These guidelines should be read in conjunction with our General provider guidelines.
Who can provide dental services?
You can provide services if:
What we can pay for
We can pay the costs of your patient’s dental services in line with our fees, without prior approval, when they are required as a result of a transport accident injury.
Please note that if your fees are greater than the TAC’s published rates we request you let the client know there will be an out of pocket expense. Clients can contact us to discuss options if the out of pocket costs will prohibit treatment or services from going ahead.
We will review our client’s treatment to ensure it’s reasonable, clinically justified, outcome focused and in line with the Clinical Framework. We'll ask you and our client for information during these reviews and may temporarily stop funding treatment if we don’t receive it.
Reviews help us understand our client’s injuries, treatment needs, their goals and how to best support them get their lives back on track. After a review we’ll let you and our client know the decision regarding further treatment.
General dental services:
- diagnostic services
- preventative services
- adjunctive general services
- restorative services
- associated dental services to adjoining teeth
Specialist dental services:
- temporomandibular joint therapy
Bridges, crowns and restorative services:
- dental implants
- implant based bridge maintenance
- crown and bridgework
- in-room oral surgery.
- surgical procedures when performed in the hospital in the first three months from the date of accident
Dental technician services:
- a partial or full denture
- relining of a full denture
- a mouth guard
- repair to, or replacement of, a client’s denture that was damaged or lost in the transport accident
Dental technician services needing prior approval:
- dental implants.
- oral and maxillofacial surgery that is not performed in the first three months following the accident