Is a doctor's referral required?
A doctor’s referral is not necessary to attend this practice as a private out-patient. A medical referral is necessary to see a physiotherapist if you are claiming the injury/treatment through a third-party insurer such as Workcover, Department of Veteran’s Affairs, or Accident Insurance.
Is physiotherapy covered by Medicare?
No, physiotherapy fees are not covered by Medicare.
However some chronic conditions may be subsidised by Medicare, these can only be approved by your Doctor. Only these patients with chronic conditions & complex care needs that are being managed by their doctor under a Chronic Disease Management (CDM) plan can claim Medicare benefits for physiotherapy treatments. Benefits can be claimed for up to five (5) allied health services in a calendar year from eligible allied health professionals (AHP) such as physiotherapists, occupational therapists, podiatrists, etc.
What about private health insurance?
Members in health funds who have extras or ancillary type cover will normally have part of the cost of our fees rebated, but not the full amount. We encourage you to personally check with your fund regarding the amount of rebate that will be provided and any limits there may be before any treatments are commenced.
Physiotherapy is available to patients admitted into the hospital and at the request of their doctor, these referrals will be forwarded to us. Of course, if you have a physiotherapist that normally looks after you and would prefer that therapist to treat you whilst you are in hospital, you would need to notify the ward staff prior to any referral being passed onto us.
Accounts, Out-of-Pocket expenses and private health fund rebates
If you belong to a private health fund, it is important that you are fully aware of the entitlements of your membership. Downs Physiotherapy accepts no responsibility for the completeness of your private health insurance knowledge and we would strongly recommend that you clarify with your private health insurer exactly what you are covered for.
Some private health funds have established special arrangements with certain hospitals whereby their members, providing they have hospital cover, will have no out-of-pocket expenses following their stay in the hospital (phone, papers, etc. excluded). This arrangement is called “bundling”.
Accounts for physiotherapy will be billed directly to and paid by the hospital under these special arrangements. Please check with your health fund and the hospital in which you will be admitted to see if such arrangements exist.
Where no such arrangements exist, patients will receive an account from us after being discharged from the hospital. This account will be separate from your hospital account.