The TAC can pay the reasonable costs of treatment and services that are:
- To treat a transport accident injury or illness for which a claim has been made and accepted.
- Payable under the Transport Accident Act 1986 and authorised by the TAC where required.
- Necessary and appropriate for the client's transport accident injuries.
- Delivered by a service provider registered under the Health Practitioner Regulation National Law or authorised by the TAC.
In most cases your patient will rely on you to make referrals or requests where required for medical and like services under the legislation.
A request should provide details of how the proposed treatment or service relates to the client's transport accident injury or illness and should include:
- claim number
- transport accident injury being treated
- type of treatment requested
- rationale as to why it is required
- proposed date the procedure/treatment will be provided
- number of services proposed or expected duration
- date treatment will be reviewed
- functional goals/outcome measures that will be used to evaluate the treatment
- self-management strategies in place.
The TAC will consider the principles of the Clinical Framework when considering whether a treatment or service request is reasonable and appropriate
Medical and healthcare services which a client can access without a request from a medical practitioner include:
- Chiropractic services *
- Medical services
- Osteopathy *
- Physiotherapy *
- Family counselling (available to immediate family members of a client who dies or is severely injured as a result in a transport accident)
*Concurrent treatment: Other than in exceptional circumstances, the TAC will only fund physical treatment by one provider or single practice where treatments are considered similar. The TAC considers physiotherapy (including occupational physiotherapy), chiropractic, osteopathic and acupuncture treatment to be similar.
Some services that your patient requires may need prior approval from the TAC before commencement. As a guide, these may include medical and like services such as:
- Elective surgery and procedures
- Car and home mods
- Gym and swim programs
- Attendant care
- Household services
- Taxi services
Independent Medical Examiners
Independent Medical Service Providers are healthcare professionals approved by the TAC to conduct independent medical examinations, the findings of which are used in decisions related to TAC claims. The TAC may also discuss the recommendations of the provider with you to assist in coordinating suitable treatment and support services to assist a client in their rehabilitation.
More information - Independent Medical Examiners.