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Published Date : 01:43PM 19 Sep 2007

EPC - Enhanced Primary Care


From the 1st of July 2004 general practitioners will be able to refer their patients to physiotherapy and other allied health services. Patients with chronic conditions and complex care needs can be treated under the Medicare System through the EPC program.

General practitioners can refer up to five consultations with a range of health providers under the enhanced primary care multidisciplinary care plan. A specific EPC Allied Health Profession referral form must be used to refer patients.

A GP must prepare the care plan in conjunction with a least two other health professionals, but they do not have to be the people who deliver the care under the plan. One of these health professionals can be a practice nurse. Ideally the GP should telephone or meet with the other health professionals. The patient does not have to be present during the care planning.

Once the GP has consulted the two other health professionals they then prepare the care plan. A copy of the plan must be placed in the patient's file and sent to each health professional that participated in the care planning. Once the EPC item is triggered the GP can then refer the patient for up to five consultations.

The patient is to contact Medicare directly (due to privacy legislation) to determine if the care plan is accepted or contact the medical clinic to ensure the care plan has been submitted.

We have asked our referring doctors to wait for two weeks after submitting the plan before referring the patient to physiotherapy. The patient must still confirm acceptance of the care plan with Medicare before starting a course of treatment. The number to ring is 13 20 11.

The patient presents the completed referral form to the allied health provider and is assessed and treated according to the requirements in the form. The health provider must report back to the GP regarding examination findings and treatment. Allied health professional may set their own fees for the consultation. The Medicare rebate is $44.95 per consultation. At our clinic we will be charging the rebate fee so there is no out of pocket cost for the patient.


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