Streamlined claiming for convalescent care

The Department of Veterans’ Affairs (DVA) has streamlined the process for health providers to receive payments for convalescent care.

Convalescent care is given to people recovering from an acute illness or operation, and must be prescribed by the treating medical officer. 

Under the new arrangements, providers are requested to invoice Medicare for convalescent care with similar details to those used for DVA nursing services.

DVA will pay the total costs for convalescent care for up to 21 days in a calendar year.

Convalescent care can be authorised at a former repatriation General Hospital, nursing home, convalescent home, public hospital or private hospital.

However the discharge planner or doctor needs to obtain financial authorisation from the department before arranging convalescent care outside a public hospital.

Hospital staff can receive financial approval by calling 1300 550 457 and selecting option 3, then option 1

Hostel or nursing home placements require an assessment from an Aged Care Assessment Team (ACAT).

Convalescent care providers need to have an allocated provider number from Medicare Australia or DVA.

Healthcare organisations can obtain a provider number by phoning 1300 550 457 and selecting option 3, then option 3 again.

Convalescent care providers are able to use their own invoices but they must include the following information:
– name and address of claimant;
– provider number;
– veteran details;
– DVA approval of hospital admission to which the care relates;
– details of prescribing medical officer;
– date(s) of service;
– cost of service;
– item number, and
– location where services provided (in home or a health care facility).

Claims should be sent to the Veterans Affairs Processing Centre at: PO Box 964,
Adelaide SA 5001.

All further enquiries should be directed to 1300 550 457.