A common enquiry of our firm is how clients can obtain funded Physiotherapy or other treatment, or have their out of pocket expenses for the same treatments reimbursed by the insurer. Under Queensland Compulsory Third Party (CTP) Insurance you may be eligible for upfront funding for rehabilitation and treatment such as Physiotherapy, chiropractic care, medical consultations and medication.
Often times after an accident your Doctor will recommend treatment such as Physiotherapy. It is important to start your treatment as soon as possible after the accident in order to improve your quality of life and mitigate any loss caused by the accident.
Before considering upfront funding or reimbursement of out of pocket expenses the CTP Insurer will need to review the CTP Medical Certificate and a referral for rehabilitation such as Physiotherapy. This can take some time.
Options available to claimants are as follows:
1.Out of Pocket Funding
While waiting for the Insurer to consider upfront funding you may elect to commence treatment and pay for the expenses out of your own pocket, these can later be considered for reimbursement by the Insurer. We recommend that accurate records are kept and that copies of receipts are provided to your Solicitor or the Insurer. Please note that other expenses such as pharmaceutical expenses may also be reimbursed by the insurer so it is important to keep accurate records of any out of pocket expenses that you incur.
2. Enhanced Primary Care Plan
You may be eligible for an Enhanced Care Plan through Medicare. This involves your General Practitioner creating a treatment plan for you where you can undertake 5 sessions of Physiotherapy, (or other prescribed services such as Chiropractic and Psychologist services) which will be paid for by Medicare, it is worth noting however that any services provided by Medicare may be subject to refunds at the conclusion of your claim.
3. Upfront funding
This method involves the Insurer reviewing the available medical information, inclusive of referrals and sending a Treatment Plan to the Physiotherapist or other medical professional. Once the treatment provider completes and returns the plan to the CTP Insurer they will make their decision on funding. If the insurer approves the treatment, they will pay the treatment provider directly for the number of sessions previously approved by them. This can take some time unfortunately.
If you have had a Motor Vehicle Accident and would like to discuss the above issues please contact our office on 1800 007 277 and our friendly staff would be happy to discuss your options with you in respect to negotiating with the Insurer to obtain funding or reimbursement.