Invoicing Guidelines for medical practitioners

The Transport Accident Commission (TAC) and WorkSafe Victoria (WorkSafe) can pay the reasonable costs of medical services required by TAC clients and injured workers as a result of their transport accident or work related illness or injury.

When paying the reasonable costs of medical services, the TAC and WorkSafe pay in line with the Medicare Benefits Schedule (MBS) explanations, definitions, rules and conditions unless otherwise specified in TAC or WorkSafe policies and the Reimbursement Rates for Medical Services booklet.

What steps do I need to follow to have an invoice paid?

For the TAC and WorkSafe Agents to process your invoice, we need your patient to have:

an accepted TAC claim and for your invoice to be mailed to the TAC. Faxed invoices will not be accepted, or

an accepted WorkSafe claim and your invoice to be sent to your patient's WorkSafe Agent.

What information is required to ensure my invoice is processed?

The TAC and WorkSafe can pay the reasonable costs of medical services in line with the MBS invoicing requirements and additional TAC and WorkSafe policies. Including the information below on your invoice will ensure prompt processing and payment:

Addressee details

Patient details:

Worker/ Client name

Claim number (if unknown, date of accident and/or date of birth is required)

Billing details:

Date of invoice

Provider and service details

Name and provider number of medical practitioner claiming for the service

Name and provider number of the medical practitioner who performed the service (if different from the provider claiming for the service)

Date of service

Indicate if procedure was provided for an 'admitted patient' or was performed 'in rooms'

MBS item number and description of each service (AMA item numbers cannot be accepted)

Fee for each service

Specialist invoices:

Name of referring medical practitioner and either their provider number or practice details (except in trauma/emergency)

Surgical invoices:

For any surgical procedures provided in a public or private hospital operating theatre, the principal surgeon is required to provide the hospital operation report generated at the time of the surgical procedure with their invoice.

Location of service

Side, site or structure of procedure

When injuries are associated with a compound (open) wound, the medical practitioner must tate on their invoice 'Open' or 'Compound' next to the procedure item number.

Consultations provided in the aftercare period following surgery must indicate 'not normal aftercare' and provide an explanation as defined by the MBS.

Assistant surgeon's invoice must:
1.  Identify the principal surgeon
2. Identify the 'assist' as defined by the MBS

Invoices without the above information will not be able to be processed and will be returned to medical practitioners with a request for the required details.

How long do I have to submit an invoice for a TAC client for payment?

The TAC can only pay invoices that are submitted within two years from the date the service was provided.

Where can I get more information regarding WorkSafe policies?

worksafe.vic.gov.au- visit Injury & Claims > Benefits, Support & Entitlement > Reasonable Medical & Like Services > Medical Practitioner Policy

If you have a query about an unpaid or returned invoice, please call the TAC Customer Service Centre on freecall 1300 654 329, the WorkSafe Advisory Service on 1800 136 089 or the relevant WorkSafe Agent of the injured worker:

ALLIANZ Workers' Compensation (Vic) Limited

1800 240 335

Cambridge Integrated Services Victoria Pty Ltd

1800 801 070

CGU Workers Compensation (Vic) Limited

1800 066 204

Gallagher Bassett Workers Compensation Vic Pty Ltd

1800 774 377

GIO Workers' Compensation (Victoria) Ltd

1800 817 969

QBE Workers Compensation (Vic) Limited

1800 817 820