Referrals and Funding

RTWSA (Formerly known as Work Cover)

Referral:

A injured worker will be required to forward a referral from a treating doctor or physiotherapist prior to booking for an initial review. Case manager approval (written email) is also required prior to commencing Exercise Physiology services. Please contact the clinic via email or phone if you need assistance in arranging the two requirements above.

Funding:

An injured worker covered under RTWSA services would have their insurer charged directly from the RTWSA fee schedule in the below link. No GAP payment or out of pocket expense required for an injured party. NPEP charge direct to your insurer.

Injured workers are often progressed towards self-managed exercise programs to promote autonomy and lifelong health and wellness. If this is the case a gym membership can be purchased by the insurer to support an injured workers ongoing recovery. The gym costs would be variable depending on the location of the membership chosen.

 

Veterans Health and DVA

Referral:

If you have a DVA Health Card – All Conditions (Gold Card) or Totally & Permanently Incapacitated (Gold) the Department of Veterans’ Affairs (DVA) will pay for exercise physiology services available through DVA arrangements that meet your clinical needs.

If you have a DVA Health Card – Specific Conditions (White), DVA will pay for exercise physiology services provided under DVA arrangements, if they are required because of an accepted war or service caused injury or disease.

A referral can be issued by a:

  • Local Medical Officer (LMO)
  • General Practitioner
  • medical specialist
  • treating doctor in hospital
  • hospital discharge planner; or
  • another exercise physiologist who has previously received a referral.

A referral remains active for twelve months from the date of referral. Referral dates cannot overlap from one twelve month period to the next.

Please do not hesitate to call the NPEP clinic should you need assistance with this process.

Funding:

Veterans supported by DVA with a White or Gold Card will not be charged any out of pocket expense.

If you have a DVA Health Card – All Conditions (Gold Card) or Totally & Permanently Incapacitated (Gold) the Department of Veterans’ Affairs (DVA) will pay for exercise physiology services available through DVA arrangements that meet your clinical needs.

If you have a DVA Health Card – Specific Conditions (White), DVA will pay for exercise physiology services provided under DVA arrangements, if they are required because of an accepted war or service caused injury or disease.

Further information on DVA funded Exercise Physiology services can be located in the link below:

https://www.dva.gov.au/factsheet-hsv30-exercise-physiology-services

 

Medicare

Referral:

To claim Medicare benefits you will need an active Chronic Disease Management Plan (CDM) or an Enhanced Primary Care (EPC) referral from your treating doctor.

Please find below link to a medicare referral form for your local doctor to complete. Please email this completed form or bring with you to your initial appointment:

http://www.health.gov.au/internet/main/publishing.nsf/content/DFEEB1B5AAEA0158CA257BF0001CAD67/$File/Referral%20Form%20for%20Allied%20Health%20Services%20under%20Medicare.pdf

Funding:

You may be entitled to Medicare benefits under a CDM or an EPC referral. You will need an active referral from a treating general practitioner or local doctor. A gap payment is required to ensure you receive the necessary clinic time to reach your goals and desired outcomes.

Following the development of an initial program you may be eligible to join supervised group sessions. Please contact the clinic for further information on group session pricing.

 

 

Income protection

Referral:

Depending on your level of cover you may not require a referral from a treating doctor to commence Exercise Physiology services with NPEP. Written approval from your claims manager can be sufficient. This would need to be provided prior to making a booking for an initial assessment.

Funding:

Funding under income protection is variable depending on the level of cover provided by the insurer. Please ensure you have contacted your insurer and have provided written approval to commence Exercise Physiology intervention prior to arranging an initial consult. Exercise Physiology services with NPEP for income protection follow the RTWSA fee schedule as noted below. Further travel fees may be requested should rehab in the home be required. If you are unsure on how this will be funded please contact NPEP for advice by email or mobile: 0423 757 900

https://www.rtwsa.com/publications/fee-schedules

 

Motor accident and compulsory third party

Referral:

Depending on your level of cover you may not require a referral from a treating doctor to commence Exercise Physiology services with NPEP. Written approval from your claims manager can be sufficient. This would need to be provided prior to making a booking for an initial assessment.

Funding:

Funding under motor vehicle accident and third party injury are dependent on the level of cover provided by the insurer. Please ensure you have contacted your insurer and have been provided written approval to commence Exercise Physiology intervention prior to arranging an initial consult. Please email written confirmation of your accepted Exercise Physiology sessions are emailed to admin@npep.com.au. Exercise Physiology services with NPEP for motor vehicle accident follow the RTWSA fee schedule as noted below. Fees for travel may apply should rehab in the home be required.

https://www.rtwsa.com/publications/fee-schedules

 

Private

You may be eligible for rebates under your own private health. NPEP requests full payment from each individual client who may then seek their own private health rebate with our invoices. Fees are subject to clinic time requirements. Initial appointments are charged at either 45 minutes or 60 minutes and will depend on the complexity of a persons goals and personal health. Subsequent appointments are again charged based on the time taken to achieve the desired results from 30 minute, 45 minute or 60 minute sessions.