Paying for treatments and services
There are two ways we can pay for your approved treatments and services. Check with your provider which is their preferred option:
- we pay your provider direct at the TAC rate
- you pay your provider, and we reimburse you at the TAC rate.
What is the TAC rate?
- We pay for treatments and services in-line with our payment rates. You can see the rates for all treatments and services on our website.
- These rates are in-line with our responsibilities under the Transport Accident Act 1986.
What is a 'gap payment'?
In most cases, we will pay your provider at the TAC rate. If your provider charges more than this, they may ask you to pay the difference. This is known as a ‘gap payment’.
You should talk to your provider about their rates before you attend your first appointment. Questions you can ask are:
- Do you charge at the TAC rate?
- Will there be a gap that I need to pay?
- Do you charge the TAC for my treatment or service, or do I need to pay in full?
If your provider charges you a gap payment, you may be able to seek reimbursement for some of this through:
- Medicare or your private health insurance
- The TAC.
Please note, in most cases, we are unable to reimburse you for a gap payment. This is because we have paid for your treatment or service at a rate we have determined is reasonable. You may still ask for a reimbursement from the TAC and we will let you know our decision.
In many cases, providers will invoice us directly for your treatment and services, but we understand this isn’t always possible.
If you have to pay your provider for an approved TAC treatment or service, we can reimburse you at the TAC rate. We aim to process client reimbursements within 10 business days. Please follow these steps:
- If we don't have your bank details, log into the myTAC portal or app and add them in 'Personal details', or complete the bank details form. This lets us make payments into your bank account.
- Scan or take a photo of your receipt and proof of payment. Send it to us via the myTAC portal or app. Go to Claim reimbursement and upload the photo along with a description of what you've paid for.
If you can't use myTAC, email the photo to firstname.lastname@example.org with your claim number in the subject line.
- When we make a payment into your bank account, you will receive a TAC remittance email confirming the payment, or letting you know of any reasons preventing the payment. This email will be sent from our partner Qvalent, a Westpac company.
If you need to change your email address with us, you can update it in our client contact details form.
Reasons we might not pay for a treatment or service
The reasons include (but are not limited to):
- We need to approve the treatment or service before we can pay for it
- The TAC is unable to pay for that type of treatment or service
- The TAC has already paid for that treatment or service at the rate we have determined is reasonable
- We need more information from you or your provider (see below)
- You have not reached your medical excess (see below)
- We have already made a decision about paying for the treatment or service. If we make a decision to deny, reduce or stop paying for a treatment or service, we will always write to let you know our decision.
We will always let you or your provider know the reason why we can't pay for something.
If we can't pay for a treatment or service, you can still access it and pay for it yourself. We can reimburse you at the TAC rate if we decide to approve the treatment or service later on.
If we need more information
If you or your provider has received a message on your remittance advice that says ‘More information needed to consider this service’, find out what information we need.
If medical excess applies to you
For accidents that happened before 14 February 2018, we can only pay for some non-hospital treatments and services once the medical excess has been reached. Find out if the medical excess applies to you.
If you disagree with a TAC decision
TAC clients have several options if they disagree with a TAC decision. You can learn more about our review process here.