Within the first 90 days of the client's accident, we can help pay for some treatments and services without the need for you or the client to contact us for approval first. In other circumstances, you or the client will need to contact us for approval.
Find out more about what we can pay for and when you need approval.
Making a request or submitting a treatment plan
If you intend to continue treating a TAC client beyond 90 days after their transport accident, and you do not have a current approval in place, you should send us a request in writing or a copy of their treatment plan.
You do not need to wait to hear from us before submitting your request or plan if your patient is likely to need treatment beyond 90 days.
You should only complete a treatment plan:
- to request approval for treatment related to a client's transport accident injuries beyond 90 days of their accident, or
- when requested by the TAC.
Providers who complete an appropriate treatment plan in these two scenarios will be paid in line with the TAC fee schedule.
This information helps us understand more about the client’s injuries and the treatment and support they need, so we can make decisions about what we can help pay for and for how long.
We will review the client’s treatment to ensure it’s reasonable, clinically justified, outcome focused and in line with the TAC Clinical Framework.
Requests can be sent to firstname.lastname@example.org with the TAC claim number in the subject line.
Information we need to consider further treatment
Allied health and rehabilitation
Please submit a treatment plan or request for your discipline as outlined below.
Type of treatment plan or request
Occupational therapy – hand therapy
Occupational therapy – other
See other treatments and services below
Orthotic and prosthetic
|Outpatient rehabilitation services||Outpatient Rehabilitation Plan or written request (see other treatments and services below)|
We will pay you for a completed treatment plan in line with the TAC fee schedule.
Mental health professionals
Please submit a Mental Health Treatment Plan at whichever point occurs first:
- Your patient needs more than 6 sessions in the first 90 days after their accident, or
- Your patient needs treatment beyond the first 90 days of their accident (regardless of how many sessions they have already had).
We will pay you for a completed Mental Health Treatment Plan in line with the TAC fee schedule.
For clients who do not begin mental health treatment until after the first 90 days, please contact us to discuss their needs.
Surgical procedures that occur in the first 90 days from the date of the transport accident do not require prior approval. For surgical procedures after the first 90 days, prior approval from us is required. This request can be made by submitting the Surgery Request Form (preferred) or by providing the information outlined in our Medical practitioner guidelines.
We'll make decisions for surgery in line with the TAC's surgery service charter.
Other treatments and services
Requests for approval must be in writing from an appropriately qualified health professional and include the following information:
- TAC claim number
- transport accident injury being treated
- type of treatment or service being requested
- rationale as to why it is required
- proposed date of the service/treatment
- number of services proposed or expected duration
- date treatment will be reviewed
- functional assessment at the beginning of the program (for outpatient rehabilitation services only)
- functional goals/outcome measure that will be used to evaluate the treatment
- self-management strategies in place (or discharge plan if hospital provider)
- hospital contact person (if hospital provider)
After you send us a request or treatment plan
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 we ask you for information about a client’s treatment and don’t receive it, we may be unable to continue paying for the treatment or service.
This does not mean we will cease your patient’s entitlement to TAC funded treatment. We simply need more information to understand their current situation, in order to make an informed decision about further treatment approval.
We can release a treatment report to the client, another health practitioner or the client's legal representative upon receipt of a verbal or written request from a client or their legal representative.