Department of Health PTSS. Patient Travel Subsidy Scheme. Information for patients and their carers. December Great state. Great opportunity.

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1 Department of Health PTSS Patient Travel Subsidy Scheme Information for patients and their carers December 2012 Great state. Great opportunity.

2 Contents What is the Patient Travel Subsidy Scheme (PTSS)?...3 Do I need to travel?...4 Patient Travel Subsidy Scheme eligibility...4 Other requirements...5 Types of assistance...5 What is not covered?...8 How do I apply?...9 How do I organise my travel?...10 Subsidy payments...10 Expectations...11 There is an expectation that:...11 Appeals...11 Feedback and complaints...11 PTSS Information for patients and carers Page 2

3 What is the Patient Travel Subsidy Scheme? The Patient Travel Subsidy Scheme (PTSS) provides financial assistance for travel and accommodation to patients, and in some cases their carers, to enable them to access essential specialist health services that are not available locally. The PTSS is managed through Queensland public hospitals that accept, assess, approve and fund all PTSS applications and subsidies. It is important to note that the PTSS is for Queensland residents only residents of another state or territory will need to apply to the relevant jurisdiction for assistance. The purpose of the scheme The purpose of the PTSS is to assist patients, particularly rural and remote patients, who are required to travel more than 50 kilometres from their closest public hospital when the specialist service they require is not available at their closest public hospital. The following are the broad principles of the PTSS: 1. As safe and sustainable health services cannot be provided at every location across Queensland, patients may sometimes be required to travel to access health services. 2. PTSS is a subsidy only and is not intended to cover all costs associated with travel. 3. As assistance cannot be provided to every patient required to travel for health services, assistance will be: based on clinical need targeted towards patients: that are Australian citizens or are eligible for Medicare whose principal place of residence is in Queensland or those with no fixed address that are in most need of assistance those who are most disadvantaged with regard to access to specialist health services that are referred by their doctor to a specialist service that are requiring essential specialist medical services. 4. PTSS is not intended to support choice of specialists. Assistance will only be provided to the closest available service of its type. 5. Assessments of PTSS claims are made by a Hospital and Health Service (HHS) officer in accordance with approved guidelines and taking into consideration the recommendations of the referring medical practitioner and other relevant health professionals. 6. It is the patient s responsibility to get to their closest public hospital. As such, assistance starts from the patient s closest public hospital and not from their place of residence. Likewise, assistance is not provided for travel to the patient s closest public hospital. 7. Information about PTSS and how to apply for assistance should be reasonably accessible to all Queenslanders. 8. PTSS does not replace the need for local health services and public transport services. 9. Where possible, initiatives should be undertaken by the HHS to reduce the need for patients to travel and support the delivery of health services in regional areas. PTSS Information for patients and carers Page 3

4 Do I need to travel? Even though the specialist or specialist service you require is not physically provided in your local area, you may be able to access these services without having to travel, through the use of Telehealth. What is Telehealth? Telehealth is the use of a TV screen or a computer screen, a small camera and microphone to transfer audiovisual and other media to the treating health professional. This allows the treating health professional to see and speak to you as if they were doing this in person. What are the benefits of using Telehealth? Using Telehealth has the following benefits: you no longer have to travel significant distances to obtain treatment you no longer have to be away from home, family or work for a period of time you no longer have to pay for expenses associated with travelling your local doctor or health professional (such as a nurse practitioner, midwife, practice nurse or Aboriginal health worker) will be with you. This means that they have a better knowledge of your healthcare requirements and can better assist your condition locally. Further information on Telehealth is available from your local hospital or Patient Travel Subsidy Scheme eligibility To be eligible for PTSS, you must be: a Queensland resident or a patient with no fixed address eligible for Medicare accessing a specialist medical service that is: recommended as medically necessary by your doctor listed under Schedule 1 as an essential specialist medical service not available within 50 kilometres of your nearest public hospital the closest service of its type. Sometimes assistance is available from other sources, including the Department of Veterans Affairs or other third-party, insurance or workers compensation claims. However, when treatment is needed, the level of assistance may not be known or the assistance may not be available for a long time. Under these circumstances you may still be eligible for assistance under PTSS. However, please note that you may be required to pay back any PTSS subsidies should your claim from another source be successful. PTSS Information for patients and carers Page 4

5 Exceptions to eligibility If you have family or friends living near a service that is not the closest, you may be able to travel to this service even though it is not the closest if the total amount of PTSS subsidies is equal to or less than that which would have been provided to travel to the closest service. If you have been taken to a specialist medical service in an emergency situation (including as an inter-hospital transfer) you can be assisted with return travel and accommodation even if the service that you have been taken to is not the closest available, as long as the service is more than 50 kilometres from your closest public hospital. Note: this is only applicable within Queensland and you must meet all other criteria. Other requirements You must obtain approval for assistance prior to travel, unless you: were not aware of the scheme and/or were not aware that you had to obtain approval prior to travelling this exception is applied once only per patient were not originally going to claim PTSS for your specialist visit, but need unexpected treatment when at your specialist appointment and subsequently want to claim PTSS required urgent travel and did not have adequate time to apply have travelled to receive treatment and subsequently require an escort to join you approval must be obtained prior to the escort travelling. Note: you must satisfy all other criteria. Assistance will only be provided to the extent to which it would have been approved had the request been made in the usual manner: Where preliminary services can be provided locally (including through Telehealth), assistance will not be provided for these. If you require further or ongoing specialist treatment: Where follow-up services (such as checking your progress or checking the condition of surgical wounds) can be provided locally, assistance will not be provided. If a closer service is established you will be approved for one additional visit to your original specialist to ensure appropriate hand-over measures are taken. All following appointments must be to the closer service to be eligible for subsidy under the PTSS. Types of assistance PTSS provides subsidies towards the cost of travel and accommodation, however it does not cover all costs (Refer to What is not covered). If the PTSS subsidy amount does not cover all the patient s travel and accommodation costs, the patient is responsible for covering the remaining costs. Note: patients and approved escorts are both this requirement under Schedule 4. It is important to note that the local hospital will only provide subsidies for what has been originally approved. In cases where follow-up, ongoing or further treatment is required (and not approved as part of the original application) approval must be obtained for any further subsidies beyond the original application. PTSS Information for patients and carers Page 5

6 Travel subsidies Your local hospital will provide travel subsidies for the most clinically appropriate and cost-effective mode of transport. Generally, the cheapest form of commercial transport (bus or rail) will be subsidised unless you are approved for a more expensive mode of transport (based on a clinical need and/or if commercial transport is unavailable). Commercial transport costs are covered from the transport terminal (airport, bus station or train station) in the town where your local hospital is located to the transport terminal in the town or city to which you are travelling. If you are required to travel more than 50km from their local hospital to reach the transport terminal, you are eligible for PTSS assistance for this leg of the trip. Once you have reached your destination, it is your responsibility to cover the cost of land transfers, which includes travel between the airport, train station or bus station and the accommodation or the health facility you will be attending. If approved for private motor vehicle travel, travel will be subsidised at 30 cents per kilometre and is calculated from the post office closest to your local public hospital to the post office (or General Post Office) of the town/city you are receiving treatment in. When you travel to a specialist service, you will need to return as soon as practicable after the completion of your treatment (e.g. as soon as transport is available), unless prior approval is granted for special circumstances. In the unfortunate case of requiring return transport for a deceased person, a relative will be provided with a subsidy equivalent to a full economy airfare, to the nearest airport to the deceased person s normal place of residence. Accommodation subsidies Accommodation will only be subsidised for the minimum period you are required to be away from home for medical reasons. For PTSS travel on or after 1 January 2013, you and your escort (if approved) are subsidised at $60 per person per night when staying in commercial accommodation. If you and your escort (if approved) choose to stay with friends or relatives (i.e. private accommodation), you and your escort are subsidised $10 per person per night. One night s commercial accommodation may be arranged if you would be travelling by car for more than 600 kilometres or for more than eight hours in one day. You would need to discuss this with the PTSS officer at your local hospital prior to travel. Note: the requirement for the patient and approved escort to both pay for the first four nights of accommodation (commercial and/or private) in each financial year still applies in each case (see Schedule 4). Patients may require accommodation prior to early morning appointment or admissions, or following late appointments. If you are away from home for an extended period of time, the need for accommodation subsidies will be reviewed every month. PTSS Information for patients and carers Page 6

7 Assistance for escorts Transport and accommodation subsidies for family or friends to escort you can only be approved if they are necessary for your medical treatment, which may in some cases include assistance with either the demands of treatment, or the demands of living away from home. Escorts are automatically approved where you: are under 17 years of age; or need assistance to travel safely following sedation, parenteral analgesia or requiring oxygen. If you do not meet these criteria, the approving officer will consider the following conditions for approval of an escort: Will you be unable to look after yourself where you are going? Will someone be needed to participate (or trained to participate) in your physical care or rehabilitation? Is there anyone where you are going that can assist you in these ways? In addition, transport and accommodation subsidies can only be provided for the minimum number of escorts that are absolutely necessary for your medical treatment to be effective. If escort assistance is approved, it will usually be for only one other person to travel with you. If you require more treatment, reapproval of an escort is also required. If you have been approved for private motor vehicle travel and your approved escort travels with you, only one private motor vehicle subsidy will be provided. Co-payments Unless you qualify for a reduced contribution, you are required to contribute the first four nights of accommodation per financial year. Patients that qualify for a reduced contribution are: Health Benefits Card holders (replaced by Health Care Card from 31 July 1997) Health Care Card holders Pensioner Concession Card holders Commonwealth Seniors Health Card holders All dependent children under 17 years of age. Approved escorts are also required to contribute to the first four nights of accommodation per financial year unless the patient they are travelling with is eligible for a reduced contribution. PTSS Information for patients and carers Page 7

8 What is not covered? The PTSS only provides a subsidy towards some travel and accommodation expenses, it does not cover all costs including: transport (e.g. taxi fares) from your residence to your local transport terminal and vice versa transport from the terminal in the town or city to which you are travelling to your accommodation facility or treatment facility transport from your accommodation facility to your treatment facility and vice versa meals and incidental expenses such as telephone calls the GST portion of your expenses when these are booked by you. In addition: If you choose to travel via a more expensive mode of transport than what is approved, you are responsible for covering any additional costs. If you are travelling by private motor vehicle, subsidies are calculated by your local hospital using the most appropriate route from the Whereis.com electronic planner. If you choose to travel a different route, you will be responsible for any additional costs. Your local hospital does not cover any additional costs associated with your motor vehicle such as running or maintenance costs. Patients are required to take out adequate insurance when travelling interstate as the PTSS does not cover interstate travel unless you are referred to an interstate medical specialist. As such you are not eligible for PTSS if you: are travelling interstate for any reason (work, holiday etc) and require unexpected treatment while interstate live near the border and go to a health facility in another jurisdiction. PTSS Information for patients and carers Page 8

9 How do I apply? 1. Complete the Patient Travel Subsidy Scheme (PTSS) application form The PTSS application form can be obtained from your local hospital or via the Queensland Health website at Your local general practitioner may also have the PTSS application forms. Submit your application form Submit your PTSS application form to your local public hospital along with supporting documentation, such as proof of residency documents. Please note that any missing information on the PTSS application form could result in processing delays. 2. You can submit the PTSS application form either in person or by mail, fax or . If you mail, fax or your application you will need to: keep copies of the PTSS application form and supporting documents provide a contact number so that you can be easily contacted in case of any issues or if more information is required contact the PTSS office at your local public hospital to confirm that your PTSS application form has been received. The local hospital does not accept responsibility for any lost forms or forms that are not received. Generally, your application will be assessed within two business days once received. If you are required to travel urgently, please notify the PTSS office at your local public hospital as soon as possible. 3. Your application will be assessed and your will be notified of the decision Your PTSS application will be assessed and you will be notified if your application has been approved or not approved. 4. Return your specialist confirmation form and travel documentation If approved, you will be required to get your treating specialist to complete the specialist confirmation form when you attend your appointment. This is to certify that treatment was provided and to notify Queensland Health of any further treatment and travel requirements. Return the specialist confirmation form, along with all travel and accommodation receipts and invoices, to the PTSS office at your local public hospital. The local hospital cannot reimburse you unless this form, all invoices and receipts for travel and accommodation you paid for are provided. Failure to provide this may result in delays in your reimbursement. PTSS Information for patients and carers Page 9

10 How do I organise my travel? Your local hospital may either: process your travel and accommodation subsidy amounts after you have travelled to receive treatment or book your travel and accommodation on your behalf. You will need to discuss available options with the PTSS office at your local hospital. Please note when you book your travel and accommodation the amount reimbursed will exclude the GST amount. If your local hospital is booking your travel and accommodation, you will be contacted to discuss the most appropriate travel itinerary and accommodation options. For your convenience, some information on transport options, accommodation facilities and major hospitals in Queensland are available from the Queensland Health website at Subsidy payments Once you have returned the required paperwork, your subsidy will be forwarded to you within 30 days. Please note: Subsidy payment by Electronic Funds Transfer (EFT) is highly recommended as it reduces the amount of administration needed and you will receive your subsidy sooner. Subsidy payments by cheque take additional time for processing of cheques and postage to your nominated address. Cash payment of subsidies is only provided in limited locations. Patient and escort subsidies will be provided to you as the patient it is your responsibility to forward any subsidies to your escort. If the accommodation provider you used has a bulk-billing arrangement with your local hospital, and you have consented for your hospital to do so, the subsidy amount will be provided directly to the accommodation provider. Please note, you will still be required to pay any amount that your approved subsidy does not cover. Tax invoices are required (from both you or your travel and/or accommodation provider) so your hospital can provide your subsidies. EFTPOS receipts are not sufficient evidence of payment. Tax invoices must have the following information: words to indicate that it is intended to be a tax invoice i.e. tax invoice, GST invoice date of Issue identity of supplier ABN of supplier identity of recipient or ABN of recipient (this is to be Queensland Health when booked by Queensland Health) description, quantity and price of each item supplied total amount payable total amount of GST payable. Queensland Health is unable to pay any subsidy unless a compliant tax invoice has been received for the costs. PTSS Information for patients and carers Page 10

11 Expectations There is an expectation that: You fully complete the PTSS application form and submit it to your local public hospital. You will advise your local PTSS officer if there is a suitable person at the treating location who can provide the required support (instead of an escort accompanying you). You may choose an appropriate escort to accompany you, if approved. It is expected that your escort will provide the assistance you need and remain with you for the required time unless there is an acceptable reason for them to be away from you. You will be willing to change your appointment time if it is more convenient for your travel itinerary. PTSS staff at your local hospital may be able to assist you with this. Subsidies provided by your local hospital are used for the purposes of travelling to the stated specialist health service. Evidence such as tax invoices or tax receipts must be provided to the PTSS officer. Where Queensland Health books your travel and/or accommodation, you will provide reasonable notice (at least 24 hours) of any changes to your itinerary i.e. delays or changes required. If the change or delay is for your convenience, you may be responsible for the costs of re-booking or any charges levied by the provider i.e. cancellation charges. You will make every reasonable effort to attend your appointment and be on time for all scheduled transport arrangements. If you require long-term accommodation, you will work with your PTSS officer to either relocate or find more suitable accommodation (such as rental property). Where you have received subsidies from your hospital, the hospital may recover costs from you if you have received financial assistance towards your travel and/or accommodation costs from an alternative source such as the Department of Veteran s Affairs or an insurance claim. Appeals If you are not satisified with the outcome of your application, you are able to appeal the decision. Please discuss this with the PTSS officer at your local public hospital. Please note that your application will be reassessed in accordance with the eligibility criteria and guidelines. Please provide any additional information to assist the PTSS approver to assess whether your circumstances have changed such that you meet the criteria. Feedback and complaints Feedback from members of the community is always welcomed as it provides the opportunity to review our health services with the aim of improving delivery. All feedback and complaints received by HHSs will be handled in a professional and confidential manner. If you would like to provide some feedback on the scheme or lodge a complaint, you can do so by providing this verbally or in writing to your local PTSS office in the first instance. They will try to resolve any issues that you have, where possible. You can also contact the complaints coordinator of your local hospital to assist even if a formal complaint has not been lodged. Please ensure you clearly describe the circumstances of your feedback/complaint including times, dates, locations, the names of persons involved, the particular issue that you have and what you would see as a PTSS Information for patients and carers Page 11

12 satisfactory resolution. Also, please provide sufficient personal details if your complaint is in relation to your particular PTSS application or treatment and contact details for a HHS staff member to contact you. General information about complaints (no personal information) may be reviewed and used to identify where improvements can and should be made to the Scheme. Alternatively, if you would like to lodge a complaint with the Health Quality and Complaints Commission (HQCC), you can do so by completing the HQCC complaint form. This form is available at or by contacting or (for callers outside Brisbane). Schedules Schedule 1 PTSS subsidies are provided for the following specialist medical services: Anaesthetics ^ Cardiology Cardio-Thoracic Surgery Clinical Haematology Clinical Immunology Dermatology Diagnostic Radiology Endocrinology Gastroenterology General Surgery Geriatrics Gynaecological Oncology Immunology Infectious Diseases Intensive Care Anaesthetics Intensive Care Internal Medicine Internal Medicine Medical Oncology Neurology Neurosurgery Nuclear Medicine Obstetrics & Gynaecology * # Organ transplant recipient Ophthalmology Orthopaedics Otorhinolaryngology Paediatrics Paediatrics Surgery Pathology Plastic & Reconstructive Surgery ~ Psychiatry Radiation Oncology Rehabilitation Medicine Renal Medicine Rheumatology Thoracic Medicine Other services covered are: Dental services where there is gross deformity including congenital abnormalities of the skull and facial structures (e.g. cleft lip and palate); syndromes of cranio-facial distortion; and surgical orthodontic cases where facial disfigurement is such that surgery is required. Health services provided as an essential component of services listed above (e.g. physiotherapy following orthopaedic surgery, psychology assessment in preparation for psychiatric treatment). Maternity/birthing services when a patient is required to travel to give birth. Ante and post-natal appointments are only covered if patient is referred to a medical specialist. Schedule 2 Excluded Medical Services PTSS subsidies will not be provided for the following: Plastic and reconstructive surgery not attracting a Medicare rebate Clinical trials and experimental procedures Laser refractive services Dental services not in Schedule I Organ donation - costs for the organ donor are considered part of treatment and are the responsibility of the treating hospital. Schedule 3 Acceptable Forms of Proof of Residence Primary documents are the patient s driver s licence or evidence of electorate enrolment. Secondary documents include the following documents: o Household utilities or rates notice o Rent bill or household lease agreement o Taxation return o Bank Letter o Tertiary education enrolment o Letter from employer Schedule 4 Reduced accommodation contributions apply for patients in PTSS Information for patients and carers Page 12

13 Urology Vascular Surgery ^ Includes Hyperbaric Medicine * Includes In-Vitro Fertilisation # Includes maternity/birthing services if not provided at patient s local health facility ~ Includes transgender services Includes wheelchair fitting services the following categories: Health Benefits Card holders Health Care Card holders Pensioner Concession Card holders Commonwealth Seniors Health Card holders All dependent children under 17 years of age Definitions Term Bulk-billing Closest public hospital Closest service of its kind Medicare eligible Queensland resident Specialist Specialist medical service Transient patient Definition A bulk-billing arrangement is when the hospital or HHS has an arrangement with the travel and accommodation provider for direct billing of the PTSS subsidies instead of charging patients directly. Patients pay any difference. The public hospital (or public health care facility) geographically closest to where the patient lives. The closest hospital may be in a different HHS. The closest specialist or specialist medical service to the patient s local public hospital that provides the required health care. To be eligible for Medicare the person must be an Australian or New Zealand citizen or have been granted permanent residency status. As persons under Reciprocal Health Care Agreements (RHCA) are to be treated in the same manner as a Queensland public patient, they are eligible for PTSS subsidies. A Queensland resident is a person whose principal place of residence is in Queensland i.e. the place where the patient lives permanently. A specialist for the purpose of this scheme is a medical practitioner (including oral surgeons and orthodontists) who is registered as a specialist (except as a specialist in general practice) by the Medical Board of Australia. A specialist medical service for the purpose of this scheme is a health service that provides specialist healthcare (listed as an essential specialist medical service in Section 6) to patients. A transient patient is a patient who does not have a principal place of residence i.e. retired couples who have sold their home and are travelling around Australia living in their caravan. About this booklet This booklet only provides limited information on PTSS and is intended as an information source only. Every effort has been made to ensure that the information in this booklet is accurate and up-to-date. PTSS Information for patients and carers Page 13

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