Independent medical examiners

SIRA requires medical practitioners and other service providers to provide itemised invoices before payment can be made by the insurer.

Invoices for relevant services rendered must include:

• the injured worker’s first and last name, and claim number
• payee name, address, telephone number and email address
• payee Australian Business Number (ABN)
• name of the relevant service provider who delivered the relevant service
• in the case of medical practitioner services, the provider’s:
  • Australian Health Practitioner Regulation Agency (AHPRA) number, and
  • Medicare provider number (unless not registered with Medicare).
• in the case of private hospital services, the service’s:
  • Medicare Benefits Schedule item (if applicable)
  • theatre banding (if applicable)
    • if the invoice is for a higher-banded procedure which requires a complexity certificate, the certificate of complexity must accompany the invoice.
  • theatre duration (if applicable).
• in the case of invoices for surgery:
  • a detailed operation report including a description of the initial injury and an outline of the mechanism of injury, time surgery commenced and finished, intra-operative findings and the procedures performed, including structures that were repaired (stating the anatomic location) and technique of repair.
• relevant SIRA payment classification code or Australian Medical Association (AMA) Fees List item number (where applicable)
• service cost for each SIRA payment classification code or AMA Fees List item number and service duration (if applicable)
• date of service
• date of invoice (must be on the day of or after last date of service listed on the invoice).

Invoices must be submitted within 30 calendar days of the service being provided.