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Enhanced Primary Care

The document outlines the Enhanced Primary Care (EPC) Program under Medicare, detailing the referral process for patients with a multidisciplinary care plan. It specifies that GPs can refer patients to a maximum of five allied health professionals and must complete separate referral forms for each service. Additionally, it includes sections for the allied health professional to document services provided and for claiming benefits from Medicare.

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yuanchao.tan
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14 views1 page

Enhanced Primary Care

The document outlines the Enhanced Primary Care (EPC) Program under Medicare, detailing the referral process for patients with a multidisciplinary care plan. It specifies that GPs can refer patients to a maximum of five allied health professionals and must complete separate referral forms for each service. Additionally, it includes sections for the allied health professional to document services provided and for claiming benefits from Medicare.

Uploaded by

yuanchao.tan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Medicare Australian Governme Hnealth Insurance Commission

Enhanced Primary Care (EPC) Program


' j l;rlt ri ,l,i [ilrl'rt'iic,e$undorMedicare
CLINICAL NOTES SHOULD NOT BE WRITTEN ON THIS FORU.
onlypatientswithanEPcmultidisciplinarycareplancanbereferredbytheirGPforuptoaoaxjouoof5allied
choose whether to access one or the other for these seryices.

PART A -
Provider Number
To be completed by referring GP
41 1 09087
Name Dr George Mon-Chiao Wu
Address Shop 2 / 28a - 32 Belmore St
BURWOOD NSW 2134
Patient Details
Medicare Number 2807951825t2
First Name Nolan
Surname Tan
Address 2119-15 Cherry St
WARRAWEE NSW 2074
Patient's Ref. No.
Patient referred to: (Please specify name or type of allied health professional)
Allied Health Professional Lian Verceluz
Address

Referral details - GP must use a separate copy of the referral form for eaeh type of service
GPs may choose to refer patients on a care plan for more than one service, up to a maximum of 5 services. lndicate the number of
services required in the box adjacent to the relevant allied health professional. Generate a separate referral for EACH AHP you refer
your patient to for services under the Allied Health Services Medicare items.
lndicate number of services (1-5) to be provided by this AHP (maximum 5 services per patient)
of No of No of
'{o
enices AHP Type ltem No. seBic6 AHP Type ltem No. !enls AHP Type ltem No.
Aboriginal Health Worker 10950 Dietitian 10954 Physiotherapist 10960
Audiologist 10952 Mental Health Worker 10956 Podiatrist 1 0962
Chiropractor 10964 5 Occupational Therapist'l 0958 Psychologist 10968
Chiropodist 10962 Osteopath 10966 Speech Patholcgist 10970
Diabetes Educator 10951

Referring GP's signatur e --a-- Z-- Dalei 712t2025

Print thiqlelgryqlg1d give the printed copy to the patient to give to the AHP.

PART B - To be completed by the servicing allied health professional


Please note, this section must be completed and signed by the allied health professional after each service. By signing this section, the
allied health professional DECLARES that they, as an allied health professional registered with the HIC to provide MBS allied health
services, have provided the relevant service/s to the patient.

HIC ProvideriRegistration Number


Servicing allied health professional's name
Allied health professional's signature Date Signed:

Note: Allied health professional must provide a written report to the patient's GP after each service

PART C - Claiming benefit and distribution


lf used for 1 service only, the allied health professional All originals and photocopies of this form
. signs Original Copy of this Form after service provided. submitted to Medicare for payment must have the
lf used for multiole services, the allied health professional: original signature of the servicing provider.
. makes relevant number of photocopies of Form prior to signing
. signs Original Copy after 1st service
. signs a photocopied Form after each subsequent service.

Copies of all signed forms must be retained for record keeping and HIC audit purposes. Allied health ssrvicBs tunded by other Commonuraalih or Stato/Tenitor programs are not
eligible for Medicare rebates under this initiative.

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