These guidelines should be read in conjunction with our General provider guidelines.
Who can provide drug and alcohol services?
Services can be provided by the following providers:
- Victorian Department of Health and Human Services (DHHS) funded alcohol and other drug services that comply with the Alcohol and Other Drug Program Guidelines 2017
- medical practitioners, including psychiatrists, with relevant qualifications and experience in treating drug and alcohol dependence
- a public or private hospital or a day procedure centre as defined by the Health Services Act 1988
What we can pay for
Within the first 90 days of a client’s accident, we can help pay for drug and alcohol services without the need for you or the client to contact us for approval first. The service must be recommended by a health professional, related to the client’s accident injuries and delivered in line with the Clinical Framework.
If you intend to continue treating a TAC client beyond 90 days 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 our client has not received treatment in 6 months they will need to seek approval from us before we will pay for further treatment. Ask our client for a copy of their approval if you haven’t seen them in 6 months.
Drug and alcohol services and supports
We can help pay for DHHS-funded drug and alcohol services, including:
- the DirectLine statewide screening and referral service
- catchment-based intake
- non-residential withdrawal
- residential withdrawal
- therapeutic day rehabilitation
- residential rehabilitation
- care and recovery coordination
- youth alcohol and other drug services
- Aboriginal alcohol and other drug services
- forensic alcohol and other drug services
We can help pay for DHHS-funded drug and alcohol additional supports, including:
- drug and alcohol clinical advisory service
- statewide neuropsychology service
- the Victorian Dual Diagnosis Initiative
- women’s drug and other drug services
- mother and baby residential withdrawal unit
- compulsory drug withdrawal services
We can help pay for services that include:
- consultations with medical practitioners
- consultations with psychologists
- drug services conducted by a private, denominational or public hospital
Other things to note
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 independence planning process between the client’s treating team and the TAC coordinator.
How much we can pay
We can pay for services in line with:
- the fees charged by DHHS, or
- the applicable fee schedule for relevant hospital or provider 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:
- 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
For more information
Access our policies for health and support services.