Working with CTP Care
Information for service providers about working with CTP Care, including how to become a provider, delivering treatment and care, service-related expenses and client privacy.
Select from the topics below:
Becoming a provider
If you’re new to CTP Care, register your vendor details with us. Go to how to invoice CTP Care for full details.
The State Insurance Regulatory Authority (SIRA) provides online education and training for allied health professionals and medical practitioners to support your understanding of providing health services in the NSW Motor Accidents CTP Scheme.
Service providers need to be familiar with legislation, guidelines and principles relevant to their area of service provision including:
- Motor Accident Injury Act, 2017
- Motor Accident Guidelines
- Motor Accident Guidelines: CTP Care
- Clinical Framework for the Delivery of Health Services
- icare’s Health Literacy Framework (PDF, 0.3MB)
When providing services paid by CTP Care, please note the legislative requirements and contact details are different to all other schemes operated by icare.
Selection of service providers
Clients are supported to choose quality service providers who meet their reasonable and necessary treatment and care needs.
Some clients may use their transfer to CTP Care as an opportunity to try new service providers, while some may continue with providers known to them.
CTP Care does not have an approved provider panel. Providers are selected from the marketplace, or approved panels including those managed by SIRA or Lifetime Care.
When a client requires guidance on finding providers the CTP Care contact may offer support by providing:
- a copy of the Choosing a service provider in CTP Care (PDF, 0.1MB)
- advice on and joint exploration of online search sites
- the names of at least two suitable providers in the client's local area that can deliver the required specialised services.
Obligations of service providers
CTP Care expects all service providers to maintain professional registrations and memberships, including insurances and relevant government checks. Your obligations are outlined in full on the final page of the Service Approval/Purchase Order we send you.
If you cannot comply with the obligations stated on the Service Approval/Purchase Order, you must notify the CTP Care contact immediately.
Feedback and complaints
If you are unhappy about something or wish to make a complaint, talk to the CTP Care contact, as they may be able to sort out your concerns immediately. Go to CTP Care’s Feedback and complaints page for full details of the complaints process.
Monitoring client engagement and progress
CTP Care proactively monitors a client's progress and their engagement with services.
We apply procedural fairness and confidentiality when monitoring treatment programs and managing any issues that may arise. We do this at both a client and systemic level. If an issue with a service provider is identified, we will contact you to seek an understanding of what has happened. We will keep you informed as issues are investigated and of the outcome.
CTP Care is obligated to report all service provider payments we make to SIRA in accordance with all SIRA Motor Accident Guidelines and the Motor Accident Injuries Act, 2017.
Treatment and care
The treatment and care services CTP Care pays for must be delivered in accordance with the Motor Accident Injuries Act, 2017. The Motor Accident Injuries Act, 2017 is the same Act applied to the client's treatment and care while with the CTP insurer. The same Motor Accident Guidelines inform our decisions, but how you work with us may be slightly different.
Service requests
Services may be requested by:
- clients and/or their families
- service providers, including the client's treating health care team at the hospital, rehabilitation unit or in the community.
Go to request services from CTP Care for full details of the request process.
How we assess treatment and care requests
CTP Care assesses each treatment and care request to ensure it is reasonable and necessary as required by the Motor Accident Injury Act, 2017.
What is 'reasonable and necessary' can differ from person-to-person, even for the same type of injury. As such, we consider requests on a case-by-case basis.
We make decisions based on the information you and the client provide to us in a request. If we are not satisfied that a request meets SIRA's 'reasonable and necessary' criteria, we will either ask for additional information or not approve the service.
Go to request services from CTP Care to learn more.
How we communicate decisions to you
Within 10 days of receiving a treatment and care request, we will formally communicate the outcome to you and the client. You will receive a Service Approval/Purchase Order detailing the services which have been approved.
The Service Approval/Purchase Order includes the:
- CTP Care client’s name
- claim number
- type of service
- number of hours/session(s)
- period of time for service delivery
- the amount/costs.
If a client asks you to provide services not covered by a current Service Approval/Purchase Order, please call or email the CTP Care contact or call our general enquiries phone number 1300 738 586 before commencing treatment.
If we can't approve the requested services, we will explain why.
When to commence service
After you’ve received our Service Approval/Purchase Order, you can schedule an appointment with the client for the approved services. We can't guarantee payment for services delivered prior to approval.
After delivering services to the client, send us your correctly rendered tax invoice.
For details of what to include on your tax invoice, refer to Invoicing requirements – CTP Care (PDF, 0.1MB)
The client needs a few more sessions
Call or email the CTP Care contact directly if the Service Approval/Purchase Order has run out and the client continues to have a need. A call or email may be all that is necessary to secure approval for the additional sessions or to extend the service delivery period.
If the client requires a more substantial service extension, a SIRA request form may be required. The CTP Care contact will guide you on this.
When you disagree with a treatment and care decision
In accordance with all SIRA Motor Accident Guidelines, only a client can apply for an internal review if they disagree with a decision. Go to CTP Care’s internal review process for full details.
Funding considerations
Funding of interpreter services
CTP Care pays for interpreter services where necessary for clients to engage fully in their treatment. The CTP Care contact will let you know if a new referral will require an interpreter service and can assist with arranging this.
Funding of mobile and home-based services
A mobile service may only be considered if the client can't travel, or your service is best delivered in the client's home, workplace or community. Please ensure the reason for a mobile service is described in the treatment and care request. We will decide the associated travel costs in alignment with the reasonable and necessary criteria. Please call or email the CTP Care contact if you have any questions.
CTP Care does not pay provider travel if the only reason a home-based service is needed is because the provider does not have accessible premises in which to deliver their services. Clients are encouraged to choose a local provider to minimise the potential burden of travel and fatigue.
Funding time to prepare reports
You are expected to keep clinical records as part of your service provision and not as an additional service.
We can only fund your time to prepare reports if the report and the preparation time are included in the Service Approval/Purchase Order.
If CTP Care needs a report from you, the CTP Care contact will discuss this with you when you are engaged to deliver services to a client.
Where initial assessment reports and progress reports have been approved, it is expected these will be shared with the client and with CTP Care. Initial assessment and progress reports need to include:
- status at the commencement of the service period (in direct relation to your area of intervention and goals of service)
- goals or objectives for the proposed intervention or services (these should be observable and measurable)
- functional capabilities expected to be impacted by interventions
- a brief summary of service/s provided, including attendance record and compliance with home programs
- objective measures of outcome.
Payment of fees for late cancellations and non-attendance
Under the Motor Accident Injury Act, 2017, no fees are payable by CTP Care for client cancellation or failure to attend scheduled sessions.
Service providers are expected to have business systems to minimise the risk of late cancellations or non-attendance. Please discuss with the client or their support person the best way to send reminders and confirm appointments. Ensure you advise your timeframe requirements for rescheduling or cancelling appointments.
Privacy
For information on the way icare collects, uses, stores and discloses personal and health information go to icare's Your privacy page.
For specific details relating to CTP Care, refer to CTP Care's privacy principles (PDF 0.1 MB).
