How do I claim for medical treatment?
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Your medical provider will be able to discuss treatment options with you, and advise you on whether you should seek advance approval.
Comcare has developed new policies on treatment approval for:
Treatment plan
You should discuss your medical treatment needs with your medical provider to establish a treatment plan. Such a plan sets out the types of treatment you need, how often and for how long.
You should forward the treatment plan to Comcare. Most doctors will include the treatment you require on their medical certificate.
Your Claims Services Officer will write to you if items included on the treatment plan do not fall under the provisions of the SRC Act.
Reimbursing medical treatment
You or your medical provider can send invoices for approved medical treatment directly to Comcare. Comcare will usually make payments within 28 days of receiving the invoice.
You will receive a written notice if Comcare will not meet the costs of the medical treatment. You will have to pay for any medical treatment you receive that Comcare decides is not payable under the SRC Act.
Advance approval
If the cost of the treatment is high, or the type of treatment is unusual, you should get written approval from Comcare for payment of such treatment before undertaking the treatment.
You should seek advance payment approval for treatments such as surgery, hospital admissions, costly tests like an MRI, types of treatments not usually related to your accepted condition or when you require medical aids and appliances.
To obtain advanced payment approval, you will need to have your doctor or specialist provide a note outlining the:
- treatment needed
- frequency of treatment
- relationship of treatment to your work-related injury or illness
Your CSO will write to you within 28 days advising of a decision on payment or reimbursement of the costs, except where further information is required. Where further information is required, your CSO will write to you or your doctor to request this information.
Checklist for claiming medical treatment
1. Discuss treatment options with your medical provider
2. Get written treatment plan from your medical provider
3. Send treatment plan to Comcare
4. Get written payment approval from Comcare for high cost or unusual treatment
5. Complete the Medical services claim form [pdf] and send it along with any invoices or receipts to Comcare, GPO Box 9905, Canberra, ACT, 2601.