Workers compensation regulation bulletin - Issue 67 (August 2019)

Reminder: no health practitioner should charge more than the maximum fee

We are reminding all stakeholders about the prescribed fees for health services in the NSW workers compensation system.

Health practitioners should charge no more than the maximum prescribed fees, which are set in law and cannot be exceeded.

To avoid overcharging and complaints, we encourage health practitioners to check whether their patients have an active workers compensation claim and charge no more than the maximum 'fees order' for the service.

An injured worker cannot be billed for a gap between the maximum fee and the excessive charge.

Insurers should also carefully check requests for payment and not pay more than the maximum prescribed fees for health services.

“SIRA takes reports of non-compliance in the workers compensation system seriously," said SIRA Executive Director, Darren Parker.

"Anyone who has information about overcharging is encouraged to tell us via [email protected] or 13 10 50."

Health providers can find out more about fees orders and how to avoid overcharging on the SIRA website.

Reminder submissions closing soon: Customer service conduct principles

We are seeking feedback on proposed customer service conduct principles for insurers dealing with workers compensation, motor accidents (compulsory third party), and home building compensation claims in NSW.

Under our proposed customer service conduct principles, insurers will be required to regularly attest to compliance with these five principles:

1. Be efficient and easy to engage
2. Act fairly, with empathy and respect
3. Resolve customer concerns quickly, respect customers’ time and be proactive
4. Have systems in place to identify and address customer concerns
5. Be accountable for actions and honest in interactions with customers.

The principles aim to ensure policy holders and people who experience injury and loss are provided with fair, timely, respectful, inclusive and appropriate services, and the opportunity to give feedback on those services.

To read the consultation paper and make a submission visit the online consultation page.

Submissions are invited by 19 August 2019.

PhD scholarship opportunity at Monash University

Interested in implementation science in a primary care setting?

Monash University invites PhD applications to conduct a pragmatic cluster randomised trial of the Clinical practice guidelines for the diagnosis and management of work-related mental health conditions.

The project is part of a partnership trial between Monash University and the National Health and Medical Research Council.

For more information visit Monash University careers. Applications close on 13 August.

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Disclaimer

This publication may contain information that relates to the regulation of workers compensation in NSW. It may include some of your obligations under some of the legislation that SIRA administers. To ensure you comply with your legal obligations you must refer to the appropriate legislation. Information on the latest laws can be checked by visiting the NSW legislation website.

This publication does not represent a comprehensive statement of the law as it applies to particular problems or to individuals or as a substitute for legal advice. You should seek independent legal advice if you need assistance on the application of the law to your situation.

This material may be displayed, printed and reproduced without amendment for personal, in-house or non-commercial use.

© State Insurance Regulatory Authority

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