Delivering hospital based care

Find out how to work with us and deliver hospital based care to our clients.

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Who can deliver hospital based care

This information is for our contracted:

• public hospitals
• private hospitals
• private mental health hospitals
• day procedure centres

Referrals and admissions for hospital treatment

If you need information on hospital admission and treatment see our Hospital admission and discharge page.

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Public hospitals

We have arrangements with all state and territory governments to provide care in public hospitals.

In most cases, you do not need prior approval before you admit a Veteran Gold Card holder to a public hospital. If you are unsure if we will pay, please contact us as soon as possible before you admit the client.

Quality reporting

Public hospital quality reporting is managed by state and territory health departments. Public hospitals are not required to submit anything extra to us.

If you have any specific queries please contact dva.public.hospitals [at] dva.gov.au

Funding arrangements in public hospitals

We provide funding to public hospitals providing:

• an activity-based payment for each episode. This includes the cost of surgically implanted prostheses.
• non-admitted services, in Tasmania to the Tasmanian Department of Health and Human Services.

For all queries regarding public hospitals please contact dva.public.hospitals [at] dva.gov.au

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Private hospitals and private mental health hospitals

Our private hospital information guide provides information for hospital staff.

Our contracted private hospitals:

• Contracted Private Hospitals (DOCX 50 KB) — updated 10 September 2020
• Contracted Mental Health Private Hospitals (DOCX 30 KB) — updated 10 September 2020

Quality reporting

All of our contracted hospitals are required to complete and submit an annual quality report (QR).

QRs must be submitted for each financial year by 31 October.

The single report template enables you to report on the following services:

• private hospital services
• private mental health services
• better discharge planning services
• client feedback and complaints
• any issues

Download the Private Hospital quality report template

• Private Hospital quality report template (XLSX 47 KB) — updated 17 November 2020

The completed private hospital quality report must be emailed to dvaprivatehospitalqualityreports [at] dva.gov.au

Program proposals for private hospital services

We invite hospitals to submit proposals for programs that may improve health outcomes in the veteran population.

We have created guidelines to help you draft your proposal:

• Guidelines for proposals for same day and sessional rehabilitation programs (DOCX 20 KB)
• Guidelines for proposals for innovative or best practice programs (DOCX 20 KB)
• Guidelines for clinical mental health day programs (DOCX 30 KB)
• Guidelines for proposals for innovative mental health programs (DOCX 20 KB)
• Guidelines for proposals for trauma recovery programs (DOCX 30 KB)

Please refer to the relevant guidelines when you write your proposal.

Send your completed program proposal to resp.priv.hospitals [at] dva.gov.au

Discharge planning

We believe that effective discharge planning has many benefits for patients. We work closely with hospitals so that transferring from hospital to home is as seamless as possible.

You can find the broad range of health services available to our clients in our two publications:

• Effective Discharge Planning Resource Guide (PDF 1.13 MB)
• Discharge Planning Checklist (PDF 503 KB)

We also introduced a Better Discharge Planning (BDP) Program to provide more coordinated support to clients. Only hospitals contracted to provide this additional service are able to claim for it.

The BDP information guide (PDF 595 KB) explains service delivery requirements for providers.

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Day Procedure Centres

The DPC Information Guide (PDF 620 KB) provides important information for Day Procedure Centres (DPCs) working with us.

A list of our contracted DPCs are available from the following document:

• Contracted Day Procedure Centres (DOCX 45 KB) — updated 10 September 2020

Quality reporting

All of our contracted Day Procedure Centres must complete and submit an annual quality report (QR).

QRs must be submitted for each financial year by 31 October.

The QR template captures both:

• quality measures
• the organisation’s Safety and Quality Accreditation Outcome status

The single report template enables you to report on the following services:

• Day Procedure Centre services
• client feedback and complaints
• any other issues

Download the DPC quality report template

• DPC quality report template (XLSX 31 KB) — updated 12 October 2020.

The completed DPC quality report template must be emailed to dvaprivatehospitalqualityreports [at] dva.gov.au

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Online schedules and hospital-related information

The Group Accommodation and Theatre Banding (GATB) Schedules and tables

As per our private hospital agreements, accommodation and operating theatre charges must be claimed-based on the GATB Schedule.

The GATB Schedule comprises 2 tables:

1 based on the Commonwealth Medicare Benefits Schedule (CMBS) CMBS-Based Group Accommodation and Theatre Banding (GATB) Schedule (XLSX 294 KB) — updated 16 July 2021

and

1 based on ICD 10 Medical Group Accommodation Banding Schedule diagnosis/disease codes:
Medical Group Accommodation Banding Schedule (XLSX 80 KB) — updated 1 July 2019.

This latest CMBS Based Group Accommodation and Theatre Banding (GATB) Schedule is an updated and corrected version of the schedule previously published on 1 July 2021. DVA apologises for the inconvenience.

Please note that there are annotations used in the Schedule and your attention is drawn to these.

Please note that the Medical Group Accommodation Banding Schedule dated 1 July 2019 is still current and no changes have been made to this schedule.

Hospital data submission

Hospital Casemix Protocol (HCP) data must be submitted by all:

• private hospitals
• mental health private hospitals
• day procedure centres

The Hospital Casemix Protocol (HCP) Data Upload link connects to our secure services login page.

Surgically Implanted Prostheses Schedule

The Department of Health provides a link to the latest listing of the Surgically Implanted Prostheses Schedule.

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Certificates and forms

• Hospital Admission Form
• Discharge Advice and Hospital Claim Form
• Acute Care Certificates to certify patients need acute care continuously 35 days or more

Critical Care Certificates

These certificates are used to:

• clinically verify the need for accommodation in a Critical Care Facility
• list the required interventions and level of nursing care

There are two critical care certificates:

• Coronary Care Patient Certificate
• Intensive Care Patient Certificate

The Rehabilitation Program certificate

The Rehabilitation Program Certificate (PDF 596 KB) is used when a patient is admitted for any of the following:

• inpatient rehabilitation
• admitted same day
• non-admitted sessional rehabilitation program

The Rehabilitation Program certificate should be signed by a rehabilitation physician.

Keeping the patient certificate

You must keep the original certificate on the patient file for audit purposes. This includes:

• coronary care certificate
• intensive care patient certificate
• rehabilitation program certificate

Do not send these documents to us or Services Australia.

If you need any help with forms, call our provider helpline on 1800 550 457

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