Item number Service description WorkSafe price (excl GST)* HSNC101 Hearing Needs Assessment Audiologist $160.50

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1 Fee Schedule for non-contracted providers Hearing services Effective as at 1 July 2009, WorkSafe Victoria (WorkSafe) will pay up to a maximum amount for the following categories of the service. Amounts shown are per service unless otherwise indicated. Item number Service description WorkSafe price (excl GST)* HSNC101 Hearing Needs Assessment Audiologist $ HSNC102 Hearing Needs Assessment Audiometrist $ HSNC201 Hearing Device Fitting Package monaural $ HSNC202 Hearing Device Fitting Package binaural $ Paid only once per worker in any 5 year period unless prior approval obtained from WorkSafe Agent HS001 Management Fee Monaural or Binaural Hearing Aid/s excluding GST * $ HSGST001 GST Component of Management Fee $25.79 HS002 Management Fee Assistive Listening Device/s excluding GST* $82.55 HSGST002 GST Component of Management Fee * $8.26 HS003 Hearing Review and/or Hearing Device Maintenance Audiologist $125.10/hr HS004 Hearing Review and/or Hearing Device Maintenance Audiometrist $108.80/hr Paid up to a maximum of 7 hours within a 5 year period unless prior approval obtained from WorkSafe Agent HS005 Hearing Device Repairs Max $ Payable only if copy of manufacturer s invoice for repairs is provided GST * WorkSafe billing requires the GST component of the Management fees for Hearing Aids and Devices to be itemised separately on invoices. For other items, amounts published have not taken into account that GST may apply to certain services. Where deemed appropriate by WorkSafe, an amount taking into account GST will be added to the listed amount. Edition No. 5 May 2009

2 Hearing services Information for contracted and non-contracted providers This information must be read in conjunction with the WorkSafe Victoria (WorkSafe) Hearing Services and Devices Policy. The policy is accessible at the WorkSafe website: under Healthcare Providers > Allied Health Providers > Hearing Services. Who can provide hearing services and devices? Hearing services and devices can be provided by WorkSafe approved hearing service providers. To apply to become an approved provider for WorkSafe, hearing service providers must fill out the WorkSafe Hearing Services Registration Application Form. WorkSafe has entered into contracts with some approved hearing service providers, known as contracted hearing service providers, to provide hearing services and devices to workers. All other hearing service providers are referred to as non-contracted providers. Both contracted and non-contracted hearing service providers will be able to provide approved hearing services and hearing devices to injured workers. Who are WorkSafe s contracted hearing service providers? A list of WorkSafe s contracted hearing service providers can be found on the WorkSafe website under the Hearing Services tab. These providers are contracted to WorkSafe to provide hearing services and devices to workers: with a focus on measuring, improving and reporting on the hearing outcomes of workers with a hearing loss in accordance with the WorkSafe Hearing Services, Fee schedule for contracted providers and the WorkSafe Approved Hearing Device List, so that workers do not incur any out-of-pocket expenses for hearing services or devices. Contracted providers have additional outcome reporting requirements. How much will WorkSafe pay? WorkSafe will pay the reasonable costs of hearing services and devices provided by all approved providers in accordance with the: Worksafe Hearing Services, Fee schedule for non-contracted providers Worksafe Hearing Services, Fee schedule for contracted providers WorkSafe Approved Hearing Device List. If a non-contracted provider charges a worker a price above that listed in the WorkSafe Hearing Services, Fee schedule for non-contracted providers and the WorkSafe Approved Hearing Device List, it is expected that a written agreement is developed with the worker that fully informs them of their expected out-of-pocket costs. Workers will be advised that they can avoid out-of-pocket costs by going to a contracted hearing service provider and will be provided with a list of these providers.

3 Services and reporting Hearing Needs Assessment A Hearing Needs Assessment must be provided by all approved hearing service providers. This can be provided by an audiologist or audiometrist and should consider the following: the worker s level of independence the results of a range of diagnostic testing to assist in determining the hearing needs that the worker has as a result of the compensable injury the worker s hearing and communication function in everyday life, including home, work, education and social or recreational activities related to the diagnosis of the worker s hearing condition the rehabilitative goals agreed with the worker recommended options for achieving the goals at a reasonable cost, and clinical justification for the relevant benefits and costs sought for the worker and details of the proposed options. A hearing service provider must complete a Hearing Assessment and Device Request Form before the provision of any hearing services and devices to the worker. A provider is also required to use the WorkSafe Approved Hearing Device List when recommending a device. The following services may be provided by approved hearing service providers: Hearing Device Fitting Package A hearing service provider can provide this service only where they have received written approval from the WorkSafe Agent to provide a specific hearing device or devices to the worker. The service will then cover all consultations for the worker within the first 12 months following a Hearing Needs Assessment. The objective of this hearing service is to assist in restoring the worker s independence and participation in hearing as much as possible, and to help them manage their day-to-day life with a hearing loss. Provision of this hearing service should include follow-up appointments to facilitate the worker s understanding of, recovery from, or adjustment to, their work-related hearing loss. This may involve providing the worker with information and support, discussing or making appropriate referrals to other healthcare professionals and assisting the worker to develop appropriate strategies to enhance communication. Hearing Review and/or Hearing Device Maintenance A hearing service provider may provide this hearing service if the worker presents for a review of difficulties they are experiencing with their work-related hearing loss and/or their hearing device, after 12 months following the initial Hearing Needs Assessment. Provision of this hearing service refers to the review of the worker s hearing function and needs, and/or maintenance of the hearing device. It may include: facilitating the worker s understanding of, recovery from, or adjustment to, their compensable hearing loss including providing the worker with information and support, discussing or making appropriate referrals to other healthcare professionals and assisting the worker to develop appropriate strategies to enhance communication reviewing a hearing device and verifying its effectiveness, and making any adjustments to ensure that the hearing device is functioning to specification. 2

4 Hearing Device Repairs This hearing service includes any restoration of a hearing device carried out offsite by the manufacturer to improve its condition for better use. Hearing Device Battery Supply This hearing service includes the provision of batteries or battery accessories (either battery testers or dry aid kits) to a worker for their hearing device. Limitations to payment for hearing services and devices There are limitations to payment for hearing services and devices as follows: Hearing device fitting package WorkSafe will only pay for one Hearing Device Fitting Package every five years for the same worker. WorkSafe will only pay for one Hearing Device Fitting Package if: it is determined at the fitting stage that a selected hearing device is inappropriate for the worker and the hearing service provider makes a subsequent request to the WorkSafe Agent for an alternative hearing device a monaural hearing device is initially selected, but it is determined at the fitting stage that the worker would benefit further from a binaural hearing device. The provider would be entitled to be paid for a binaural hearing device fitting fee, if approved by WorkSafe. Hearing review and/or hearing device maintenance WorkSafe will pay a maximum of seven hours of hearing review and/or hearing device maintenance within five years of the provision of a hearing device to a worker. Review of the worker s hearing function and needs, and/or maintenance of the hearing device within the 12 month period after the Hearing Needs Assessment will not be paid as it is included in the fee for the Hearing Device Fitting Package. Repair and maintenance of hearing devices WorkSafe can pay for the reasonable cost of maintenance and repairs to hearing devices and assistive listening devices caused by normal wear and tear. WorkSafe will not pay for the repair and maintenance of hearing devices that are covered by the manufacturer or supplier warranty. All hearing devices on the WorkSafe Approved Hearing Device List are covered by a minimum 12 month warranty. 3

5 Replacement or loss of hearing devices WorkSafe will only pay for one replacement of hearing devices and/or assistive listening devices within a five year period. Lost devices will not be replaced without a statutory declaration of loss by the worker which outlines the circumstances of loss. The hearing service provider may be required to complete another Hearing Needs Assessment. Assistive listening device supply A hearing service provider will only be paid one Management Fee Hearing Device and a Hearing Device Fitting Package if an assistive listening device is provided to a worker at the same time or within 12 months of the provision of a hearing device. If an assistive listening device is provided to a worker 12 months after the provision of a hearing device, WorkSafe will pay the reasonable cost of a Hearing Review and/or Hearing Device Maintenance fee, the price of the assistive listening device as per the WorkSafe Approved Hearing Device List, and the Management Fee Assistive Listening Devices. Hearing device battery supply WorkSafe will not pay for the provision of a hearing device battery supply within six months after the initial provision and fitting of the hearing device to a worker. Non-attendance/cancellation WorkSafe will not pay for appointments where a worker cancels or does not attend. Telephone conversations WorkSafe will not pay for telephone consultations or conversations with the injured worker or others such as the employer, Agent, self-insurer or other healthcare professionals. More than one consultation on the same day WorkSafe will not pay for more than one hearing service consultation provided on the same day to the same worker. Need more information? Contact the WorkSafe Advisory Service on freecall or info@worksafe.vic.gov.au 4

6 WorkSafe Victoria Advisory Service 222 Exhibition Street Phone Toll-free Head Office 222 Exhibition Street Phone Toll-free Website worksafe.vic.gov.au Local Offices Ballarat Bendigo Dandenong Geelong Melbourne (628 Bourke Street) Mildura Mulgrave Preston Shepparton Traralgon Wangaratta Warrnambool WorkSafe Agents ALLIANZ Workers Compensation (Vic) Limited Level 26, 570 Bourke Street, Ph: (03) Fax: (03) Freecall GIO Workers Compensation (Victoria) Ltd Level 14, 447 Collins Street, Ph: (03) Fax: (03) Freecall Cambridge Integrated Services Victoria Pty Ltd Level 10, 390 La Trobe Street, Ph: (03) Fax: (03) Freecall QBE Workers Compensation (Vic) Limited Level 8, 628 Bourke Street, Ph: (03) Fax: (03) Freecall Gallagher Bassett Workers Compensation Vic Pty Ltd Ground Floor, 50 Queen Street, Ph: (03) Fax: (03) Freecall CGU Workers Compensation (Vic) Limited 181 William Street, Ph: (03) Fax: (03) Freecall The information contained in this publication is protected by copyright. WorkSafe Victoria encourages the free transfer, copying and printing of the information in this publication if such activities support the purposes and intent for which the publication was developed. VWA1042F/05/05.09 WorkSafe Victoria is a trading name of the Victorian WorkCover Authority. 2