We are preferred providers for all the major health funds and do process all PHI payments onsite through Hicaps and you can pay your gap with cash or through EFTPOS. However, there are times in your life where you may need to access our services through other avenues.
There are a range of Third Party Payee options to assist people to access our services and receive the health care they require. Both Physiotherapy and Exercise Physiology (and some Remedial Massage) services are accessible through Third Party Payee facilities.
Please see below for more information on what you need to know to access our services via Third Party Payee.
Medicare Individual sessions [EPC]: Did you know that Medicare can cover Physiotherapy and Exercise Physiology for some people?
In June 2004, the Federal Government introduced access to Medicare funded physiotherapy. The Medicare Enhanced Primary Care (EPC) program provides more preventive care to older Australians. The program also improves care co-ordination between GPs and health professionals who provide care for people of any age with chronic conditions and complex care needs. Through the EPC program, certain people can gain access to Medicare rebates for up to five allied health and an additional eight diabetic services per year. A chronic condition is one that is of more than six months duration. Your GP will be able to assess whether you have complex care needs. To access Medicare funded physiotherapy/exercise physiology, you will need to speak to your GP about whether you are eligible for this initiative.
If eligible, you and your doctor will develop a care plan. You will then be able to access up to five Medicare funded allied health services in a calendar year. Your physio will communicate with you and your doctor about your progress and at the end of your treatment there is an opportunity for your GP to review the care plan and discuss your future healthcare needs. Additional Medicare funded visits are available for clients with Type II Diabetes.
For more information about the EPC program talk to your physiotherapist/exercise physiologist and your GP, go to the Medicare Australia website: www.medicare.gov.au, or call Medicare Australia on 132 011.
If you suffer from a chronic medical condition and/or complex care need and are eligible for funding through Medicare under the ‘Enhanced Primary Care [EPC] plan’ you can access our Physiotherapy and Exercise Physiology services. We utilise Medicare Online, and there is a gap for these Medicare service if the appropriate referral and paperwork has been received.
Medicare Group sessions [DCP]:If you have been diagnosed with Type 2 Diabetes, you may be eligible for an initial consultation and up to 8 group classes rebated through Medicare per calendar year upon suitable referral from your GP. We utilise Medicare Online, and there is a gap for this Medicare service if the appropriate referral and paperwork has been received.
Remedial Massage services are NOT available under an EPC.
IMPORTANT: When you call the office on 83311557 to make an appointment, please let our lovely admin staff know that you have an EPC allocated to Physiotherapy (or Exercise Physiology) services and if you or your GP has a copy of the EPC. This allows time before your appointment for us to retrieve the EPC and validate the number of visits you have available for use this year with Medicare, and how many visits are allocated to physio. By doing this check before you attend we are able to ascertain if some EPC visits have been used elsewhere in this calendar year (it is not uncommon for there to be some confusion if appointments were used around the new year period) and avoid any unnecessary stress for you at the reception desk.
Department of Veteran’s Affairs (DVA) :If you are an eligible Veteran with a DVA White or Gold card, you may be able to access Exercise Physiology, Dietitian and/or Physiotherapy services to treat a specific medical condition upon suitable referral from your GP or Specialist.
Referral requirements: LMOs may either use a D904 Request / Referral Form, or their own stationary/letterhead, provided it contains the following information:
- Veteran’s name Veteran’s DVA file number (shown on the Repatriation Health Card)
- Condition to be treated must be stated
- Description of the requested service
- Referral duration (e.g. 12 months)
- LMO’s name and provider number
- Date of referral
Length of Referral: Patient’s referral will typically last for 12 months unless otherwise stated, or be an ongoing referral if stated as such on the referral. For referral to any health care provider, it is the LMO’s responsibility to provide the above information about a veteran to ensure that the provider understands the veteran’s medical history and to allow the provider to claim payment from DVA.
Remedial Massage services are NOT available through DVA.
IMPORTANT: When you call the office on 83311557 to book your first appointment, please let our lovely admin staff know what type of DVA card you have and if you are bringing your GP referral with you or if they are going to send it straight to us. This will prevent any delay to beginning your treatment.
Worker’s Compensation: We are a recognised Return To Work SA provider, and deliver a comprehensive range of services for injury management and physical rehabilitation. If you require a physical conditioning program to successfully return to work, a referral from your GP or Physiotherapist can initiate the process. Some Remedial Massage services may be available for RTW and Third Party clients.
IMPORTANT: When you call the office on 83311557 to book your first appointment, please let our lovely admin staff know that this will be a RTW or Third Party claim. Please have your claim number, case manager’s name and which insurance company is covering the claim (if a third party case) to hand when calling so that we can record the information on your file. If you do not have your claim number allocated to you as yet, you can still access our services, you will just be asked to sign a contract stating that if your claim is rejected you will be liable for all services billed.
National Disability Insurance Scheme (NDIS)
Our Physiotherapists and Accredited Exercise Physiology team are NDIS providers. The NDIS is an Australian government scheme designed to support people living with disabilities to access high quality healthcare.
For more information on NDIS please go to their website: www.ndis.gov.au
IMPORTANT: When you call the office on 83311557 to book your first appointment, please let our lovely admin staff know that you are a NDIS client. If NDIS services are Plan Managed or NDIA managed please have your NDIS number and the name of company managing your plan. You will also need to know how much you have allocated in your support budget (physiotherapy and exercise physiology are in your CB Daily Activity section), carers/powers of attorney contact details so that we can have your service agreement prepared for you and your physiotherapist (or exercise physiologist) to discuss and reduce lengthy waits after your appointment. If your case is NDIA managed, please bring your NDIS plan in on your first visit so we can attach to your file.
