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					                    HEALTH DEPARTMENT OF WESTERN AUSTRALIA

                                          CIRCULAR

Applicable to: ALL HOSPITALS

Enquiries to:     Administrative Services                           Number:       A 5656
                  (ext. 638)                                        Date:         5 October 1984
File No:          5223/83/11


Subject:     MOTOR VEHICLE THIRD PARTY INSURANCE PATIENTS' FEES



      Under the provisions of the Commonwealth/State Medicare Agreement and the Hospitals
      (Services Charges) Regulations a compensable patient is not eligible to elect to be a public
      patient or a private patient. A motor vehicle accident patient must be classified as a
      "compensable patient" if in respect of the injury for which he is being treated he has
      received or established a right to receive payment by way of compensation or damages,
      including a payment in settlement of a claim for compensation or damages.

      Public hospitals classify as "compensable" those motor vehicle accident patients who have
      a current claim on the Western Australian Motor Vehicle Insurance Trust (or similar
      authorities in other States) but do not classify as compensable those patients who have
      received an award or out-of-court settlement to meet the cost of future hospitalisation for
      their compensable injury. In future, compensable charges should be raised against such
      patients until award or settlement moneys have been utilised from which time the person
      will cease to be a compensable patient and will be eligible to be a public patient or a private
      patient.

      To ensure all motor vehicle accident patients are correctly classified as compensable,
      public or private, it is important that they be asked whether they are being admitted
      because of a motor vehicle accident and, if so, they should complete the attached revised
      form HA22B (redesigned for use by patients entitled to compensation and by those who
      have received awards or out-of-court settlements).             In determining the inpatient
      classification, total reliance should be placed on information supplied by the patient.

      If a patient who has received an award or a settlement following a motor vehicle accident is
      unable to complete part B of Form HA22B because he is unsure that any money was
      included in the award/settlement to meet future hospital expenses the hospital may assist
      in determining this matter by studying the court award judgement or the out-of-court
      settlement details which may possibly be obtained through the Department (for
      non-teaching hospitals) if the patient does not hold a copy of such documents. The
      Departmental contact officer is the Clerk in Charge, Clerical Section. The following
      guidelines are given to assist in determining whether to classify the patient as
      compensable:-

      (i)    If no costs for future hospitalisation are provided the patient should not be classified
             as compensable and may elect to be admitted as a public patient or as a private
             patient.




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(ii)    If an amount for future hospital costs is provided, the patient should be charged the
        appropriate compensable rate until such moneys have been expended. Patients
        should certify in writing when their award/settlement funds become exhausted from
        which time they will cease to be compensable and may elect to be a private patient
        or a public patient.

(iii)   If the award/settlement includes an amount for future medical costs it should be
        regarded as including required hospitalisation costs unless the patient can establish
        that hospitalisation costs have not been included. The Department should be
        contacted for advice about patients with this type of award or settlement.

(iv)    If the award/settlement provided for a lump sum amount for general damages
        making no reference to future hospital or medical costs the patient should not be
        classified as compensable and may elect to be admitted as a public patient or as a
        private patient.

(v)     If a lump sum is provided and stated to include but does not specify an amount for
        future hospitalisation, charge the patient as a compensable patient until he can
        demonstrate that the total amount charged for hospital treatment has reached a
        reasonable assessment of the amount included in his lump sum settlement for
        hospital treatment. The patient should cease to be a compensable patient from the
        date the assessed amount has been used. The Department should be contacted
        for advice about patients with this type of award or settlement.

Where a patient is classified as "compensable" new Form HA22C should be completed
indicating the elected inpatient status if award/settlement moneys become exhausted or the
compensation claim is rejected. This election classification should be agreed at the time by
the patient's doctor.

Fees charging and statistical recording arrangements for motor vehicle insurance accident
patients are:-

1.      Patients who have lodged claims or who intend to lodge claims against the Western
        Australian Motor Vehicle Insurance Trust:-

        Classify as "Motor Vehicle Insurance Trust" but do not raise any fees because
        special payment arrangements exist with the Trust. (Department submits a claim on
        behalf of hospitals.)

2.      Patients who have received awards/settlements for hospital costs:-

        Classify as "Motor Vehicle Insurance Other" and charge compensable patient rates
        until award/settlement funds are exhausted and then classify and charge or treat
        without charge in accordance with the patient's election on Form HA22C.

3.      Patients who have lodged claims or who intend to lodge claims against other States'
        Motor Vehicle Third Party Insurance Authorities:-

        Classify as "Motor Vehicle Insurance Other" and charge compensable patient rates
        and send accounts to the patients or to the authorities (if known).




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4.     Patients classified as "Motor Vehicle Insurance Other" (2 and 3 above) should be
       shown in the appropriate MVIT days column of the inpatients' fees journal, the days
       circled (for identification purposes) and a suitable comment made in the remarks
       column. Care must be taken not to include these days in the monthly returns sent
       to the Motor Vehicle Insurance Trust or in the annual return of MVIT days sent to the
       Department.

Hospitals should implement this policy for all new admissions. Patients presently in hospital
who are known to have received an award or a settlement to meet future hospital expenses
should be informed of the change in policy and a social worker's assessment made of their
ability to pay compensable rates from the date of their current admission.

Any motor vehicle accident outpatients who have received awards/settlements for future
hospital costs should be charged and compensable outpatient fee as set out in the
Determination made by the Minister (currently $33 in teaching hospitals and $28 in
non-teaching hospitals).

This circular covers patients regarded as compensable because they have received an
award/settlement under Motor Vehicle Third Party Insurance and does not relate to
Workers Compensation Act patients or Merchant Seamen who have received
compensation or damages because under the appropriate legislation such payments would
not include money for future hospital costs. Such persons admitted after receiving
settlements are not compensable patients and may elect to be treated as public or private
patients. Prior to settlements they are regarded as compensable, as at present, and should
complete Form HA22C to cover a situation of a claim for compensation being rejected.

If hospitals have any queries about any aspect of this circular the Department should be
contacted for advice. The matter will receive immediate attention.




W D Roberts
COMMISSIONER OF HEALTH
                                                                                       HA 22 C

                         COMPENSABLE PATIENT DECLARATION


I _______________________________________________________________________
                             (full name of patient)

Tick one box:

¨       have received an award/out-of-court settlement under Motor Vehicle Third Party
        Insurance to cover the cost of this hospital treatment.

¨       believe I am eligible to claim compensation/damages under Workers’
        Compensation, Motor Vehicle Third Party Insurance or as a Merchant Seaman for
        the cost of this hospital treatment.


When my award or settlement moneys are used up or if my compensation/damages claim
is unsucessful (for whatever reason), I elect to be a:

¨       Public (Non-chargeable) patient, in which case I will not be charged for hospital
        accommodation or medical or other services provided during my hospitalisation.

¨       Private (Chargeable) patient, in which case I will be:

        (1)     the private patient of the doctor under whose care I have been admitted.

        (2)     responsible for fees for medical services.

        (3)     responsible for the hospital’s accommodation charge.


Signature of Patient       _________________________________

Date:                      ___/___/___


NOTE:

If the patient is a minor or is unable to sign, the next of kin or the person responsible for the
patient should sign hereunder and print his/her full name (for identification purposes).

Signature                         _________________________________

Date:                             ___/___/___

Full name of person signing
                                                                                                                                                   HA 22 B
                                                  HEALTH DEPARTMENT OF WESTERN AUSTRALIA

                                                    VEHICLE ACCIDENT PATIENT DECLARATION


PART “A” (COMPLETE IF YOU BELIEVE YOU ARE ENTITLED TO COMPENSATION/DAMAGES

I _______________________________________________________________________________________________________________
                                                        (FULL NAME)

of ______________________________________________________________________________________________________________
                                                      (FULL ADDRESS)

believe I am entitled to compensation or damages under Motor Vehicle Third Party Insurance and submit the following details about the accident:-

(1)       Date of Accident:

(2)       If a Police Officer attended the accident scene what was his name:-

          ____________________________________________________________________________________________________________

(3)       Please give a brief description of the accident:-

          ____________________________________________________________________________________________________________

          ____________________________________________________________________________________________________________

          ____________________________________________________________________________________________________________

(4)       Was more than one vehicle involved?         Yes/No

(5)       Were you the Driver?             Yes/NO

(6)                  were all of the vehicles:-
                     (a)         Commonwealth Government vehicles?                                                                      Yes/No
                     (b)         Vehicles registered in the Eastern States?                                                             Yes/No
                     (c)         Unregisterable vehicles, eg. off road vehicles?                                                        Yes/No
                     (d)         A combination of (a), (b) and (c)?                                                                     Yes/No

(7)       Details of vehicles involved:-

                                           Vehicle I was in                 Second Vehicle                 Third Vehicle (if any)
          Type of vehicle

          Registration Number

          Owner’s Name

          Driver’s Name and address




If you were the driver in a one vehicle accident or if all vehicles in the accident were CommonweaIth Government vehicles or vehicles registered in the
Eastern States your hospital costs are not the responsibility of the Australian Vehicle Insurance Trust. If hospitalisation costs are the responsibility of
another authority please advise:-

(a)       Name of Authority: ____________________________________________________________________________________________

(b)       Address of Authority: __________________________________________________________________________________________


PART "B" (COMPLETE IF YOU HAVE RECEIVED COMPENSATION OR DAMAGES FOR THE ACCIDENT)

I ________________________________________________________________________________________________________________
                                                        (FULL NAME)

of ______________________________________________________________________________________________________________
                                                      (FULL ADDRESS)

do/do not have money specifically awarded or paid to me for the costs of this hospital treatment.


PART "C" (SIGN AFTER COMPLETING PART "A" OR PART "B"

SIGNATURE OF PATIENT _________________________________________________________                            DATE ___________________
(or person responsible for patient)

SIGNATURE OF HOSPITAL OFFICER RECEIVING PATIENT _____________________________________________________________

				
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