Changes for providers

TAC clients and when to seek approval

From 17 August 2020, our approval requirements depend on whether a treatment or service is delivered within the first 90 days of the client’s accident, or after 90 days. We define a new client as one accessing treatment within the first 90 days of their accident.

What we can pay for after an accident

Within the first 90 days of a client’s accident, we will pay for some treatments and services without the need for you or the client to contact us for approval first. The treatment or service must be:

On our list of Approved treatments and services for new TAC clients, and
Recommended by a health professional, related to the client’s accident injuries and delivered in line with the TAC Clinical Framework.

For details, see What we can pay for.

When you need to seek TAC approval

You or your patient will need to contact the TAC for approval of treatments or services when:

The treatment or service is on our list of Treatments and services that need approval, or
The treatment or service is on our list of Approved treatments and services for new TAC clients, but it is approaching, or more than 90 days since your patient’s accident and we have not already approved further treatment, or
More than 6 months have passed since the client received any TAC support.

For details, see What we can pay for. For information on our approval process, see How to seek TAC approval.

Allied Health Treatment and Recovery Plan

If you provide allied health services to TAC clients, you will need to complete an Allied Health Treatment and Recovery Plan if it is approaching, or more than, 90 days since the client’s accident and we have not already approved further treatment. The plan can be completed and submitted online.

You do not need to wait to hear from us before submitting your request or treatment plan if your patient is likely to need treatment beyond 90 days. We will pay you for a completed Allied Health Treatment and Recovery Plan in line with the TAC fee schedule.

This plan helps us better understand our client’s injuries, treatment needs and goals in line with the TAC Clinical Framework. If we don't receive a completed plan from you when required, we may not pay you for any further treatment for this client.

This does not mean we will cease their entitlement to TAC funded treatment. We simply require more information to understand their current situation in order to make an informed decision about further treatment approval. Once we have the plan, we'll let you know if the client is approved for further treatment, and for how long.

The Allied Health Treatment and Recovery Plan replaces all previous TAC treatment plans for the following services:

Physiotherapy
Exercise physiology
Chiropractic
Osteopathy
Acupuncture
Podiatry
Hand therapy

Mental Health Treatment Plan

Within the first 90 days of a client’s accident, we will help pay for up to 6 mental health sessions without the need for you or the client to contact us for approval first.

The treatment must be recommended by a health professional, related to the client’s accident injuries and delivered in line with the TAC Clinical Framework.

You will need to complete a Mental Health Treatment Plan at whichever point comes 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.

You do not need to wait to hear from us before submitting your plan if your patient is likely to need more than 6 sessions in the first 90 days, or treatment beyond 90 days. We will pay you for a completed Mental Health Treatment Plan in line with the TAC fee schedule.

This plan helps us better understand our client’s treatment needs and goals in line with the TAC Clinical Framework. If we don't receive a completed plan from you when required, we may not pay for more than six sessions for this client.

LanternPay

To ensure TAC clients receive the support they need, we continue to review the treatments and services they are receiving. At times, these reviews may result in changes to their eligibility for TAC funded treatments or services.

As of 28 September 2019, our systems share this information with LanternPay in real time, with eligibility checks performed automatically as you go through the LanternPay invoice creation process.

As you create and submit an invoice using LanternPay, you will receive an on-screen message if:

the service or item for which you are invoicing is not approved for the chosen patient
your billing amount exceeds how much we will pay for the approved service
the patient is not eligible for TAC-funded treatment.

A message will be displayed if a treatment or service is not approved for TAC payment or will only be part paid.

Please note: For some service types, you can no longer bill for multiple items on the same invoice line or for previously paid treatments and services.

Access information about LanternPay to learn about the process you should follow when billing through LanternPay and the messages you may now see as you process an invoice.

Clinical support for TAC providers

As part of the TAC Clinical Framework, treating providers are asked to set outcome measures for all TAC clients and regularly review their progress.

If a client isn’t achieving functional outcomes, the Clinical Panel is available to provide additional support to providers.

Clinical Panellists cover a range of disciplines and can discuss the most effective treatment options and pathways, provide support for managing complex clients and address any concerns you have about a client.

After a gap in treatment

If a client hasn’t accessed any TAC funded treatment or services in 6 months, they’ll need to contact us before we can consider paying for further treatment.

This allows us to discuss with the client how they’re progressing toward recovery. Please ask the client to contact us if 6 months have passed since they last accessed treatment.

Equipment items

Equipment items cannot be invoiced through LanternPay. If you prescribe or supply basic equipment to TAC clients, you should submit a manual invoice to invoices@tac.vic.gov.au with a clear description of the item.

Please ensure that any equipment you prescribe or supply to TAC clients is reasonable, clinically justified and supporting specific recovery outcomes.

In some cases the TAC will contact you to discuss the expected client outcomes from the use of equipment items before it processes invoices.


Changes for providers TAC clients and when to seek approval From 17 August 2020, our approval requirements depend on whether a treatment or service is delivered within the first 90 days of the client’s accident, or after 90 days. We define a new client as one accessing treatment within the first 90 days of their accident. What we can pay for after an accident Within the first 90 days of a client’s accident, we will pay for some treatments and services without the need for you or the client to contact us for approval first. The treatment or service must be: On our list of Approved treatments and services for new TAC clients, and Recommended by a health professional, related to the client’s accident injuries and delivered in line with the TAC Clinical Framework. For details, see What we can pay for. When you need to seek TAC approval You or your patient will need to contact the TAC for approval of treatments or services when: The treatment or service is on our list of Treatments and services that need approval, or The treatment or service is on our list of Approved treatments and services for new TAC clients, but it is approaching, or more than 90 days since your patient’s accident and we have not already approved further treatment, or More than 6 months have passed since the client received any TAC support. For details, see What we can pay for. For information on our approval process, see How to seek TAC approval. Allied Health Treatment and Recovery Plan If you provide allied health services to TAC clients, you will need to complete an Allied Health Treatment and Recovery Plan if it is approaching, or more than, 90 days since the client’s accident and we have not already approved further treatment. The plan can be completed and submitted online. You do not need to wait to hear from us before submitting your request or treatment plan if your patient is likely to need treatment beyond 90 days. We will pay you for a completed Allied Health Treatment and Recovery Plan in line with the TAC fee schedule. This plan helps us better understand our client’s injuries, treatment needs and goals in line with the TAC Clinical Framework. If we don't receive a completed plan from you when required, we may not pay you for any further treatment for this client. This does not mean we will cease their entitlement to TAC funded treatment. We simply require more information to understand their current situation in order to make an informed decision about further treatment approval. Once we have the plan, we'll let you know if the client is approved for further treatment, and for how long. The Allied Health Treatment and Recovery Plan replaces all previous TAC treatment plans for the following services: Physiotherapy Exercise physiology Chiropractic Osteopathy Acupuncture Podiatry Hand therapy Mental Health Treatment Plan Within the first 90 days of a client’s accident, we will help pay for up to 6 mental health sessions without the need for you or the client to contact us for approval first. The treatment must be recommended by a health professional, related to the client’s accident injuries and delivered in line with the TAC Clinical Framework. You will need to complete a Mental Health Treatment Plan at whichever point comes 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. You do not need to wait to hear from us before submitting your plan if your patient is likely to need more than 6 sessions in the first 90 days, or treatment beyond 90 days. We will pay you for a completed Mental Health Treatment Plan in line with the TAC fee schedule. This plan helps us better understand our client’s treatment needs and goals in line with the TAC Clinical Framework. If we don't receive a completed plan from you when required, we may not pay for more than six sessions for this client. This does not mean we will cease their entitlement to TAC funded treatment. We simply require more information to understand their current situation in order to make an informed decision about further treatment approval. Once we have the plan, we'll let you know if the client is approved for further treatment, and for how long. LanternPay To ensure TAC clients receive the support they need, we continue to review the treatments and services they are receiving. At times, these reviews may result in changes to their eligibility for TAC funded treatments or services. As of 28 September 2019, our systems share this information with LanternPay in real time, with eligibility checks performed automatically as you go through the LanternPay invoice creation process. As you create and submit an invoice using LanternPay, you will receive an on-screen message if: the service or item for which you are invoicing is not approved for the chosen patient your billing amount exceeds how much we will pay for the approved service the patient is not eligible for TAC-funded treatment. A message will be displayed if a treatment or service is not approved for TAC payment or will only be part paid. Please note: For some service types, you can no longer bill for multiple items on the same invoice line or for previously paid treatments and services. Access information about LanternPay to learn about the process you should follow when billing through LanternPay and the messages you may now see as you process an invoice. Clinical support for TAC providers As part of the TAC Clinical Framework, treating providers are asked to set outcome measures for all TAC clients and regularly review their progress. If a client isn’t achieving functional outcomes, the Clinical Panel is available to provide additional support to providers. Clinical Panellists cover a range of disciplines and can discuss the most effective treatment options and pathways, provide support for managing complex clients and address any concerns you have about a client. After a gap in treatment If a client hasn’t accessed any TAC funded treatment or services in 6 months, they’ll need to contact us before we can consider paying for further treatment. This allows us to discuss with the client how they’re progressing toward recovery. Please ask the client to contact us if 6 months have passed since they last accessed treatment. Equipment items Equipment items cannot be invoiced through LanternPay. If you prescribe or supply basic equipment to TAC clients, you should submit a manual invoice to invoices@tac.vic.gov.au with a clear description of the item. Please ensure that any equipment you prescribe or supply to TAC clients is reasonable, clinically justified and supporting specific recovery outcomes. In some cases the TAC will contact you to discuss the expected client outcomes from the use of equipment items before it processes invoices.