Network Occupational Therapy Services

The Network Occupational Therapy services performed after 1 October 2016 are no longer payable and have been replaced by a new model called Framework Occupational Therapy.  Please refer to the Framework Occupational Therapy services policy for further information.

POLICY

The TAC can fund the reasonable cost of Network occupational therapy services required as a result of transport accident injuries, where the service is provided by an occupational therapist who has met specific selection criteria and has signed a contract with the TAC to provide those services.

Transport Accident Act 1986 reference: s.3 'rehabilitation service', s.23 and s.60

DEFINITIONS

In this policy, a Network occupational therapist (Network OT) refers to an occupational therapist who has:

  • met the eligibility criteria to provide occupational therapy services as outlined in Schedule 1 - Authorised Rehabilitation Services
  • a minimum of 3 years demonstrated, relevant clinical experience in occupational therapy
  • met specific selection criteria in a TAC tender process for the provision of Network OT services
  • signed a contract with the TAC to provide Network OT services.

For a list of the TAC contracted providers, refer to Locate a service provider.

GUIDELINES

What are the differences between a Network OT and a general OT?

A Network OT is an OT who has been specifically authorised by the TAC to work with TAC clients. A Network OT has experience in treating transport accident-related injuries and has signed a contract to provide Network OT services to TAC clients.

Network OTs have set requirements relating to the treatment they provide TAC clients which include:

  • coordinating treatment with a client's other treating practitioners
  • understanding and offering clear explanations to a client relating to TAC policies and procedures
  • no out of pocket expenses to the client
  • specific reporting requirements, including forms and timeframes.

Unless otherwise specified in the contract between the TAC and the Network OT, the Network OT must also comply with the Occupational Therapy Services policy.

What advantages are there to choosing a Network OT to provide OT services?

A Network OT aims to maximise a client's participation and independence in the everyday activities at home, at work or school and in the community. A Network OT may use a variety of strategies to achieve this, including:

  • treatment to maximise a client's function and promote the recovery of an injury (where possible)
  • prescribing adaptive and/or alternative techniques to make it easier for a client to perform activities, e.g. breaking strenuous tasks into smaller more manageable tasks
  • prescribing equipment that will facilitate and/or maximise a client's independence
  • prescribing modifications to an environment to maximise a client's independence and participation, e.g. installing a rail in a bathroom
  • conducting assessments to assist in establishing the level of help or care that a client may require as a result of your injury/illness and
  • helping to prepare a client to return to work. When the client is ready, the network occupational therapist can assist in facilitating a referral to a TAC registered vocational rehabilitation provider who will assist the client to get back to work.

Choosing a Network OT may have the following benefits over a general OT:

  • Skills and experience with working with clients with transport accident injuries
  • Network occupational therapists will work with you, your treating medical practitioner and other healthcare professionals involved in your care to provide comprehensive coordinated treatment, and
  • Explaination of some of the support services the TAC can pay for to help the client in their recovery.

Does a client have to use a Network OT to receive OT services?

A TAC client can choose which OT they wish to receive OT services from as long at the OT has met the eligibility criteria to provide occupational therapy services as outlined in Schedule 1 - Authorised Rehabilitation Services.

What Network OT services can the TAC fund?

The TAC can fund the reasonable cost of Network OT services where:

  • there is clinical justification for the services, and
  • the service is likely to be effective and achieve or maintain a measurable functional improvement, and
  • the service promotes progress towards functional independence and self-management.

The TAC will fund Network OT services where it is demonstrated that the services are related to the transport accident.

What are the Network OT reporting requirements?

A network OT must submit relevant assessment and reporting documents as required by the contract. Network OTS have theor own reporting documents which differ from the general OT forms.

Can the TAC fund Network OT services performed by a member of a client's immediate family?

Refer to the Funding Treatment by a Member of a Client's Immediate Family policy.

In relation to Network OT services what will the TAC not fund?

The TAC will not fund:

  • services for a person other than the injured client
  • services and/or travel to services for a condition that existed before the transport accident or that is not a direct result of the transport accident
  • services where there is no objective evidence that a service is safe and effective
  • services and/or travel where there is no clinical justification for this service
  • travel to more than one consultation per day per client
  • network occupational therapy services separately where this cost is included in the hospital bed fee
  • the cost of telephone calls and telephone conversations between providers and clients, and between other providers, including hospitals
    fees associated with non-attendance
  • treatment or services subcontracted to a non-registered provider
  • 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 to Apply for the Payment of Medical and Like Expenses policy.

Disclaimer

While care is taken in selecting and authorising network OTs in accordance with section 23 of the Transport Accident Act 1986:

  • the TAC does not endorse, guarantee or make any representations about an individual provider's clinical performance or clinical outcomes, and
  • each client and referring doctor is responsible for making their own enquiries as to the suitability and professionalism of the network OT of choice.