Authorised Provider Model FAQs

Please read our Authorised Provider Model frequently asked questions below.

    General questions

  • Why has icare developed the Authorised Provider Model?
    The Authorised Provider Model has been developed in response to customer feedback to meet the needs of large eligible customers by creating greater choice of claims management service provider.
  • What will the authorised providers deliver?

    Authorised providers will deliver claims management services to eligible customers in accordance with the principles of icare’s claims management service model for the price of their premium. Find out more about the icare claims service model and claims decision management framework.

    Authorised providers have the ability to offer additional services tailored to meet eligible customer needs in addition to the core services they receive for the price of the policy. These services will be negotiated directly between eligible customers and in some instances will involve a fee from the authorised provider.

     

  • What was the authorised provider pilot?
    icare partnered with Allianz to pilot the Authorised Provider Model with eligible larger customers for the purpose of testing the model from 31 December 2018 to 30 June 2019. icare used the pilot period to evolve the design and delivery of the authorised provider service to meet our customers’ needs. 

    Customer eligibility questions

  • What is the phased approach for eligible customers to choose an authorised provider?

    icare is using a phased approach to allow for a smooth delivery for eligible customers to nominate and transfer to an authorised provider, to minimise disruption for customers.

    Phase one eligible customers

    These eligible customers can now nominate their choice of authorised provider: 

    • Customers where Average Performance Premium (APP) or Basic Tariff Premium (BTP) exceeds $1,000,000 for the most recently issued renewal period or; 
    • Customers that are part of a Group, where its Group Average Performance Premium (GAPP) or Basic Tariff Premium (GBTP) exceeds $1,000,000 for the most recently issued renewal period. 

    Phase two eligible customers

    From 18 February 2020, these eligible customers can nominate their choice of authorised provider and transfer for new claims at renewal date on or after 30 June 2020:

    • Customers where Average Performance Premium (APP) or Basic Tariff Premium (BTP) exceeds $500,000+ or; 
    • Customers that are part of a Group, where its Group Average Performance Premium (GAPP) or Basic Tariff Premium (GBTP) exceeds $500,000+ 

    Phase two eligible customers also include customers who have new claims currently managed at Allianz and GIO. 

    Claims lodged prior to transfer to the authorised provider will remain with the existing provider until all claims are migrated onto the icare claims management platform. 

  • Can customers who were previously granted an exemption to remain with Allianz or GIO transfer to another provider?
    Yes. Phase two eligible customers will also include customers who have new claims currently managed at Allianz and GIO. 
  • Will icare offer smaller customers a choice of provider?
    icare is committed to delivering fair and sustainable outcomes for all customers, regardless of their size. icare has commenced reviewing an industry-based approach that supports small to medium-sized businesses. We will provide more detail on this approach later in 2020.
  • What core services do I receive from my provider for the price of my premium?

    icare continues to use customer feedback to refine our core services and provide coverage that meets customer needs for the price of the premium. For the price of the premium, customers receive access to a pool of skilled case managers, use of icare’s Medical Support Panel and triage tools. 

    icare will share more information on these core services shortly. Customers may negotiate directly with their chosen authorised provider for access to more tailored services, such as a dedicated case manager or a mobile case manager. However, these may involve an additional fee.

  • Can authorised providers make different decisions about claims?

    icare empowers authorised providers to make consistent decisions that deliver fair outcomes for both customers and injured workers. For more information, please refer to icare’s Claims Management Decision Framework.

  • How can I compare the performance of the authorised providers?
    icare publishes provider performance information on the icare website. In addition to considering this information, we encourage customers to discuss their organisation’s unique requirements with potential authorised providers before making a transfer decision. 

    Nomination and transfer questions

  • When can I transfer to Allianz, GIO or QBE?

    Phase one eligible customers can transfer to an authorised provider before their policy renewal date, as follows:

    Transfer date option Nomination deadline Authorised providers available to manage new claims
    1 April 2020 15 March 2020 Allianz and GIO
    1 May 2020 15 April 2020 Allianz, GIO and QBE
     1 June 2020  1 May 2020  Allianz, GIO and QBE
     30 June 2020 (policy renewal date only)  1 May 2020  Allianz, GIO and QBE

    Phase two eligible customers are able to nominate their choice of authorised provider from 18 February 2020 and transfer their new claims management on their policy renewal date on or after 30 June 2020.

    From 1 July 2020, all eligible customers can transfer on their policy renewal date, providing they give 15 days' notice.

  • When can I transfer to QBE?

    Phase one eligible customers can nominate QBE as their authorised provider now. QBE will start managing new claims from 1 May 2020 and they will use icare’s claims management platform to manage new claims. 

    Phase two eligible customers are able to nominate their choice of authorised provider from 18 February 2020 and transfer their new claims management on their policy renewal date on or after 30 June 2020.

  • Can I move from one authorised provider to another?

    In future all eligible customers will be able to transfer from one authorised provider to another (Allianz, GIO, QBE) on their policy renewal date.

    Phase one eligible customers also have the option of transferring before their policy renewal date if they transfer before 30 June 2020.

    For eligibility criteria and transfer dates, please refer to icare’s authorised provider web page. Please note, you can only transfer once during a 12-month renewal period. 

  • Do I need to complete a nomination form if I want to stay with my existing claims service provider?
    Customers who want to stay with current providers do not need to complete a form.
  • How do eligible customers nominate and transfer to an authorised provider?

    Phase one eligible customers have been emailed a nomination form to complete in November 2019 and were sent the form again in February 2020. 

    Phase two eligible customers have been emailed a nomination form on 18 February 2020. Once a nomination is confirmed and accepted, eligible customers will be contacted by the authorised provider for transfer.

    For more information on how to nominate and transfer please contact us at AuthorisedProvider@icare.nsw.gov.au.

  • Will my existing claims transfer to the authorised provider?

    icare is building the technology to manage all claims on a single system. Claims lodged prior to a transfer to an authorised provider will remain with the existing provider until all claims have been moved to icare’s central claims platform. 

    At that time icare will work with the providers to facilitate a customer’s claims to all be managed by their preferred provider. The migration of claims will be phased to minimise disruption for recovery.  More information about this will be communicated to you later in 2020. 

  • When will I be eligible to have my claims managed by an authorised provider?

    Eligible customers can exercise their choice to have their claims managed by an authorised provider in line with the icare phased approach. 

    Upon receipt of a completed nomination form, icare will review the information provided within five working days and confirm by email if the nomination meets the customer eligibility requirements, and if so, the nominated provider will contact the eligible customer regarding transfer of new claims.

    For Phase one customers new claims will be managed by the nominated provider from the beginning of the nominated month. Nominations from 30 June 2020 onwards, may only transfer at renewal date.

  • Can an authorised provider choose not to accept my nomination for transfer?
    No. Once icare has approved a customer’s nomination, the authorised provider must accept the nomination for transfer as per the agreed terms with icare. 

    Technology questions

  • What will happen to my icare claims portal access?
    If you are with EML, and have access to icare’s claims portal, and you choose to transfer to Allianz or GIO, you will not be able to view your new claims on the icare claims portal after your date of transfer.  However, you will be able to continue to view existing claims managed by EML on the icare claims portal, and you will see new claims once Allianz and GIO start using the system.If you are with EML and transfer to QBE you will continue to see all your claims in the portal.
  • Which claims management platform will an eligible customer use?
    Allianz’ and GIO’s existing claims management platforms will be used until the icare claims management platform becomes available.
  • When will the icare claims management platform be available?
    icare is working on delivering the icare claims management platform to be available to all our customers. Presently the platform is not available to all eligible customers. icare will provide more information later in 2020 on the progress of platform delivery.
  • What happens to the claims I lodged with my old provider?
    Any claims lodged prior to transferring to the authorised provider will remain with the existing provider until icare migrates all claims onto icare’s claims management platform.
  • Is EML an authorised provider?
    EML is icare’s default provider and manages many claims across the scheme. For those customers who choose not to transfer new claims to Allianz, GIO or QBE, EML will continue to be the default provider.
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