Information for Doctors

 
 

+ What referral types do you accept?

We accept a wide range of referrals to our Psychologists including;

  • Mental Health Treatment Plan (Medicare)
  • Private referrals
  • Workers Compensation
  • Department of Veteran Affairs (DVA)
  • Open Arms - Veterans & Families Counselling
  • Wesley Mission – Psychological Therapies Program (PTP)
  • NDIS – Self Managed or Plan Managed only (unable to see NDIA Managed clients)

+ Does my patient need a referral letter?

The need for a referral letter will be dependent on the type of referral the patient is being see under. Medicare: Yes, however there is no standard form for referrals. Eligible medical practitioners can refer patients for allied mental health services with a signed and dated referral letter that includes the following;

  • The patient’s symptoms
  • The number of treatment services the patient needs to receive – (Referrals cannot be provided for the full 10 sessions. A referral is for a maximum of six sessions).
  • A statement about whether the patient has a GPMHTP, shared care plan or a psychiatrist assessment and management plan
  • All patients require a current Mental Health Treatment Plan (MHTP) to claim a rebate for Better Access services from Medicare. A MHTP may be provided to the allied mental health provider with the referral. A MHTP does not expire. A referral is valid until the referred number of sessions have been completed, regardless of whether a patient chooses to change their allied mental health provider.

Private Health: No, there is no requirement for a letter when patients will be claiming under their private health insurance. Workcover: Yes, a referral is needed for clients to be seen under workers compensation insurance. Referral letters will also need to be sent directly to the insurer and funding must be approved before we are able to invoice the consultations to the Workcover.

  • DVA: Yes, a referral is required for an entitled person to receive DVA funded allied health care services. A referral is valid for twelve months unless it is an ongoing referral, the referral must be written on either a ‘DVA Request/Referral Form’ (Form D904) or using the letterhead of the referring health care provider. All referrals must include the following information about an entitled person to ensure the provider understands the entitled person’s medical history and to allow the provider to claim payment from DVA:
  • Name and DVA file number of the entitled person (as shown on the DVA Health Card);
  • The treatment entitlement of the person, i.e. Gold Card or White Card (include accepted conditions, if known, for White Card);
  • If the entitled person is resident in a Residential Aged Care Facility (RACF), the level of care that they are funded to receive and the date the funding began;
  • Provider name and number of the referring health care provider;
  • Date of the referral;
  • Entitled person’s clinical details (including recent illnesses, injuries and current medication, if applicable); and
  • Condition(s) to be treated.

Insurance: Yes, as with Workcover a referral is needed for clients to be seen under an insurance policy. Referral letters will also need to be sent directly to the insurer and funding must be approved before we are able to invoice the consultations to the insurer.

Wesley Mission Psychological Therapies Program: Yes, a valid referral will need to be sent directly to Wesley Mission for prior approval. Once approved the referral will be forwarded to Evolve Wellbeing so we can contact the patient and book them in for a consultation. Please note: We do not receive the referrals from Wesley Mission unless the patient is approved.

NDIS: Yes, we are currently able to see NDIS clients under the following management types. • Self Managed • Plan Managed only

Please Note: We are currently unable to see clients who are only NDIA Managed.

+ When can I complete a review for my client?

Patients are eligible for up to ten individual and 10 group sessions in a calendar year. Referrals cannot be provided for the full 10 sessions. A referral is for a maximum of six sessions. At the completion of the referred number of consultations the treating Psychologist will complete a letter of review to the referring doctor to help determine whether further sessions are needed.

An initial review should occur between four weeks to six months after the completion of a GP Mental Health Treatment Plan and if required, a further review can occur three months after the first review.

Please Note: A rebate will not be paid within three months of a previous claim for the same item/s or within four weeks following a claim for a GP Mental Health Treatment Plan item. Service MBS items Frequency practitioners can use it Prepare a GP mental health treatment plan (GPMHTP) 272, 276, 281, 282, 2700, 2701, 2715 or 2717 • Practitioners can use these items once every 12 months • Practitioners can’t use these items within 3 months of using a review items 277 or 2712 Review a mental health treatment plan 277 or 2712 • Practitioners can use these items once every 3 months • Practitioners can’t use these items within 4 weeks of claiming item 272, 276, 281, 282, 2700, 2701, 2715 or 2717

+ Will I get updates about my patient?

Yes, the treating psychologist will complete a review letter at the completion of the referred number of session, treatment completion, should the client disengage or if an urgent update is needed for adequate care of the patient.

+ Do you offer after hours appointments?

Yes, a number of our practitioners are able to offer afterhours appointments during the week, these time slots however are very popular and do book out in advance so it is best to get in early.

+ Do you bulk bill?

No, however for holders of a current Pension, Concession or Health Care cards we are able to offer a discounted rate when the card is presented.

+ Can I refer my patient under a mental health treatment plan for relationship counselling?

No, Medicare arrangements do not currently allow for the provision of relationship counselling, as it does not constitute the valid use of a Better Access item. Even when a mental disorder is present in both parties, having two clients in the same consultation would not meet the requirements of the Better Access item descriptor. In certain circumstances and if therapeutically indicated, during the course of treatment the treating Psychologist may wish to briefly involve the partner of a client however this should not comprise the primary focus of a course of treatment under Better Access.

+ Can my patient claim both a medicare refund and a rebate private health insurance?

No, when consultations are processed they are allocated an item number for either Medicare or private health insurance, claiming only allows for one item number to be charged, therefore the consultation can only be claimed under one pathway.