Physiotherapist

Treating TAC clients

If you are providing treatment to a patient who has been injured in a transport accident:

  • If your patient has an ‘Immediate approval of services letter’ dated within 12 months of today's date you can treat the patient immediately. If not, call the TAC on 1300 654 329 to ensure your patient has an accepted TAC claim and find out what you need to do.
  • Check the medical excess has been reached (if the excess hasn’t been reached, you may be able to bill the patient’s private health insurance for the treatment). You can contact the TAC to check your patient’s medical excess status.
  • Ensure you are recording the patient’s baseline outcome measures; you do not need to send reports to the TAC unless specifically requested.
  • If there has been a significant gap in treatment or the patient doesn't have an 'Immediate approval of services letter' you will need to prepare and submit a Treatment Notification Plan.  We may also request a TNP at other times during a patient's treatment.
  • Send your invoice directly to the TAC via mail to Transport Accident Commission (TAC) GPO Box 2751, Melbourne Vic 3001.

For more information about treating TAC clients view the physiotherapy policy.

Early Intervention Physiotherapy Framework

What is the Early Intervention Physiotherapy Framework?

The Early Intervention Physiotherapy Framework (EIPF) is a physiotherapy model that focuses on early intervention to maximise return to work and health outcomes. The EIPF supports physiotherapists in their clinical practice through training and increased fees in the early stages of treatment following an injury.

How do I join the Early Intervention Physiotherapy Framework?

    1. Ensure you are registered to provide services to the TAC
    2. Read the fact sheets below to decide if joining the EIPF is right for you (including the service standards and sample declaration)
    3. Complete the online training (hyperlink: http://www.earlyinterventionphysiotherapyframework.com.au)

      To log in, you need to register (the 'Register' button is on the right of the screen). This allows you to resume the training later if you need to.

      Questions throughout the training are for learning purposes only. Your answers will not affect your ability to enrol in the EIPF program.

      If you experience any issues, please email the following addresses. Technical support will be available Monday - Friday (8am - 5pm). info@vide.co.nz or cameron.gosling@monash.edu.
    4. Sign and return the declaration to:
      Email: provider@tac.vic.gov.au
      or
      Fax: (03) 9656 9432

      Your enrolment will start from the date your declaration is received by the TAC and VWA. A confirmation letter will also be sent, for your records.

Change of address or new practice location

To ensure that the TAC & WorkSafe account systems are kept up to date, please notify the TAC of a change or addition to your practice locations by emailing us at provider@tac.vic.gov.au.

EIPF Enquiries


Send enquiries to provider@tac.vic.gov.au

Further information

Physiotherapy Servicing and Certified Capacity Measures

Q&A for physiotherapists
August 2016

FREQUENTLY ASKED QUESTIONS

  1. What are Physiotherapy Servicing and Certified Capacity Measures?
  2. Who receives Servicing and Certified Capacity Measures?
  3. What measures are used?
  4. Over what period of time are these measures taken?
  5. How do I find my patient's date of injury and first service?
  6. Does the medical or employer excess apply to my data?
  7. What should I do when my patient has made minimal improvement in the past six months?
  8. What can I do when the measures I receive are unexpected?
  9. Does receipt of the Servicing and Capacity Measures require me to take any action or contact the TAC or WorkSafe?
  10. Can anyone request my Servicing and Certified Capacity Measures?
  11. Are the Certified Capacity Measures based on my certifying behaviour?
  12. What if I disagree with the primary certifier's opinion of a patient's capacity?
  13. Can I complete the Certificate of Capacity?
  14. Why is a case mix adjustment made for certified capacity measures?
  15. Is the case mix adjustment applied to the servicing measures?


1
.  What are Physiotherapy Servicing and Certified Capacity Measures?

Developed by the TAC and WorkSafe in partnership with the Australian Physiotherapy Association (APA), the Physiotherapy Servicing and Certified Capacity Measures is an initiative of the Quality Improvement Framework (QIF).

The measures outline frequency of treatment provided over the life of a patient's claim and shows improvements in their certified capacity. The measures also allow the TAC and WorkSafe to identify opportunities to work with physiotherapists to ensure that an injured person receives treatment focused on return to health and return to work outcomes.

This data gives physiotherapists an overview of how they rate against their peers when treating TAC and WorkSafe clients.

The information comprises private physiotherapy treatment only. It does not include treatment provided in hospitals, outpatient rehabilitation or c ommunity health centre settings.

2. Who receives Servicing and Certified Capacity Measures?

The TAC and WorkSafe provide Physiotherapy Servicing and Certified Capacity Measures to physiotherapists who have treated 10 or more patients w ith a TAC or WorkSafe claim in the past six months.

3. What measures are used?

The measures are based on two key areas that review treatment provided in a recent 12 month period.

  1. Service - the frequency and duration of treatment post initial treatment after injury and/or surgery:
  • 3 month measure – proportion of your patients receiving two or more treatments per week after three months post initial treatment after injury and/or surgery
  • 6 month measure – proportion of your patients receiving more than one treatment per week after six months post initial treatment after injury and/or surgery
  • 12 month measure – proportion of your patients receiving continuing treatment after 12 months post initial treatment after injury and/or surgery
  1. Certified capacity:
  • Certified capacity data is calculated on patients who are receiving loss of earnings/weekly compensation payments and have no certified capacity at the first paid treatment date
  • This is collated based on a certificate certifying a person's capacity and not their actual return to work
  • Information is derived from the Certificate of Capacity which reflects a change from unfit to fit for alternate, modified or full duties by 3 and 6 months post initial treatment after injury and/or surgery

Physiotherapists can assist with return to work outcomes through early expectation setting and by completing a Certificate of Capacity. To find out more information on how to complete a Certificate of Capacity, visit tac.vic.gov.au/certificate or worksafe.vic.gov.au/certificate

4. Over what period of time are these measures taken?

The measures reflect data that has been collected in the most recently available 12-month period.

The first six months of the period overlap with the previous scorecard, but the second six months are new.

Physiotherapists can determine whether their treatment patterns and case mix are changing significantly over time by comparing the most recent scorecard with previous data.

5. How do I find my patient's date of injury and first service?

A TAC client or WorkSafe injured worker's date of injury is recorded when their claim is lodged. If the client or injured worker is unsure of the date of first private service, the TAC or WorkSafe Agent can provide this information.

6. Does the medical or employer excess apply to my data?

Data is taken from the treatment date where the TAC or WorkSafe Agent has paid the first physiotherapy treatment on the claim.

7. What should I do when my patient has made minimal improvement in the past six months?

The TAC and WorkSafe Clinical Panel can discuss your concerns and provide you with clinical advice and support.

Please email the TAC at provider@tac.vic.gov.au or WorkSafe at provider@worksafe.vic.gov.au.  Alternatively, you can call the TAC on 1300 654 329 or WorkSafe on 1800 136 089 for further assistance.

8. What can I do when the measures I receive are unexpected?

The TAC and WorkSafe Clinical Panel can discuss your concerns and provide you with clinical advice and support.

Please email the TAC at provider@tac.vic.gov.au or WorkSafe at provider@worksafe.vic.gov.au.  Alternatively, you can call the TAC on 1300 654 329 or WorkSafe on 1800 136 089 for further assistance.

9. Does receipt of the Servicing and Capacity Measures require me to take any action or contact the TAC or WorkSafe?

You do not need to take any action .

10. Can anyone request my Servicing and Certified Capacity Measures?

The information is only available to you and the members of the TAC and WorkSafe Clinical Panels. No other parties are provided with this information .

11. Are the Certified Capacity Measures based on my certifying behaviour?

Measures reflect any Certificate of Capacity written on your patient's claim by a medical practitioner, physiotherapist, chiropractor or osteopath .

12. What if I disagree with the primary certifier's opinion of a patient's capacity?

Contact the primary certifier to discuss your clinical opinion on your mutual patient's functional capacity and certification.

Please contact the TAC and WorkSafe Clinical Panel if you have further questions.

13. Can I complete the Certificate of Capacity?

For TAC claims, the Certificate of Capacity can be completed by a medical practitioner, dentist, optometrist, physiotherapist, chiropractor, osteopath, podiatrist or occupational therapist.

For WorkSafe, the Certificate of Capacity for a work-related injury or condition can be issued as follows:

  1. First Certificate
  • by a medical practitioner, physiotherapist, chiropractor or osteopath if the injured worker is not going to be claiming weekly payments (or loss of earnings)
  • by a medical practitioner if the injured worker is going to be claiming weekly payments
  1. Subsequent Certificates
  • by a medical practitioner, physiotherapist, chiropractor or osteopath.


14. Why is a case mix adjustment made for certified capacity measures?

The case mix adjustment aims to take into account the complexity of patients which a physiotherapist is managing .

15. Is the case mix adjustment applied to the servicing measures?

The case mix adjustment does not apply to the servicing measures as most severe claims (e.g. major head injury claims) have been removed from the population.

DOWNLOADS

Policies that relate to you

Other policies you may use

Fees

How to invoice the TAC

When invoicing for services provided to a TAC client, it's important to include the below information. This will help ensure prompt and accurate payment.

Invoicing information required

Payee details

  • Group/company/agency
  • TAC payee number (this will be advised once the TAC has received your initial invoice for services.  This number will then be required for future invoicing)
  • Payee billing address
  • Payee practice/clinic address  - if different to your billing address

Client/Patient details

  • Family name and given name/s
  • Patient's TAC claim number for example 04/12345.  If this is unknown, please use your patients date of birth and date of the transport accident

Service details

  • Name of health professional /service provider
  • Date of service
  • Time of service if more than one service was provided on the same day
  • TAC item number and description - as per the TAC fee schedule
  • Duration of each service
  • Itemised fee for each service
  • Service location - if different to the practice/ clinic address
  • Total charge for invoiced items
  • Services which are subject to GST must be submitted on a GST compliant invoice

If you require multiple providers on the one invoice you must be clearly identify the service listed under each health professional/service provider.

You can also use this invoice template XLS, 0.03MB to assist you in preparing your invoices.


Submitting your invoice

Online invoice submission

You can now process TAC payments through LanternPay, a digital solution that allows you to submit paperless invoices, view payment decisions immediately, and receive payment the next business day. You can also see in real time if a client has a TAC-approved claim.

http://www.tac.vic.gov.au/__data/assets/video_file/0003/232869/Tac-Lantern-Pay-04.09.17-Captions-1-web.mp4 http://www.tac.vic.gov.au/__data/assets/image/0015/233106/vlcsnap-2017-09-11-10h43m16s241.png

To sign-up to LanternPay, visit www.lanternpay.com/TAC.

Invoices by post

Please send an original copy of your invoice to the below address.  Please note duplicate accounts, such as statements, photocopies or facsimiles will not be processed for payment.

Transport Accident Commission (TAC)
GPO Box 2751
MELBOURNE   VIC   3001

Payment of invoices

Electronic Funds Transfer (EFT) is our preferred method of payment. Please complete the EFT/ Direct Deposit Authority form to help ensure the prompt payment of invoices.

Additional information required for:

Common Law, VCAT, s.93 and recoveries.  Please refer to the TAC's letter of instruction for this information.

If you have further invoicing or payment queries please contact us.

Certificate of Capacity

The Certificate of Capacity form is for authorised providers to provide information about their TAC patient's transport accident conditions and to assess and certify their capacity for work as a result of these injuries.

Information you provide on a TAC certificate of capacity helps us make claim decisions to better support your patient's independence, recovery and return to work. When you accurately complete a certificate of capacity you provide critical information about your patient's injuries and their capacity for work and help to facilitate better outcomes for your patient.

Download the Certificate of Capacity form.

Or find out more about completing the Certificate of Capacity here.

Extended consultations

Extended consultations can be funded for physiotherapy services.  These sessions are for people injured in a transport accident who require treatment beyond that of a standard consultation.  These injuries may include:

  • A significant acquired brain injury
  • A spinal cord injury
  • Lymphoedema
  • Severe burns
  • Complex and multi-site orthopaedic injuries. See also the TAC Criteria for CSMO.

The TAC expects extended physiotherapy consultations are delivered in line with the principles of the Clinical Framework for the Delivery of Health Services PDF, 1.29MB.

If your patient has a severe injury that is not listed above, an application can be made for the injury to be assessed 'on merit'.

Prior approval is required for all extended consultations. 

Applying for extended consultations

Physiotherapists must submit written information along with their Physiotherapy Treatment Notification Plan (TNP) or Physiotherapy Management Form specifying the length of direct patient contact time required per session, for example 31-40 mins or greater than 40 mins, and justifying the need for extended consultations.

Treatment will be reviewed at regular intervals as negotiated between the physiotherapist and the TAC.

 

Resources

Professional Development - Training and Webinars

The Personal Injury Education Foundation (PIEF) offer a free series of training presentations which have been designed to assist healthcare professionals, specifically physiotherapists, to learn more about the important role they play in helping patients to return to work after a work or motor vehicle related injury.

The training presentations are available on the PIEF website:

http://www.pief.com.au/healthprofessionalstraining/allied-health-vic

Equipment

Refer to the Equipment List when recommending equipment for your patient

Forms and brochures

Additional forms and brochures when treating your patient are also available. 

Gym/Swim program: evaluation form (for Provider use only) Summary: 

This form is for reporting the progress of clients participating in TAC-funded gym, swimming and pilates programs as part of their rehabilitation.


Physiotherapy: management review (PMR) form Summary: 

This form is to be completed by physiotherapists to report on the progress and/or effectiveness of a client's physiotherapy treatment and self-management plan. The separate 'notes' document in this section provides additional instructions and clarification to help complete the form.


Physiotherapy: treatment notification plan (TNP) form Summary: 

A treatment notification plan (TNP) includes information relating to a TAC client's clinical diagnoses, proposed treatment plan, self-management strategies and outcome measures.  A TNP is required to be submitted to the TAC if there has been a gap in treatment of longer than six months. For most new clients you will not need to complete a TNP unless specifically asked to do so. Clients with a 'severe injury' or in receipt of an 'Immediate approval of services' letter do not need a TNP submitted to the TAC prior to treatment. The TAC may request a TNP at other times during your patient's treatment.


Independence Plan - Information for providers Summary: 

Our attendant care providers support clients to achieve their independence goals in daily living activities, therapy support, personal and domestic skills retraining and community access skills.


Billing Review Program - Information for Allied Health Providers Summary: 

The TAC and WorkSafe conduct periodic reviews of payments made to providers for medical and allied health services provided to TAC clients and injured workers through the Health Practitioner Billing Review Program.

The primary focus of the program is to ensure that payments made to medical and allied health providers are appropriate and comply with TAC and WorkSafe policies and fee schedules.


CMSO (Complex and Multi-site Orthopaedic Injuries) Summary: 


This document outlines to Physiotherapists the TAC's Complex and Multi-site Orthopaedic injuries criteria