Complying with DVA Notes — Allied health providers

Allied health providers who provide and claim for treatments to DVA clients have an obligation to understand and comply with the Notes for Allied Health Providers, also known as the Provider Notes.

The Provider Notes are made up of two documents:

1. Section 1 - applicable to all allied health providers.
2. Section 2 - applicable to specific allied health provider groups.

We have highlighted the key clauses from Section 1 of the Notes for you. You must be aware of and accurately apply these rules to remain compliant. Please check the Notes for full details.

• Clause 7: Health care providers are required to deliver treatment and meet the accountability requirements as set out in the DVA Provider Notes.
   
• Clause 20-32: Treatment thresholds and limits exist, as do referral requirements.
   
• Clause 25: Referrals for most clients are valid for one treatment cycle, which is the lesser of 12 months or 12 sessions of treatment.
   
• Clause 26: Referral requirements for clients who receive the Totally and Permanently Incapacitated (TPI) payment differ for physiotherapy and exercise physiology services.
   
• Clause 36-42: Health care providers must formulate a written Patient Care Plan after the first consultation.
   
• Clause 43-46: At the conclusion of treatment or the end of the treatment cycle, the allied health provider must provide a report to the DVA client’s usual GP. The GP will then decide whether further treatment is warranted and, if so, will issue another referral.
   
• Clause 68-73: Home visits and kilometre allowance for travel to treat clients.  Please be particularly aware of the restrictions at clause 69.
   
• Clause 74-81: There are specific conditions for treatment and services provided to eligible DVA clients living in a residential aged care facility (RACF).
   
• Clause 85-87: To be eligible to provide treatment under DVA health care arrangements, a healthcare provider must be a registered provider with DVA at the time the service is provided. They must also meet qualification and accreditation requirements for allied health providers.
   
• Clause 98-103: Restrictions apply to advertising health services to DVA clients that you or your third party advertising provider must meet.
   
• Clause: 106-109: DVA conducts audits of health care providers as per these clauses. Audits will examine whether a health care provider is complying with both:
  • DVA’s administrative arrangements
  • DVA’s treatment guidelines.
• Clause 110-118: Inappropriate Claiming and DVA’s right to recover payments made for incorrect claims or services not appropriately provided.