TAC and WorkCover patients

Dr Spelman sees patients under Transport Accident Commission (TAC) and WorkCover claims. The process differs from a standard private appointment, and having the right paperwork ready makes it considerably faster.

What to bring to your first appointment

Bring all of the following. Without them, you may need to pay the consultation fee yourself and seek reimbursement later.

•          Your claim number

•          Written confirmation that your claim has been accepted — a letter or email

•          The name and contact details of your case manager or insurer

•          A current referral from your GP or treating doctor

•          All imaging — X-rays, CT, MRI, including films from before the injury if you have them

•          Any prior specialist reports relating to the injury

If your claim is still pending, tell the rooms when you book. You can usually still be seen; the billing arrangement will simply be different.

How billing works

Where a claim has been accepted, the rooms bill the insurer directly for your consultation.

If your claim has not yet been accepted, or if the injury being assessed falls outside the accepted claim, you will be asked to pay as a private patient and claim reimbursement yourself.

If surgery is recommended

Surgery under TAC or WorkCover requires prior approval from the insurer. The rooms will write to your insurer requesting approval, including the clinical justification and the proposed procedure.

Approval takes time. Allow several weeks. Complex or contested requests can take longer, and occasionally an insurer requests an independent medical examination before deciding. The rooms will keep you informed, and will let you know if anything further is needed from you.

Once approval is received, surgery is scheduled and the insurer is billed directly.

Certificates of capacity and return to work

Dr Spelman can provide certificates of capacity and advice on restrictions and graduated return to work. Please raise this during your appointment rather than afterwards — it is much easier to complete accurately while you are in the room.

Independent medical examinations

Dr Spelman does not routinely perform or accept referrals for independent medical assessments (IME) reports. If there is a specific case that you would like to discuss please contact his office.