ambulance or out-patient driver services that do not involve the actual transporting of a client for the purpose of receiving, or returning from, hospital or medical treatment
- treatment or services where there is no objective evidence that a treatment or service is safe and effective
- attendance-only charges for ambulance services
- ambulance or out-patient driver services for a condition that existed before a transport accident or that is not a direct result of a transport accident
- treatment or services received by the injured person outside the Commonwealth of Australia
- treatment or services provided more than 2 years prior to the request for funding except where the request for payment is made within 3 years of the transport accident. Refer to the Time Limit fto Apply for the Payment of Medical and Like Expenses policy.