These guidelines should be read in conjunction with the information at Working with the TAC.

Who can provide Alcohol and other Drug (AOD) services?

Services can be provided by the following providers:

• Public drug and alcohol treatment services contracted by the Commonwealth government or through state governments complying with Alcohol and Other Drug Program Guidelines 2017
• Medical practitioners, including psychiatrists, nurses and General Practitioners with relevant qualifications and experience in treating AOD disorders
• Public or private hospital or a day procedure centre contracted through the commonwealth or state government

What we can pay for

Within the first 90 days of a client’s accident, we can help pay for an initial AOD service consultation without the need for you or the client to contact us for approval first. The service must be recommended by a medical or health professional, related to the client’s accident injuries and delivered in line with the Clinical Framework.

Following an initial consultation and report, we may help pay for the reasonable costs of the TAC approved services listed below, after a review of the treatment plan.

If you intend to continue treating a TAC client beyond the initial assessment after their transport accident you will need to send us a request in writing or a copy of their treatment plan.

We will review our client’s treatment to ensure it’s reasonable, clinically justified, outcome focused and in line with the Clinical Framework. We will assess your request and let you and the client know our decision about what we can help pay for and for how long.

If your client has not received treatment in 6 months they will need to seek approval from us before we will pay for further treatment. Ask your client for a copy of their approval if you haven’t seen them in 6 months.

In some rare circumstances, it may not be possible to access a publically funded AOD provider. The TAC may consider paying for a private organisation on a case by case basis for a short period until and appropriate solution is found.

The TAC’s decision will be based on the principals of the TAC’s Clinical Framework following a treatment request

For details see What we can pay for and How to seek TAC approval.

Drug and alcohol services and supports

We can pay for:

• AOD assessment and AOD counselling; when provided by an approved drug and alcohol treatment service
• non-residential withdrawal
• residential withdrawal
• therapeutic day rehabilitation
• residential rehabilitation
• pharmacotherapy

We can also help pay and refer for services that include AOD counselling, assessments and treatment by:

• medical practitioners
• psychologists
• psychiatrists
• nurse practitioners
• addiction specialists
• social workers

Other things to note

Medical excess

For accidents that occurred prior to 14 February 2018 a medical excess may apply. Visit the medical excess page to see if it applies to your patient.  If the medical excess applies you will need to invoice the client directly.

Clients with a severe injury

For clients with a severe injury, the discussion, referral and approval of drug and alcohol services may form part of the client's MyPlan.  A formal request must be submitted separate to your client's MyPlan.

How much we can pay

We can pay for services in line with:

• the applicable state and commonwealth fees relevant for AOD services

If your fee is higher than our fee, you may choose to charge the client the difference in the form of a gap payment.

What we cannot pay for

We cannot pay for:

• Providers who do not meet our registration or service standard requirements
• services that are not clinically effective, reasonable or necessary
• services for an injury, condition or circumstance that existed before a transport accident or is not a direct result of a transport accident

Also see general items we cannot pay for.

For more information

Access our policies for health and support services.