100010013901.12.2023                    OG  Y   Y
2001.12.202300041.0000000.0000000.00
5001.12.2023GENERAL PRACTITIONER - COMPLETED FORM
5001.12.2023Received by insurer after 10 working days
100010014001.12.2023                    OG  Y   Y
2001.12.202300083.0000000.0000000.00
5001.12.2023GENERAL PRACTITIONER - COMPLETED FORM
5001.12.2023Received by insurer within 10 working days
100010014101.12.2023                    OG  Y   Y
2001.12.202300166.0000000.0000000.00
5001.12.2023GENERAL PRACTITIONER - PROGRESS REPORT
5001.12.2023Received by insurer within 10 working days
100010014201.12.2023                    OG  Y   Y
2001.12.202300083.0000000.0000000.00
5001.12.2023GENERAL PRACTITIONER - PROGRESS REPORT
5001.12.2023Received by insurer after 10 working days
100010014401.12.2023                    OG  Y   Y
2001.12.202300412.0000000.0000000.00
5001.12.2023GENERAL PRACTITIONER - COMPREHENSIVE REPORT
5001.12.2023Received by insurer within 10 working days
100010014501.12.2023                    OG  Y   Y
2001.12.202300206.0000000.0000000.00
5001.12.2023GENERAL PRACTITIONER - COMPREHENSIVE REPORT
5001.12.2023Received by insurer after 10 working days
100010015001.12.2023                    OS  Y   Y
2001.12.202300688.0000000.0000000.00
5001.12.2023SPECIALIST - COMPREHENSIVE REPORT
5001.12.2023Received by insurer within 10 working days
100010015101.12.2023                    OS  Y   Y
2001.12.202300344.0000000.0000000.00
5001.12.2023SPECIALIST - COMPREHENSIVE REPORT
5001.12.2023Received by insurer after 10 working days
100010015501.12.2023                    HG  Y   Y
2001.12.202300206.0000000.0000000.00
5001.12.2023GENERAL PRACTITIONER - TRAVEL
5001.12.2023Travelling time per hour
100010015601.12.2023                    HG  Y   Y
2001.12.202300412.0000000.0000000.00
5001.12.2023GENERAL PRACTITIONER - WORKPLACE ASSESSMENT
5001.12.2023Relating to rehabilitation or treatment options
100010015701.12.2023                    HS  Y   Y
2001.12.202300551.0000000.0000000.00
5001.12.2023SPECIALIST - WORKPLACE ASSESSMENT
5001.12.2023Relating to rehabilitation or treatment options
100010015801.12.2023                    HG  Y   Y
2001.12.202300494.0000000.0000000.00
5001.12.2023GENERAL PRACTITIONER - CASE CONFERENCE
5001.12.2023Relating to rehabiltiation or treatment options
100010015901.12.2023                    HS  Y   Y
2001.12.202300690.0000000.0000000.00
5001.12.2023SPECIALIST - CASE CONFERENCE
5001.12.2023Relating to rehabiliation or treatment options
100010016001.12.2023                    OG  Y   Y
2001.12.202300084.0000000.0000000.00
5001.12.2023GENERAL PRACTITIONER - TELECOMMUNICATIONS - LESS10 MIN
5001.12.2023Telephone, secure e-mail, facsimile relating to rehabilitation or treatment
5001.12.2023options
100010016101.12.2023                    OS  Y   Y
2001.12.202300114.0000000.0000000.00
5001.12.2023SPECIALIST - TELECOMMUNICATIONS - LESS 10 MIN
5001.12.2023Telephone, secure e-mail, facsimile relating to rehabilitation or treatment
5001.12.2023options
100010016201.12.2023                    OG  Y   Y
2001.12.202300168.0000000.0000000.00
5001.12.2023GENERAL PRACTITIONER - TELECOMMUNICATIONS - 11 - 20 MIN
5001.12.2023Telephone, secure e-mail, facsimile relating to rehabilitation or treatment
5001.12.2023options
100010016301.12.2023                    OS  Y   Y
2001.12.202300228.0000000.0000000.00
5001.12.2023SPECIALIST - TELECOMMUNICATIONS - 11 TO 20 MINS
5001.12.2023Telephone, secure e-mail, facsimile relating to rehabilitation or treatment
5001.12.2023options
100010016401.12.2023                    OG  Y   Y
2001.12.202300109.0000000.0000000.00
5001.12.2023GENERAL PRACTITIONER - FACILITY FEE
5001.12.2023Facility fee
100010020801.12.2023                    OG  Y   Y
2001.12.202300166.0000000.0000000.00
5001.12.2023GENERAL PRACTITIONER - PHONE & FAX REPORT
5001.12.2023Immediate
100010021101.12.2023                    OS  Y   Y
2001.12.202300748.0000000.0000000.00
5001.12.2023SPECIALIST - INDEPENDENT MEDICAL EXAMINATION (IME) REPORT
5001.12.2023Received by insurer within 10 working days
100010021201.12.2023                    OS  Y   Y
2001.12.202300375.0000000.0000000.00
5001.12.2023SPECIALIST - INDEPENDENT MEDICAL EXAMINATION (IME) REPORT
5001.12.2023Received by insurer after 10 working days or if payment requested prior to
5001.12.2023supply of report
100010023701.12.2023                    OG  Y   Y
2001.12.202300000.7800000.0000000.00
5001.12.2023GENERAL PRACTITIONER - TRAVEL
5001.12.2023Vehicle Cost
100010027901.12.2023                    OS  Y   Y
2001.12.202300210.0000000.0000000.00
5001.12.2023SPECIALIST - CONSULTATION ASSOCIATED WITH A REPORT
5001.12.2023Specialist - initial consultation
100010029301.12.2023                    OS  Y   Y
2001.12.202300112.0000000.0000000.00
5001.12.2023SPECIALIST - CONSULTATION ASSOCIATED WITH A REPORT
5001.12.2023Specialist - subsequent consultation
100010029601.12.2023                    OS  Y   Y
2001.12.202300498.0000000.0000000.00
5001.12.2023SPECIALIST - CONSULTATION ASSOCIATED WITH A REPORT
5001.12.2023Psychiatrist - consultation between 45-75 mins
100010029701.12.2023                    OG  Y   Y
2001.12.202300082.0000000.0000000.00
5001.12.2023GENERAL PRACTITIONER - SHORT REPORT
5001.12.2023Received by insurer within 10 working days
100010029801.12.2023                    OG  Y   Y
2001.12.202300041.0000000.0000000.00
5001.12.2023GENERAL PRACTITIONER - SHORT REPORT
5001.12.2023Received by insurer after 10 working days
100010030001.12.2023                    OS  Y   Y
2001.12.202300398.0000000.0000000.00
5001.12.2023SPECIALIST - CONSULTATION ASSOCIATED WITH A REPORT
5001.12.2023Consultant physician - initial consultation
100010030101.12.2023                    OS  Y   Y
2001.12.202300184.0000000.0000000.00
5001.12.2023SPECIALIST - CONSULTATION ASSOCIATED WITH A REPORT
5001.12.2023Consultant physician - subsequent consultation
100010030201.12.2023                    OS  Y   Y
2001.12.202300590.0000000.0000000.00
5001.12.2023SPECIALIST - CONSULTATION ASSOCIATED WITH A REPORT
5001.12.2023Psychiatrist - consultation more than 75 mins
100010030301.12.2023                    OS  Y   Y
2001.12.202300355.0000000.0000000.00
5001.12.2023SPECIALIST - NON ATTENDANCE / CANCELLATION FEE (FOR IME OR PI ASSESSMENT ONLY)
5001.12.2023Consultant physician - less than 48 hours notice (excluding non-working days)
100010030401.12.2023                    OS  Y   Y
2001.12.202300188.0000000.0000000.00
5001.12.2023SPECIALIST - NON ATTENDANCE / CANCELLATION FEE (FOR IME OR PI ASSESSMENT ONLY)
5001.12.2023Specialist - less than 48 hours notice (excluding non-working days)
100010030501.12.2023                    OS  Y   Y
2001.12.202300445.0000000.0000000.00
5001.12.2023SPECIALIST - NON ATTENDANCE / CANCELLATION FEE (FOR IME OR PI ASSESSMENT ONLY)
5001.12.2023Psychiatrist - less than 48 hours notice (excluding non-working days)
100010036901.12.2023                    OS  Y   Y
2001.12.202300498.0000000.0000000.00
5001.12.2023SPECIALIST - TELEHEALTH CONSULTATIONS ASSOCIATED WITH A REPORT
5001.12.2023Psychiatrist telehealth consultation between 45-75 mins
100010037001.12.2023                    OS  Y   Y
2001.12.202300590.0000000.0000000.00
5001.12.2023SPECIALIST - TELEHEALTH CONSULTATIONS ASSOCIATED WITH A REPORT
5001.12.2023Psychiatrist telehealth consultation more than 75 mins
100010050101.12.2023                    OS  Y   Y
2001.12.202300090.0000000.0000000.00
5001.12.2023SPECIALIST - SPECIALIST MRI
5001.12.2023MBS item codes 63491, 63494
100010050201.12.2023                    OS  Y   Y
2001.12.202300672.0000000.0000000.00
5001.12.2023SPECIALIST - SPECIALIST MRI
5001.12.2023MBS item codes 63010,63040, 63334, 63548
100010050301.12.2023                    OS  Y   Y
2001.12.202300717.0000000.0000000.00
5001.12.2023SPECIALIST - SPECIALIST MRI
5001.12.2023MBS item codes 63043, 63151, 63154, 63161 - 63170, 63179 - 63185, 63461
100010050401.12.2023                    OS  Y   Y
2001.12.202300762.0000000.0000000.00
5001.12.2023SPECIALIST - SPECIALIST MRI
5001.12.2023MBS item codes 63301, 63304, 63307
100010050501.12.2023                    OS  Y   Y
2001.12.202300806.0000000.0000000.00
5001.12.2023SPECIALIST - SPECIALIST MRI
5001.12.2023MBS item codes 63001 - 63007, 63046 - 63073, 63322, 63340, 63361, 63391,
5001.12.202363401, 63404, 63416, 63425, 63428, 63440
100010050601.12.2023                    OS  Y   Y
2001.12.202300869.0000000.0000000.00
5001.12.2023SPECIALIST - SPECIALIST MRI
5001.12.2023MBS item codes 63201, 63204, 63219 63243, 63385, 63388
100010050701.12.2023                    OS  Y   Y
2001.12.202300986.0000000.0000000.00
5001.12.2023SPECIALIST - SPECIALIST MRI
5001.12.2023MBS item codes 63101, 63111, 63114, 63125, 63128, 63131, 63271 - 63280
100010050801.12.2023                    OS  Y   Y
2001.12.202300717.0000000.0000000.00
5001.12.2023SPECIALIST - SPECIALIST MRI
5001.12.2023MBS item codes 63173, 63176, 63325, 63328, 63331, 63337
100010050901.12.2023                    OS  Y   Y
2001.12.202301380.0000000.0000000.00
5001.12.2023SPECIALIST - SPECIALIST MRI
5001.12.2023MBS item codes 63464, 63467, 63487, 63547
100010051001.12.2023                    OS  Y   Y
2001.12.202301254.0000000.0000000.00
5001.12.2023SPECIALIST - SPECIALIST MRI
5001.12.2023MBS item code 63473
100010051101.12.2023                    OS  Y   Y
2001.12.202300070.0000000.0000000.00
5001.12.2023SPECIALIST - APPLICATION FEE FOR PATIENT RECORDS
5001.12.2023Application fee for the provision of patient records relating to the workers
5001.12.2023compensation claim including file notes; results of relevant tests eg.
5001.12.2023Pathology, diagnostic imaging and reports
100010051201.12.2023                    OG  Y   Y
2001.12.202300070.0000000.0000000.00
5001.12.2023GENERAL PRACTITIONER - APPLICATION FEE FOR PATIENT RECORDS
5001.12.2023Fee for providing patient records relating to the workers' compensation claim
5001.12.2023including file notes; results of relevant tests e.g. pathology, diagnostic
5001.12.2023imaging and reports
100010051301.12.2023                    OG  Y   Y
2001.12.202300000.3200000.0000000.00
5001.12.2023GENERAL PRACTITIONER - COPYING CHARGE FOR PATIENT RECORDS
5001.12.2023Copying charge per page for patient records
100010051401.12.2023                    OS  Y   Y
2001.12.202300000.3200000.0000000.00
5001.12.2023SPECIALIST - COPYING CHARGE FOR PATIENT RECORDS
5001.12.2023Copying charge per page for patient records
100010080001.12.2023                    HS  Y   Y
2001.12.202300275.0000000.0000000.00
5001.12.2023SPECIALIST - TRAVEL
5001.12.2023Travelling time per hour
100010080101.12.2023                    OS  Y   Y
2001.12.202300220.0000000.0000000.00
5001.12.2023SPECIALIST - PHONE & FAX REPORT
5001.12.2023Immediate
100010080201.12.2023                    OS  Y   Y
2001.12.202300897.0000000.0000000.00
5001.12.2023SPECIALIST - PERMANENT IMPAIRMENT (PI) ASSESSMENT
5001.12.2023Report using appropriate assessment method and in the approved form. Received
5001.12.2023by insurer within 10 working days
100010080301.12.2023                    OS  Y   Y
2001.12.202300448.0000000.0000000.00
5001.12.2023SPECIALIST - PERMANENT IMPAIRMENT (PI) ASSESSMENT
5001.12.2023Received by insurer after 10 working days or if payment requested prior to
5001.12.2023supply of report
100010080501.12.2023                    HS  Y   Y
2001.12.202300536.0000000.0000000.00
5001.12.2023SPECIALIST - PRE-CONSULTATION READING TIME (FOR PI & IME ASSESSMENT AND
5001.12.2023REPORT)
5001.12.2023Additional reading time: more than 30 minutes
100010080601.12.2023                    OS  Y   Y
2001.12.202300415.0000000.0000000.00
5001.12.2023SPECIALIST - PROGRESS REPORT
5001.12.2023Received by insurer within 10 working days
100010080701.12.2023                    OS  Y   Y
2001.12.202300207.0000000.0000000.00
5001.12.2023SPECIALIST - PROGRESS REPORT
5001.12.2023Received by insurer after 10 working days
100010080801.12.2023                    OS  Y   Y
2001.12.202300138.0000000.0000000.00
5001.12.2023SPECIALIST - COMPLETED FORM (2-3 QUESTIONS)
5001.12.2023Received by insurer within 10 working days
100010080901.12.2023                    OS  Y   Y
2001.12.202300000.7800000.0000000.00
5001.12.2023SPECIALIST - TRAVEL
5001.12.2023Vehicle cost
100010081001.12.2023                    OS  Y   Y
2001.12.202300138.0000000.0000000.00
5001.12.2023SPECIALIST - SHORT REPORT
5001.12.2023Received by insurer within 10 working days
100010081101.12.2023                    OS  Y   Y
2001.12.202300068.0000000.0000000.00
5001.12.2023SPECIALIST - SHORT REPORT
5001.12.2023Received by insurer after 10 working days
100010081401.12.2023                    OS  Y   Y
2001.12.202300068.0000000.0000000.00
5001.12.2023SPECIALIST - COMPLETED FORM (2-3 QUESTIONS)
5001.12.2023Received by insurer after 10 working days
100010081501.12.2023                    HS  Y   Y
2001.12.202300553.0000000.0000000.00
5001.12.2023SPECIALIST - COMPLEX CASE REVIEW
5001.12.2023Specialist report based on review of medical information
100010081601.12.2023                    OS  Y   Y
2001.12.202300182.0000000.0000000.00
5001.12.2023SPECIALIST - INTERPRETER
5001.12.2023Additional fee for examination and report conducted with the assistance of an
5001.12.2023interpreter
100010081701.12.2023                    OG  Y   Y
2001.12.202300083.0000000.0000000.00
5001.12.2023GENERAL PRACTITIONER - INTERPRETER
5001.12.2023Additional fee for examination and report conducted with the assistance of an
5001.12.2023interpreter
100010081801.12.2023                    OS  Y   Y
2001.12.202300145.0000000.0000000.00
5001.12.2023SPECIALIST - ILO REPORT
5001.12.2023Received by insurer within 10 working days
100010081901.12.2023                    OS  Y   Y
2001.12.202300071.0000000.0000000.00
5001.12.2023SPECIALIST - ILO REPORT
5001.12.2023Received by insurer after 10 working days
100040060201.12.2023                    OS  Y   Y
2001.12.202300415.0000000.0000000.00
5001.12.2023SPECIALIST - SUPPLEMENTARY REPORT- LONG
5001.12.2023Supplementary report (4-6 questions) following the completion of an
5001.12.2023independent medical examination or permanent impairment assessment and report.
100040060301.12.2023                    OS  Y   Y
2001.12.202300250.0000000.0000000.00
5001.12.2023SPECIALIST - SUPPLEMENTARY REPORT- SHORT
5001.12.2023Supplementary report (1-3 questions) following the completion of an
5001.12.2023independent medical examination or permanent impairment assessment and report.