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

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

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

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

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

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

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) or

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

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

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

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

Eligibility & Prior Approval Eligibility Checks: Patients presenting White Cards Phone: (metro callers) (regional callers) Prior Approval: Patients presenting White Cards Dental procedures Convalescent care

Prior Approval Surgical/medical procedures not listed on Medicare Benefits Schedule Non-listed prostheses items In-vitro fertilisation procedures Cosmetic surgery Exceptional cases/treatments Fax: (08) Mail: Medical & Allied Health DVA GPO Box 9998 Adelaide 5001

DVA Forms DVA Health Care Forms can be ordered online from the DVA website To register for online ordering of all forms: Phone Download fillable and printable forms for service providers /Pages/Forms.aspx /Pages/Forms.aspx

Provider Enquiry Telephone Numbers All provider enquiries to DVA (unless previously specified) should be directed to: (metro callers) (regional callers)