The Insurance Commission pays for almost 100,000 GP visits for over 15,000 claimants each year in WA.
Claimants will now be able to provide GPs with a 19-digit treatment number, which can be keyed into a HICAPS terminal to receive real-time approval notification for pre-approved services. Payments will be made within 48 hours or sooner depending on the practice’s banking arrangements.
Before providing treatment, practices can also use the HICAPS quote facility to check if a service is pre-approved.
Central City Medical Centre’s practice manager Claire Stocks said this was the “logical next step”.
“The Insurance Commission historically took about three weeks to make a liability decision on a claim,” Ms Stocks said.
“This created a lack of certainty for us on whether we would get paid.
“It also meant we waited up to a month to get paid from when we delivered treatment.
“To avoid that uncertainty, a few years ago, we begun to charge claimants up front for the service. This meant that the claimant was out-of-pocket and had to wait up to a month to learn if the Insurance Commission would reimburse them.”
The Insurance Commission recently approached Ms Stocks to enquire whether Central City Medical would participate in a trial of this payment technology, and eventually adopt it.
“I was very supportive and happy to be involved,” Ms Stocks said.
“The Insurance Commission’s initiative avoids those poor historic outcomes.
“It’s a win for the patient who gets the treatment they need and early, and is not charged for it.
“It’s a win for the medical practice, as we get greater payment certainty and improved cash-flow management. Plus, it will result in less administration as we don’t have to generate and send off paper invoices.
“And it is a win for the Insurance Commission, as it obviously streamlines and simplifies their payment process, creating greater efficiency.”
The first treatment types to be enabled for automated payments are: GP, physiotherapy. chiropractor treatment, osteopathy and medical specialties.
These treatment types have been chosen due to the high-volume of services provided to injured motorists and government employees with workers’ compensation claims.
HICAPS will be the first automated payment channel, with others to follow.
The Insurance Commission is understood to be the first motor injury or workers’ compensation insurer in Australia to pay for pre-approved treatment services via HICAPS.
Insurance Commission implements automated payments for pre-approved treatments via HICAPS.
- Supporting WA doctors to receive payment more quickly.
- Same faster payment process used by private health insurers.
- Pre-approved services support early access to, and payment for, treatment.
- Roll-out from July 2020 with other payment channels to follow.