How to invoice us
What WorkCover will pay
We pay for services based on the table of costs and reimburse up to the maximum amount listed for an item code.
If you choose to charge an amount above the maximum schedule fee in the table of costs, you should tell the worker the excess amount and let them know that we don't refund the excess amount. The excess amount should not be invoiced to us.
Tables of costs are updated regularly and you should be familiar with the current fees payable at the time you invoice us for a service. We will not alter payments made due to incorrect use of the costs.
How we pay
We pay our providers by electronic funds transfer (EFT). When you register as a provider you must provide your bank account details (we do not pay by cheque). If you change your bank account details, you should immediately update your details by calling 1300 362 128.
Your invoice must be submitted within two months of the completion of treatment (date of service). It is your responsibility as a provider to submit your invoices within this time. It's also your responsibility to follow up on any outstanding accounts within this time. Unfortunately, if an invoice is submitted outside the two month cut-off, payment may be refused.
A valid invoice must include:
- your name
- your ABN. This must be clearly displayed as per ATO requirements—only one ABN per invoice
- it should state 'tax invoice'
- the date the invoice is issued
- if the invoice is for supplies of $1,000 or more, the invoice is required to also show the recipient's identity or ABN—this is an ATO requirement
- your business address and contact details
- an invoice number (invoice numbers should not be re-used)
- your WorkCover provider number (if known)
- WorkCover claim number (if known)
- claimant's name, date of birth and residential address
- date of service
- name of practitioner who provided the service
- table of costs item code
- description of service provided
- cost of service clearly displaying the GST component
- name and the address of the worker's employer.
Please be aware that if we consider that you have applied GST incorrectly we may ask you to re-issue your invoice, due to ATO requirements. Please see the ATO website for more information about which services attract GST.
Submitting an invoice
Our electronic invoicing means you can receive payment much faster, and you can also track all invoices you've submitted to us.
Our short video guide has easy step-by-step instructions on how to create an invoice online. Alternatively, providers that submit a high volume of invoices may prefer to utilise our B2B services, which are available to a number of approved practice management vendors.
More information can be found under our electronic invoicing initiative. If you have any questions, please contact your Relationship Manager or call 1300 362 128.
Providers can use our secure online service, Provider Connect, to search, view, print and/or download your remittances and invoices online. Remittances are displayed in the same format as the printed remittances from our provider payment runs.
You can also download the remittances in .pdf and .csv formats. This means you can save copies or import the data to analyse the remittances in your accounting system.
The search function allows you to search through remittances using one or more of the following search filters:
- invoice number
- claim number
- date of service.
By viewing remittances this way, you will be able to see the status of your invoices on a line-by-line basis.
If you are submitting an invoice for radiology services, the invoice must be accompanied by the radiology report. WorkCover is unable to pay radiology invoices without the accompanying report.
More information on how to invoice us is available here.
If you feel the maximum schedule fee under the table of costs is inadequate, you may apply to us in writing for an increase. You must specify the special circumstance and the reason/s the cost should be increased in the particular case.
We may approve the increase if, after considering the application, we accept the increase is justified. An application must be made and approved before you can commence treatment.
Frequently asked questions
Why was my payment denied under the 'two month rule'?
WorkCover has an important role to play in balancing fair and appropriate benefits for workers with reasonable cost levels for employers. To do this, we need to identify claims costs in a timely manner, and this is why the Workers' Compensation and Rehabilitation Act 2003 (the Act) states that invoices are to be submitted within two months after the treatment is completed. As it's a legislative requirement for invoices to be submitted within this timeframe, we're unable to pay you if your invoice is submitted outside this time. We recommend you monitor your payments via Provider Connect. If you become concerned about a missing payment, please follow up within two months of the date of service by calling us on 1300 362 128.
What is the fastest way to get paid?
We offer a priority invoice payment turnaround for invoices submitted directly via Provider Connect. Our online portal guide has easy step-by-step instructions on how to create an invoice online. Alternatively, providers who submit a high volume of invoices may prefer to utilise our B2B services, which are available to a number of approved practice management vendors. You must also check prior to invoicing, that the worker has a current Workers' Compensation Medical Certificate to cover the date of your services, and that the requested services are approved. Please review our electronic invoicing initiative for more information. If you have any questions, please contact your Relationship Manager, or call 1300 362 128.
Should I mail in an original invoice if I fax in or upload using Provider Connect?
Please do not submit originals via mail as well. This creates duplicates in our system.
What do I do if my account hasn't been paid?
If you have submitted an invoice and it has not been paid, please do not simply re-submit the invoice. Check your Provider Connect account and confirm the payment has not been made by searching by claim number, invoice number and/or service date. If you can't confirm the payment via Provider Connect, call us within two months of the service date on 1300 362 128.
What do I do about billing before I know the claim is accepted?
You can either:
* wait until acceptance is confirmed and then submit your invoices directly to us
* invoice the patient directly. The patient may then be reimbursed by us (if the claim is accepted).
How do I receive payments?
We make payments by electronic funds transfer (EFT). You should make sure you complete this section in the service provider application form.
What will WorkCover Queensland pay?
We will only pay for services outlined in the Medical or Allied services table of costs. A scheduled fee exists for most services; however some are 'fee by negotiation'. You will need to discuss this with us, as approval is needed before any treatment is given.
What private/public hospitalisation costs do we pay?
We are liable for the cost of hospitalisation of a worker, with an accepted claim, as an in-patient at a private or public hospital for:
* non-elective hospitalisation:
− for not more than four days, or
− if prior approval is obtained from us for more than four days before hospitalisation.
* elective hospitalisation:
– for a period agreed to by us with prior approval before hospitalisation.
Do we pay gap fees for medical services?
We will not make gap payments to medical providers, i.e. no payments will be made above the table of costs.
- Last updated
- 25 March 2020