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Factsheet HIP40 - Providers - Hospital Admission and Discharge

Purpose

This Factsheet provides information to medical providers about the Department of Veterans’ Affairs (DVA) hospital arrangements.

Who is eligible for health care under DVA’s hospital arrangements?

Patients holding a DVA Health Card – For All Conditions (Gold Card), a DVA Health Card – For Specific Conditions (White Card) or a written authorisation for treatment are eligible to receive health care under DVA’s hospital arrangements.

DVA will pay for all necessary hospital treatment for Gold Card patients.

DVA will pay White Card patients’ hospital treatment costs required for:

  • an accepted war or service caused injury or disease;
  • malignant cancer (neoplasia);
  • pulmonary tuberculosis; and
  • any mental health condition

If your patient is a Commonwealth or allied veteran, please see Factsheet HSV62 Commonwealth and Allied Veterans for eligibility and treatment information.

Where can I admit my patient for hospital treatment?

Any medical practitioner or specialist can refer a patient to a:

  • public hospital;
  • DVA contracted private hospital;
  • DVA contracted private hospital for mental health services; or
  • DVA contracted day procedure centre.

Under DVA’s hospital arrangements, you must contact DVA for approval before admitting your patient to a:

  • non-contracted private hospital;
  • non-contracted private hospital for mental health services; or
  • non-contracted day procedure centre.

Please confirm specialists have admitting rights to DVA preferred hospitals before making referrals.

A list of DVA contracted private hospitals, mental health hospitals and day procedure centres is available on the DVA website at: Hospitals, Day Procedure Centres and Mental Health Private Hospitals | Department of Veterans' Affairs

What are my patient’s responsibilities if they choose to be treated as a private patient at a private hospital using their private health insurance?

The costs of hospitalisation will be at your patient’s expense. DVA will be unable to reimburse any out of pocket expenses that may occur. This may include costs for any intensive care and rehabilitation services that may arise. These costs could be substantial so you should discuss it with your patient before making a decision.

What if I need to admit my patient to a non-contracted facility?

You will need to seek approval from DVA before admitting your patient to a non-contracted facility. DVA may request the following information to determine your request:

  • your provider details;
  • your patient’s details;
  • the condition(s) being treated;
  • your patient’s degree of pain or discomfort;
  • the clinical necessity and urgency of the admission;
  • the waiting times of public or contracted hospitals in your area; and
  • if you have sought admission to a public or contracted facility.

What are DVA’s billing arrangements?

Hospitals send their accounts to the Department of Human Services (DHS).

What if my patient needs to be admitted to hospital in an emergency?

Your patient can be admitted to the nearest hospital in an emergency. They should only be admitted to the emergency department of a non–contracted hospital when it is the closest facility available.

If possible, confirm your patient’s treatment entitlements before arranging admission to a non-contracted hospital. If this is not possible, obtain DVA’s approval on the next working day after the admission.

Do I need to check if country residents can obtain travel assistance?

Yes. When referring a country resident to a metropolitan hospital or day procedure centre, you should contact DVA first to confirm their travel assistance entitlements. DVA will not pay for unapproved travel.

Entitled persons should be treated at the nearest local facility. DVA may not pay travel assistance to patients who choose to travel to other facilities when local care is available. For more information, please refer to Factsheet HIP80 Transport Information for Health Providers.

What are my discharge planning responsibilities as a General Practitioner(GP) or Local Medical Officer (LMO)?

As a GP or LMO, you are the most appropriate post-discharge care coordinator for your patient; as such you are responsible for:

  • providing advice to hospital discharge planning staff about the management of your DVA patients' hospital care; or
  • providing advice to hospital discharge planning staff about your DVA patient (when other health care professionals are managing your patients' hospital care); and
  • continuing the medical care of your DVA patient following their discharge from hospital.

More Information

DVA General Enquiries

Phone: 1800 550 457 *

Email: GeneralEnquiries@dva.gov.au

DVA Website: www.dva.gov.au

Factsheet Website: www.dva.gov.au/factsheets

DVA Service Provider Enquiries

Service Provider Website: www.dva.gov.au/providers

DVA Prior Approvals and Eligibility for Treatment

Phone: 1800 550 457 *

Fax: (08) 8290 0422 *

* Calls from some mobile phones and pay phones may incur additional charges.

Related Factsheets

Disclaimer

The information contained in this Factsheet is general in nature and does not take into account individual circumstances. You should not make important decisions, such as those that affect your financial or lifestyle position on the basis of information contained in this Factsheet. Where you are required to lodge a written claim for a benefit, you must take full responsibility for your decisions prior to the written claim being determined. You should seek confirmation in writing of any oral advice you receive from DVA.

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27 September 2018