WorkCover releases new public hospital fee schedule

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Thursday 1 May 2008

WorkCover has released a new Public Hospital fee schedule effective Thursday 1 May 2008. 

SISA has been provided with the following documents:
- fee schedule 
- payment guidelines
- fee calculator (provided by Dept of Health)

These can be found in the medical fees section of the SISA website document library.

Some key changes in this schedule include:
• a new version of DRGs (now 5.0)
• a 12.62 per cent increase to all fees
• separating fees and cost weights for teaching and non-teaching hospitals
• differentiating between public and private patient fees
• removing the same day and long stay outlier rates
• the framework and methodology better reflecting true cost recovery at an individual service level.

DRGs, Emergency Department, Outpatient and Outpatient group services and Outreach services have been split into a number of classifications (eg, specialist, teaching, other metro, other country, etc). All have differing fees for public and private patients.

The fee calculator will assist in determining the correct fee for specific services. The fee calculator is only applicable to this schedule and will be replaced when fees are reviewed in July. The payment guidelines may assist those organisations that use the IDEAS database to pay accounts. Aspects of these guidelines may also be useful for other organisations. 

WorkCover is not printing hard copies of this schedule because an updated fee schedule will be released in July 2008 to bring them in line with other fee schedules that are also regularly reviewed and updated on an annual basis.