Information for Medical Practitioners Module 2 DVA’s Health Programs

1. Information for Medical Practitioners Module 2 DVA’s Health Programs (Hospital, Medical and Allied Health Services)

2. DVA’s Health Programs • Exist to promote, improve and maintain the health, well-being and independence of the veteran community • Include access to medical and specialist practitioners, hospital treatment, allied health providers and counsellors

3. Treating Veterans New medical practitioners who: • are eligible to provide services under the Medicare Scheme; and • meet the registration criteria for DVA’s Local Medical Officer (LMO) Scheme are eligible to provide services to veterans under the LMO Scheme

4. Fees • LMOs claiming from LMO Fee Schedule are paid at 115% of Medicare Benefits Schedule (MBS) • Veterans’ Access Payments (equivalent to Medicare Bulk Billing Incentive payments) may be claimed for appropriate items • LMOs with appropriate qualifications are eligible to claim for procedures in Repatriation Medical Fees Schedule starting at 140% of MBS rate

5. Fees • Rural Enhancement Initiative pays LMOs an extra 10% for their services in rural public hospitals designated under State Government programs • Coordinated Veterans’ Care (CVC) Program pays LMOs/GPs: • an initial incentive payment for the admission of a veteran to the program • quarterly care payment - for care as part of an ongoing clinical leadership of a participant in the CVC Program • Incentive payments are in addition to all existing DVA Fee Schedule items for consultation and chronic disease management items • Fees reviewed annually

6. Claiming Payment • Medicare Australia is contracted to process health provider claims on behalf of DVA • Online claiming solutions are available to all DVA providers: • Online Claiming ensures a secure connection for lodgement of claims • Claims can be transmitted 24 hours a day, seven days a week

7. Claiming Payment • Online Claiming (cont’d): • Remittance advice statements detailing payment of claims allow automated account reconciliation • Online Veteran Verification confirms the veteran’s details are known to DVA prior to submission of a claim For information regarding online claiming phone (03) 6221 6725 or email onlineclaiming@dva.gov.au

8. Payment Methods • Payments are made by Electronic Funds Transfer (EFT) • To register for EFT: • download ‘DVA and Bulk Bill EFT Payment Application’ from the Medicare Australia web site

9. Medical Specialists Where a clinical need exists for a referral to a medical specialist, it is requested that referral is to one who: • accepts DVA fees and arrangements for treating veterans; and • has treating rights at DVA contracted hospitals

10. Hospital Arrangements DVA has agreements/contracts which allow for eligible veterans to be admitted, as private patients, in a shared ward with their doctor of choice, to: • Public Hospitals in all Australian States/Territories; and • Private Hospitals, Day Procedure Centres and Mental Health facilities throughout Australia

11. Allied Health Services • Medical practitioners may refer eligible veterans to a range of allied health care providers (including mental health care providers) • Referrals are valid for 12 months • In special circumstances ongoing referrals may be granted

12. Eligibility & Prior Approval

13. Prior Approval

14. DVA Forms DVA Health Care Forms can be ordered online from the DVA website To register for online ordering of all forms: Phone 1800 155 355 Download fillable and printable forms for service providers http://www.dva.gov.au/service_providers/Pages/Forms.aspx

15. Provider Enquiry Telephone Numbers All provider enquiries to DVA (unless previously specified) should be directed to: • 1300 550 457 (metro callers) • 1800 550 457 (regional callers)