Standard 10 - payment of invoices and reimbursements
Prompt payment of invoices and reimbursements for medical, hospital and rehabilitation services ensures workers can remain focused on their recovery and helps to maintain the integrity of the system.
Payment of invoices and reimbursements
Principle: Workers and providers will receive prompt payment of invoices and reimbursements for medical, hospital and rehabilitation services.
| Expectation | Benchmarks | |
|---|---|---|
| S10.1 | As soon as practicable after receipt of relevant documentation, insurers must pay invoices that meet SIRA’s standard invoicing requirements and are for treatment that does not require pre-approval or for which pre-approval has been obtained. | Payment no later than ten working days from receipt of a valid invoice for approved treatment. |
| S10.2 | Where there is likely to be a delay in payment of an invoice, for example in the case of illegible invoices or invoices submitted more than 12 months after treatment, insurers must advise the party to whom payment is due of the reasons for delay and the anticipated time to resolution. | Advice to relevant party within ten working days of receipt of invoice. |
| S10.3 | As soon as practicable after receipt of relevant documentation, insurers must pay reimbursements to workers for expenses that do not require pre-approval or for which pre-approval has been obtained. | Payment no later than ten working days from receipt of relevant documentation. |
| S10.4 | Where there is likely to be a delay in payment of a reimbursement, for example in the case of receipts submitted more than 12 months after the expense was incurred or where insufficient evidence is provided, insurers must advise the worker of the reasons for delay and the anticipated time to resolution. | Advice to the worker within ten working days of receipt of relevant documentation. |