How long does it take TAC to reimburse?

Generally speaking, if there are no issues in terms of approval of the medical and like expense and the TAC is responsible for payment, then you should expect payment by the TAC within a couple of weeks from when you submit the reimbursement documentation to the TAC.

This applies in relation to (but is not limited to);

• Medical treatment expenses such as GP attendances, physiotherapy, psychologist, specialist appointments
• Imaging such as x-ray, CT, ultrasound or MRI expenses
• Travel expenses, for example to and from medical treatment
• The provision of equipment, either something that you have purchased outright or hired

What if it takes longer than two weeks?

You might find that it takes for TAC longer than a couple of weeks to reimburse you for a particular expense.

If this is the case it’s a good idea to contact the TAC, either email or phone them and just follow up and enquire as to why you haven’t been reimbursed.

Sometimes this will result in the reimbursement being made shortly thereafter.

However, sometimes the reason you haven’t been reimbursed is because the TAC might have an issue with a particular request.

For example, you may be seeking reimbursement for an expense that you needed to obtain approval from by the TAC first.

Or the TAC may need further material or documentation to, for example, clarify something, before they can reimburse you.

Sometimes it can take a little while for the TAC to notify you they’ve got an issue with a particular reimbursement request and by contacting them after a couple of weeks you might be able to find out if there is an issue sooner rather than later, helping to minimise any delay with payment.

If there is a significant delay in payment

If there is a significant delay in reimbursing you, or you think the delay is unfair, you can put a complaint in with the TAC using their complaint process. To do so you need to call or email them and tell them you wish to lodge a complaint.

You have a lawyer then it would be a good idea to discuss the issue with your lawyer and see whether they can help you.

If the TAC refuse to reimburse you for a particular expense

If they make a decision not to pay reimburse you for something you can ask the TAC to perform an informal review or a dispute application if you have a solicitor.

If the matter doesn’t resolve after you’ve pursued one or both of these options, then you have the option of pursuing the matter to VCAT however very few reimbursement disputes end up in VCAT and one of the reasons for this is that it can be costly and time consuming for a person to pursue a matter to VCAT, and you really need to have a matter that makes it financially sensible to do so.

For example, if you’re trying to get reimbursed for a single physiotherapy attendance worth $80, it wouldn’t make sense to pursue the matter to VCAT.

However if it concerns ongoing physiotherapy attendances which could amount to several thousand dollars, then it might make sense to pursue the matter to VCAT.

What if I don’t have the money to pay for a particular type of medical expense upfront and seek reimbursement later?

You should discuss the matter with your treatment provider if you can because the treatment provider can bill for TAC directly.

Keep in mind however some providers don’t want to do this because they may have done this in the past and not been paid or they find it too much of it administrative hassle.

If you are experiencing financial hardship which makes it difficult to pay for a particular type of medical expense upfront, then you can always contact the TAC and discuss this with them.

In certain circumstances they might be able to pay you up front prior to a treatment or service, rather than you having to pay and then be reimbursed.

If you have a lawyer that is acting on a no win no fee basis for you then you can always contact them and ask them to discuss the matter with the TAC on your behalf.

Conclusion

In some instances it can take the TAC a couple of weeks or more to reimburse a person for a medical and like expense that they’ve paid for.

However, sometimes it can take longer simply because the TAC have a lot on their plate administratively speaking and may take some time before they reach your reimbursement.

Sometimes however there can be a delay because the TAC don’t want to pay for a particular type of medical expense or treatment because you didn’t get approval for it first or they might need further information before reimbursing you.

If you haven’t heard from the TAC within a couple of weeks after submitting the reimbursement material to them, it’s not a bad idea to give them a call and find out where things are at.

Does TAC cover remedial massage?

Once you have an accepted TAC claim, TAC will be required to pay you for the reasonable cost of any medical and like expenses related to the treatment of any injuries you suffered in the accident.

A common treatment that people often want to attain for injuries is massage.

The TAC will pay for remedial massage treatment.

However, the TAC guidelines state that they will only pay for massage therapy when it is performed by a registered physiotherapist, chiropractor, or osteopath.

This means that if you try and obtain payment for massage treatment performed by a remedial masseur or say a Myotherapist, the TAC are very likely to refuse to pay for this treatment.

However, if the TAC does refuse to pay for the cost of massage treatment

Do I need approval from the TAC for massage treatment?

Yes, you do need approval from the TAC before you can obtain payment for massage treatment.

What you should do to obtain approval is to attend a treatment session with your chosen provider and then ask your provider to complete a treatment plan or alternatively to send a written request outlining why you need to treatment for your injuries, to the TAC.

Ensure that any correspondence that is sent to the TAC your claim number is listed.

Once the request has gone to the TAC ensure that you follow them up if you haven’t heard from them within a reasonable amount of time.

How much will the TAC pay for massage treatment?

As of 1 July 2021 will pay a maximum rate of $43.41 for massage treatment which involves 30 minutes of direct contact time.

What if the TAC don’t pay for massage treatment?

If the TAC make a decision not to pay for massage treatment for you, then you should read this page if you wish to contest that decision.

The first step in appealing the decision is to ask the TAC to perform an internal review or if you have a lawyer, ask your lawyer to lodge a dispute application on your behalf.

If the matter still doesn’t resolve you can pursue the matter to VCAT and if you want to do this we would recommend that you have a lawyer to represent you.

Medical service or rehabilitation service?

The TAC refuse to pay for massage treatment that isn’t provided by a physiotherapist, chiropractor or osteopath because it doesn’t fall within the definition of a ‘medical service.’

However, in some cases it might be possible to argue that such treatment falls under the definition of ‘rehabilitation service’ in which case the TAC may be required to pay for the treatment, even if it isn’t provided by a physiotherapist, chiropractor or osteopath.

Conclusion

Yes, the TAC will in some instances pay for the cost of remedial massage treatment after an accident.

However, the TAC guidelines state that they will only pay for massage treatment if it is provided by a registered physiotherapist, chiropractor or osteopath and not a remedial masseuse or Myotherapist.

Before you can obtain payment from the TAC for massage treatment you will need to get approval from the TAC for the treatment first.

If you believe that you are entitled to the payment of massage related costs which the TAC are not paying, then you contest their decision not to pay.

Does TAC cover chiropractic costs?

Once you have an accepted TAC claim, the TAC will be responsible for the payment of reasonable medical and like expenses.

One such type of medical treatment is chiropractic services.

Claiming treatment within the first 90 days after a traffic accident

You can obtain payment for chiropractic treatment within the first 90 days of an accident without the need to contact the TAC for approval before obtaining treatment.

The chiropractic treatment provided needs to be for the treatment of injuries suffered in the accident.

In order to obtain payment for treatment you can ask the chiropractors rooms to send their bill to the TAC directly.

Ensure to provide them with your TAC claim number.

If you’re not sure where to find your TAC claim number, view this page.

Alternatively, you can pay for the treatment yourself and then submit proof of payment to the TAC for reimbursement.

Claiming treatment 90 days or more outside the accident

If you require treatment 90 days or more after your accident occurred, you’ll need to obtain approval from the TAC for payment.

You should speak to the chiropractor about this and ask them to complete a treatment and recovery plan.

This then needs to be submitted to the TAC.

The TAC will then make a determination in relation to what they will pay for and they should let you and your chiropractor know when they have done so.

As with chiropractic treatment obtained within 90 days of the accident, you can either ask the chiropractor to send their account to the TAC directly or alternatively you can pay for the treatment and then seek reimbursement from the TAC.

Chiropractors and certificates of capacity

If your ability to work has been impacted by the accident, that is you’re not able to work at all or only able to work on a limited basis and you wish to obtain income payments from the TAC, you will need to obtain certificates of capacity.

Chiropractors are able to complete certificates of capacity for you.

You can read about certificates of capacity here.

Other chiropractic related treatment expenses the TAC will pay for

If your chiropractor sees you outside of their rooms, the TAC can also pay for this.

If your chiropractor suggests that you undergo medical imaging, in the form of an MRI, CT, x-ray ultrasound, generally speaking the TAC will pay for these expenses.

You can read more about the TAC and the payment of medical imaging costs here.

You can claim travel to and from your chiropractic treatment.

Supervised exercise programs or programs where your chiropractor needs to monitor and/or evaluate gym swim programs.

Payment rates for chiropractic treatment

These rates are current as at 1 July 2021.

For an initial consultation with a chiropractor the maximum amount that TAC will pay is $59.87, and for a standard consultation they will pay $48.92.

Both of the above amounts relate to consultations in the chiropractors rooms.

If you have a telehealth consultation with a chiropractor, the TAC will pay a maximum of the figures referred to above.

If you have a chiropractor see you outside of their rooms, whether that be in your home or at another location such as a gym or pool, then for an initial consultation the maximum amount the TAC will pay is $85.19 and for a standard consultation the maximum amount they’ll pay is $78.02.

What if the TAC refuse to pay for chiropractic treatment?

If the TAC refuse to pay for chiropractic treatment, or there are issues with payment, you should read this page which goes through your options in relation to appealing a decision made by the TAC.

In a nutshell, you can ask the TAC to perform an internal review which involves someone from the TAC team reviewing the decision to relating to chiropractic treatment.

This person should be someone who was not involved in the making of the original decision.

If you have a lawyer, then you can pursue a dispute application and conference.

If the matter fails resolve either by way of internal review or via a dispute application conference then you can pursue the matter to VCAT.

If you elect to pursue the matter to VCAT we would recommend that you have a lawyer to assist you.

How long to request chiropractic treatment from the TAC?

You must make an application for treatment within three years from the date of the accident or alternatively, two years from the date that the chiropractic treatment expense was incurred.

Conclusion

Yes, the TAC will pay for the cost of reasonable chiropractic treatment if you have an accepted TAC claim.

You should be aware that if you are claiming chiropractic treatment within 90 days an accident occurring, you do not need to obtain permission from the TAC in relation to the treatment however if you are claiming chiropractic treatment outside 90 days then you will need to.

If there are issues in relation to the TAC not paying for the cost of chiropractic treatment there are options open to you to appeal that decision.

Does TAC cover ambulance costs?

Yes, the TAC will pay for the cost of an ambulance if you need it to transfer you to hospital after an accident.

How do I claim payment for ambulance costs from the TAC?

Many times, you will not need to do anything in order to get the ambulance bill paid for.

What often happens is that they hospital will lodge a TAC claim on your behalf.

They will do this because they want to ensure that all treatment expenses are paid for.

Often, people will not even be aware that the hospital has lodged a TAC claim on their behalf.

Once the TAC claim has been lodged and accepted, the hospital can then ensure that the ambulance bill has been paid.

If however you do receive an ambulance bill, you should send this off to the TAC.

You may have a TAC claim number if you were taken to hospital after the accident.

However if you do not know your claim number (perhaps because you don’t know whether a claim has actually been lodged on your behalf) then you should call the TAC and discuss the matter with them and they should be able to assist you.

If it turns out that a claim was never lodged by the hospital on your behalf, then they can lodge a claim over the phone and you can then send through the ambulance bill after the call.

What about other ambulance expenses?

Say that you have a back injury that flares up 12 months after the accident to such an extent that you call an ambulance to your home and it takes you to hospital.

If there is medical support for the fact that the back problem that you are experiencing relates to the accident, than the TAC should be responsible for paying the cost of the ambulance expense.

Likewise, if whatever reason you need an ambulance, say to transport you somewhere after surgery, then again if the reason for this relates to the accident then the TAC should be responsible for paying for this provided the expense is reasonable.

Wherever possible it’s a good idea to get approval from the TAC before incurring an ambulance related expense (obviously, in situations other than when the ambulance is required after the accident happens).

What happens if the TAC refuses to pay for an ambulance related expense?

This page will assist you.

It goes into detail about what your options are to appeal a decision made by the TAC.

In a nutshell, you can request that the TAC perform an internal review, you can pursue a dispute application and conference if you have a lawyer, and you can pursue the matter to VCAT.

Conclusion

TAC will be required to pay for the cost of ambulance expenses after motor vehicle accidents in most cases.

If you were hospitalised after an accident, the hospital may have lodged a TAC claim on your behalf which will then ensure that the ambulance bill gets paid for.

If you get sent an ambulance bill after an accident you should contact the TAC and make sure a claim has been lodged. Once you’re aware that a claim has been lodged, you should forward the ambulance bill to the TAC.

If the TAC fuse to pay for an ambulance related expense, then there are appeal avenues that you can pursue.

TAC physiotherapy – what you need to know

If you’ve been involved in a motor vehicle accident, the TAC is able to pay for medical treatment.

You can read about TAC and the payment of medical expenses here.

This page will specifically explore TAC physiotherapy and what you need to know if you are wanting to claim the cost of treatment from the TAC.

Physio treatment within 90 days after the accident

If you need TAC treatment within 90 days after your accident you do not need to get approval from the TAC to have physiotherapy treatment.

You just need to make sure that you have an accepted TAC claim, that the treatment is recommended by a medical or health practitioner, and that the treatment is for an injury or injuries that you suffered in the accident.

You do not need to contact the TAC and ask them to provide you with the details of a physiotherapist in your area that is approved by the TAC.

You are able to see any physiotherapist that you choose.

You just need to contact the physiotherapist that you want to book in with, tell them that you have a TAC claim and when you attend your appointment provide them with your TAC claim number.

Physio treatment 90 days or more after the accident

If you are wanting to claim physiotherapy treatment 90 days or more after the accidentand the TAC haven’t previously approved more treatment, then you’ll need to contact the TAC and ask them to approve physiotherapy treatment.

It’s likely that they will require material in support from your physiotherapist or another medical practitioner saying why you need the treatment.

This might mean that you just need to get a short letter from the physiotherapist after your first session and then provide it to the TAC.

If it is more than six months since you’ve had any medical treatment paid for by the TAC, then the TAC will generally request that you ask for approval for treatment.

Gap costs

As with other medical expenses the TAC will cover, when it comes to physiotherapy treatment they will have set fees that they will pay.

If your provider bills you more than the amount the TAC is prepared to pay for physiotherapy treatment, then you’ll be required to pay any extra amount to the physiotherapist.

What the TAC will pay for in relation to physiotherapy

For an initial consultation the maximum rate payable by the TAC is $75.43.

For a standard consultation the maximum rate is $57.48.

If the physiotherapist is required to attend and provide treatment outside their rooms, for an initial consultation the TAC will pay a maximum of $107.66.

For a standard consultation (again outside their rooms) the TAC will pay $86.15.

If the physiotherapist is required to inspect equipment and provide a report (again outside of their rooms) the maximum amount payable is $126.35.

In relation to telehealth consultations, the maximum amount that the TAC will pay is $75.43 for an initial consultation and $57.48 for a standard consultation.

There’s more information on the TAC’s website in relation to specific amounts that they will pay.

The above figures are affective 1 July 2021 and may change every financial year.

Paying for physio treatment

You have two options when it comes to paying a physiotherapist for treatment.

You can give the physiotherapist your TAC claim number and ask them to send their account to the TAC directly.

The TAC will then need to pay the physiotherapist on your behalf.

As mentioned above, if the physiotherapist wants to bill more than what the TAC will pay for, then you’ll need to pay the difference.

The other option is to pay the physiotherapist yourself after your treatment and then submit proof of payment to the TAC who will then need to reimburse you.

Note that some providers will prefer you to pay and then seek reimbursement from the TAC yourself.

If this is a concern of yours then before you book in with a particular physiotherapist it’s not a bad idea to ask them what they prefer to do in terms of payment.

If the TAC don’t approve physio treatment

If the TAC doesn’t approve treatment, then you can ask them to perform an internal review or alternatively, if you have a lawyer, lodge a dispute application.

If the matter still doesn’t resolve, then you can pursue the matter to VCAT.

You can read more about these options here.