Our Policies and Procedures

Chronic Disease Management Plan

Referral under Chronic Disease Management Plan (sometimes referred to as a Team Care Plan) – Allied Health Therapists

Referral and Sessions

• A referral must be provided by a GP on the correct form, including the type of professional (e.g. psychologist or speech therapist), date of referral, number of sessions referred, GP name and GP provider number.
• Each referral is only valid for the number of sessions indicated by the GP, up to a maximum of five sessions per calendar year.
• When patients have used all of their referred services they will need to obtain a new referral from the referring practitioner if they are eligible for further services. It is the parent’s responsibility to ensure an initial or new referral is obtained prior to the next appointment.
• The allied mental health professional must be in receipt of the referral at the first allied mental health consultation. It is required that the allied health professional retain the referral for 24 months from the date the service was rendered (for the Department of Human Services auditing purposes).
• In the first session, fifteen minutes of the session will be used to write the compulsory letter to the referring doctor outlining the proposed course of treatment.
• The client must be present. Parent only sessions are not eligible for a rebate.

Payment

• Sessions held with an allied health therapist under this referral are charged at the full professional rate (even for academic consultation services).
• Payment is required at the time of the appointment in alignment with the PosAbility Payment Procedures.
• Clients must pay in full at the time of the appointment. Medicare claims may be processed at the time of payment through the Hicaps machine with correct referral details and the client’s Medicare card. Alternatively, a receipt may be provided for the client to claim the rebate.
• Patients need to decide if they will use Medicare or their private health insurance ancillary cover to pay for these services. Patients cannot use their private health insurance ancillary cover to ‘top up’ the Medicare rebate paid for the services.