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Allied health professionals

For: Service providers Information seekers

We provide information for people who provide allied health services to employees who have an accepted claim under the Safety, Rehabilitation and Compensation Act 1988 (SRC Act).


Overview of allied health services

Allied health services are delivered by professionals who are not doctors, dentists or nurses. There are a broad range of allied health services and the services may be provided under the direction of a legally qualified medical practitioner, such as a general practitioner or a medical specialist.

Allied health services include:

  • counselling
  • exercise therapy
  • massage therapy
  • osteopathy
  • pharmacy
  • physiotherapy
  • psychology.

In recognition of the health benefits of good work, Comcare’s goal for allied health services is to support the employee to recover at and return to work.

If you are an employee, see medical treatment to find out how to apply for allied health services.

Standards for allied health professionals

Allied health professionals providing services under the SRC Act must have the appropriate qualifications, skills and experience to provide those services.

Australian Health Practitioners Regulation Authority (AHPRA) standards

The Australian Health Practitioners Regulation Authority (AHPRA) sets registration standards for the allied health sector professions of chinese medicine, chiropractic, occupational therapy, optometry, osteopathy, pharmacy, physiotherapy, podiatry and psychology.

Allied health professionals offering these services must meet AHPRA’s registration standards to deliver services in the Comcare scheme.

Registration with professional association

Comcare strongly recommends that employees engage an allied health provider with relevant membership to an appropriate professional body.

By choosing a provider with a membership to a professional body, the employee and Comcare can be confident that the provider has the training and competencies to deliver high quality, individualised services.

The Clinical Framework

Comcare endorses the Clinical Framework for the Delivery of Health Services (PDF, 1.2 MB). This framework outlines a set of guiding principles for the delivery of allied health services to injured or ill employees.

The principles include:

  1. measure and demonstrate the effectiveness of treatment
  2. adopt a biopsychosocial approach
  3. empower the injured person to manage their injury
  4. implement goals focused on optimising function, participation and return to work
  5. base treatment on the best available research evidence.

We expect you, as a provider of an allied health service, to adopt these principles within the standards of your profession.

The process for engaging an allied health provider

Step 1: Employee applies

An employee identifies treatment requirements with their medical practitioner or allied health provider. The employee receives a plan for their treatment – this can be included in their medical certificate. The employee seeks approval for medical treatment from their claims manager.

Step 2: Assessment

A claims manager will assess this application. The claims manager may require more information from you or the employee to make a determination and may require a treatment plan to be completed.

The claims manager will general consider whether:

  • there is a clinical justification for treatment
  • the treatment is likely to be effective and support functional improvement
  • the treatment helps the employee move towards functional independence, participation and self-management
  • in the case of psychology and counselling services, there is an up-to-date referral (within 12 months) from a legally qualified medical practitioner.

Step 3: Determination

If approved, the claim manager issues a determination for the services to the employee in writing.

The determination shows the level of services that have been approved and the length of time.

Step 4: Employee receives treatment

The allied health provider works with the employee to deliver the approved services.

Step 5: Services are reviewed

Claims managers regularly review the services that are approved to ensure the:

  • employee is receiving an appropriate level of service; and
  • type of assistance being provided meets the employee’s needs.

We expect the type and frequency of allied health services an employee requires will reduce as they recover and adapt.

Treatment plans

Employees of an Australian Government agency or statutory authority

Requirements

A treatment plan must be provided when working with employees of an Australian government agency or statutory authority and:

  • treatment is expected to exceed five sessions, or
  • there has been a gap in treatment of more than 12 months, or
  • the employee is receiving services from a new allied health provider.

There are special requirements for invoicing when the services are delivered under a treatment plan. See payment for services for more information.

Forms

These forms are for employees of an Australian government agency or statutory authority.

Physiotherapy forms

Psychology forms

Employees of self-insured licensees

If the employee works for a self-insured licensee, allied health providers should check with the claims manager to confirm any specific requirements around treatment plans.

See a list of corporations and organisations with a self-insurance licence.

Payment for services

Rates of payment

Comcare provides guidance on the upper limits for fees for allied health treatment. See Rates for medical and allied health treatment.

Invoicing for a Treatment Plan

When a Treatment Plan is required, Comcare will pay for the completion and submission of the Treatment Plan, including a consultation. See Rates for medical and allied health treatment.

The item numbers are:

  • physiotherapy - PHYST1 (Consult with PTP)
  • psychology - PSYT1 (Psychology Consult with PTP)

How providers are paid

There are two ways you can be paid:

  1. through the claims manager (preferred method), or
  2. by the employee.

Through the claims manager

If the employee's claim is managed by Comcare, you can send invoices for approved services directly to Comcare. Invoices should include the information required in a service provider invoice.

Email the invoice to general.enquiries@comcare.gov.au.

Comcare usually makes payment within 28 days of receiving the invoice. For more information, see Operating as a Comcare service provider.

If the employee’s claim is managed by a self-insured licensee, you work directly with the licensee.

By the employee

Where necessary, allied health service providers can seek payment directly from the employee receiving the service. The employee can then seek reimbursement from their claims manager.

Page last reviewed: 14 December 2020
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Comcare
GPO Box 9905, Canberra, ACT 2601
1300 366 979 | www.comcare.gov.au

Date printed 18 Jan 2021

https://www.comcare.gov.au/service-providers/medical-allied-health/allied-health