We work with medical and allied healthcare professionals to deliver treatment, rehabilitation and care for people who are injured or unwell in NSW.
We do this through three different schemes:
- icare workers insurance: treating people who are injured in a NSW workplace
- icare dust diseases care: treating workers who have been diagnosed with a work-related dust disease
- icare lifetime care: treating people who have been severely injured in a motor accident (NSW)
Administrative Changes to Provider Services Deeds
Through the workers compensation system and our care schemes, we work with a range of practitioners including GPs, allied health professionals, case managers, rehabilitation practitioners, attendant and domestic care providers, equipment providers, home maintenance providers, and a range of others.
icare are transforming the NSW Workers Compensation Scheme and announced the selection of EML, GIO and Allianz to continue as Claims Service Agents beyond 31 December, 2017. These organisations will work closely with icare and our customers to provide a smooth and uncomplicated transition to the new claims service model over the coming months.
Because we’re legislated by NSW legislation, there are some providers who need to be approved or appointed to provide services.
Becoming a medical service provider with us is different for each scheme. For information specific to the scheme you want to work with, select from the accordion below.
icare workers insurance
Medical practitioners providing treatment to injured workers should refer to the State Insurance Regulatory Authority (SIRA) for guidelines, forms and information.
Medical and healthcare professionals working in the workers compensation system are identified by SIRA as:
- A nominated treating doctor (NTD)
- Injury management consultants
- Approved medical specialists
- Assessors of medical impairment
- Surgeons and Orthopedic Surgeons
- Independent medical examiners
- Medical specialists
The SIRA website has specific definitions for each of these roles and what they can do.
SIRA has also produced a comprehensive workers compensation guide for medical practitioners, containing information about your role and responsibilities as a treating doctor or other healthcare professional.
icare lifetime care
Most icare lifetime care participants have a case manager who acts as a single point of contact to both the participant and other service providers.
The types of service providers we generally work with include:
- medical practitioners and allied health professionals
- case managers
- attendant care providers
- other service providers, including equipment suppliers and home maintenance or modification providers.
If you want to provide services to a participant, you will first need to liaise with the case manager. If the participant doesn’t have one, you can contact their icare lifetime care coordinator.
The case manager is responsible for developing a treatment and rehabilitation plan with participants, and most services are requested as part of plan. Care needs are usually reviewed by a health professional and requested as part of a care needs review.
There are other services that may be requested directly by other service providers, such as equipment, vehicle and home modifications but this should be in consultation with the participant’s case manager.
All requested services must meet the criteria of being ‘reasonable and necessary’.
If you want to become a case manager or attendant care provider, you will need to be approved by us to deliver services to our participants.
We also have a panel of building modifications occupational therapists and project managers.
All other service providers don't need to be approved or appointed to work with in icare lifetime care participants.
Before providing services or equipment to a participant you should:
- Work with the case manager or coordinator to obtain relevant information.
- Request approval for your services and don’t provide any services that haven’t been approved
- Check the details of the service approval. Service approvals will be detailed in a certificate or purchase order. This will include the approval number (RP), payment codes, type and amount of service approved, and start and end dates. The case manager or coordinator will provide you with a copy of this certificate or purchase order.
- You should not provide services beyond the end date of the approval on the certificate, or more services than what has been approved.
- If you think the participant needs additional services, you can liaise with the case manager or coordinator to request these.
icare dust diseases care
We provide care for workers with a dust diseases in partnership with service providers including:
- medical practitioners
- allied healthcare professionals
- other service providers, including equipment providers and lawn mowing services.
Medical treatment we can pay for includes:
- doctor's visits and medication, including home-based oxygen and nebulisers
- ambulance services to transport the worker to a doctor or hospital because of their dust disease
- treatment for their dust disease in a hospital or nursing home, or in a palliative care or rehabilitation centre
- therapeutic treatments like exercise and massage
- respite care (out of home) or rehabilitation centre admissions
- wheelchairs and other mobility aids - like walking frames or motorised scooters
- therapeutic needs - like reclining chairs, beds, pressure relief cushions, and shower chairs
Under the legislation, we are only able to provide treatment that is considered ‘reasonable and necessary’ and related to the worker’s dust disease.
If you have provided medical services to a worker with a dust disease, you can send your invoices directly to us for payment.