Transcript First Service Initiative
TAC 2015
The TAC First Service Initiative
November 2013
1
What is First Service
• Focuses on faster and easier claim lodgement • Addresses how quickly and easily the TAC accepts a claim • Clients get the services and benefits they need sooner • For hospitals, streamlined claim lodgement, earlier funding confirmation, earlier discharge to rehab services • On average, 20 days elapse between the date of accident and the initial contact with the TAC to lodge a claim • On average, 70 days elapse between the date of accident and the TAC’s receipt of a completed claim form
Aim to have 80% of clients connected to benefits and services within five days of their accident
First Service
2
How will this be achieved
• Hospitals directly submit claim forms to the TAC on behalf of patients who have been treated or admitted to hospital as a result of a transport accident • Early and proactive contact made by the TAC with clients to lodge a claim • Number of questions on TAC claim forms is significantly reduced - less information required for TAC to accept claims • All relevant information is collected at the time of lodgement so TAC can accept the claim more quickly
3
First Service
First Service Process Map
Hospital PLO
Completes the Claim data Patient Liaison Officer (PLO) completes the claim application including the client consent and sends it to TAC via e-mail (PKI) or fax.
Communication Link
Send claim data via e-mail PKI required
Send Claim Acceptance Result/ Request for further information External Partners
FSO TAC TAC Avanti
Data validation Receives the data Inputs data & create claim in Avanti Make Claim decision & notify client & hospital Make LOE decision & notify client First Service officer (FSO) receives the claim data and inputs the data into Avanti. Then makes a decision on the claim .The result is then sent back to the PLO via e-mail followed by a formal confirmation letter to the client
.(Income decision is also communicated to the client)
First Service
4
•
Pilot to date
The TAC has delivered First Service to 11 hospitals since April 2013 • Three hospitals participated in the First Service Pilot between April and September 2013 whilst eight additional hospitals commenced from 7th October 2013 • These hospitals, including the three which participated in the pilot are: – Alfred Health (
Pilot
) – Royal Melbourne Hospital (
Pilot
) – Barwon Health (
Pilot
) – – – Dandenong Hospital ( Monash Medical Centre ( Maroondah Hospital (
Monash Health Monash Health Eastern Health
) ) ) – – Box Hill Hospital ( Angliss Hospital (
Eastern Health Eastern Health
) ) – – – Western Hospital - Footscray ( Sunshine Hospital (
Western Health
The Northern Hospital
Western Health
)
(Northern Health)
)
Further Information
• Hospitals can contact the TAC directly to seek general information or to enquire about specific TAC clients claims • It is anticipated that the TAC will continue to provide support to hospitals as the First Service process becomes embedded with new hospitals
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First Service
Megan Buick
Lead Stakeholder – Partnerships Health and Disability Strategy Group
Tel/ 52257946
Contact
Kelly Harris
Provider Relationship Coordinator Transport Accident Commission
Tel/52256349
Aaron Murnane
Hospital Engagement – TAC Service Health and Disability Strategy Group
Tel/ 52257558