In short: DocHelp sets up TAC and WorkCover billing correctly in Best Practice, builds tracking worksheets for scheme accounts, and manages medico-legal report requests, scoping, quoting and billing for GPs and medical centres in Melbourne and Australia-wide.
Compensable patients are billed wrongly, reports are under-quoted or written for free, and accounts sit unpaid because nobody is tracking them. We set the schemes up correctly in Best Practice, build the tracking worksheets, and work with doctors and lawyers on the reports so the practice is paid for the work it already does.
WorkCover · TAC · DVA · Medico-legal reports · Tracking
First, the consultation is billed to Medicare because reception did not know the patient had a claim, or the claim details were never entered. The scheme fee is higher than the rebate, and the claim is now wrong. Second, the scheme account goes out and nobody follows it. Ninety days later it is still unpaid and nobody can say why. Third — and this is the big one — a lawyer writes asking for a report, the doctor spends hours on it, and the practice invoices it at the scheme’s short-report rate, or not at all.
We have run this in our own centres for fifteen years. Done properly it is a straightforward, well-paid part of general practice, and one that patients with serious injuries need done well.
The RACGP’s guide to preparing medical reports is clear: report preparation falls outside Medicare, and the fee is agreed between the doctor and whoever asks for it. What that means in practice depends on who is asking.
Treating practitioner reports requested by the WorkSafe agent or the TAC are paid under their published fee schedules — short, standard and comprehensive categories with a fixed maximum for each, updated each July. Bill the right category, on time, with the claim details, and follow it up.
A medico-legal report for a claim is a different service: a full chronology, treatment history, and an opinion on causation, capacity and prognosis, prepared to the lawyer’s brief. It is quoted to the requesting firm before the doctor starts, on the hours and complexity involved, with payment terms agreed in writing.
The largest single report fee we have had paid is $10,500, for a medico-legal report requested for a WorkCover patient. The clinics we walk into have typically never billed a report above $1,500. The difference was not the doctor — it was scoping the request, quoting the real work, and billing the right party.
A written brief of what the report has to answer, the records pulled and the chronology drafted, the consent documented, and a fee agreed before a word is written. The doctor writes the opinion. Everything else is ours.
Compensable accounts are the ones that go unpaid because they sit outside the daily Medicare batch. We build the tracking so they cannot.
Patient, claim number, insurer or agent, date of service, item, amount, date sent — entered the day the account goes out, by the person who sent it.
Scheme remittances matched line by line. Paid amount recorded — not the invoiced amount — with any shortfall queried the same week.
Anything unpaid at thirty days is followed up with the case manager, with the call noted on the worksheet. Nothing reaches ninety days unnoticed.
One page for the owner: scheme billings, outstanding, average days to payment, reports quoted, reports paid. Doctor pays flow from the same sheet.
No. WorkCover and TAC consultations are billed to the scheme under its own fee schedule and item codes, with the claim number and accident date on the account — never to Medicare. Billing a compensable injury to Medicare is one of the most common errors we find in audits, and it is both a compliance problem and lost revenue, because the scheme fees are higher than the Medicare rebate.
No. The RACGP’s own guide states plainly that the preparation of medical reports falls outside the scope of Medicare. Reports are paid for by whoever requests them. When WorkSafe or the TAC request a treating practitioner report they pay a fixed maximum under their published fee schedules (short, standard and comprehensive report categories). When a patient’s lawyer requests a medico-legal report for a claim, that is a separate service billed to the requesting firm at a fee agreed for the work involved.
A treating practitioner report requested by the WorkSafe agent or the TAC answers their questions at their capped fee. A medico-legal report requested by a lawyer — for a common law claim, an impairment dispute or a serious injury application — is a different, usually much larger piece of work: a full chronology, treatment history, and an opinion on causation, capacity and prognosis, prepared to a brief. It is quoted to the requester before it is written, and the fee reflects the hours, the complexity and the doctor’s time. Most practices bill it as if it were a scheme report and lose thousands.
There is no ceiling on a lawyer-requested medico-legal report — the fee is agreed with the requester and should reflect the actual work. The largest single report fee DocHelp has had paid is $10,500, for a medico-legal report requested for a WorkCover patient. The practices we walk into have typically never billed a report above $1,500, and in twelve years before that one we had not seen one above $2,500. We are not promising that figure; we are saying the ceiling most practices assume does not exist.
Yes. We work with the doctor and the patient’s legal team on what the report needs to answer, agree scope and fee in writing before the doctor starts, and manage the timeline, the consent and the invoicing so the doctor writes and the practice gets paid.
With a worksheet per scheme, updated as accounts go out: patient, claim number, date of service, item, amount, date invoiced, date paid, rejections and follow-up. It is reconciled against the practice software and the scheme remittances so nothing sits unpaid for ninety days because nobody noticed.
General information for practice owners and managers. Scheme fee schedules are published by WorkSafe Victoria and the TAC and change each July; medico-legal report fees are a matter for agreement between the practitioner and the requesting party. This page is not legal, tax or financial advice.