Document ID: chunk:federal_register_of_legislation:F2024L00146:front:0:p10
Version: federal_register_of_legislation:F2024L00146
Segment Type: other
Provision Reference: 
Character Range: 39658–42710

Two Plus Persons No Adults (policy cover type)                                              Means a policy under which two or more people are insured, none of whom is an adult.

Waiting Period                                                                              The waiting period for a benefit under an insurance policy is the period:
                                                                                                 1. starting at the time the person becomes insured under the policy; and
                                                                                                 2. ending at the time specified in policy;
                                                                                            during which the person is not entitled to the benefit.

Psychiatric care definitions
Benefits Paid Amount                             The benefits paid amount under a psychiatric care waiting period exemption means the total eligible benefits paid by the PHI for an episode that occurred during the two months waived period for the quarter.

First Admission                                  To be considered a first admission with psychiatric care waiting period exemption, a first admission must have occurred within the first two months of the upgrade and the person must have decided to use the once-off exemption for the admission.

Not Applicable (Admission Type)                  Means the admission type does not apply.

Psychiatric Care Indicators                      Report Yes if psychiatric care has been provided, otherwise report No.

Psychiatric Care Waiting Period Exemption Types  A psychiatric care waiting period exemption has been used if:
                                                        * a person transfers to a policy which provides higher benefits for psychiatric treatment than the benefit for psychiatric treatment under the old policy;
                                                        * the person makes a claim under the new policy for psychiatric treatment within the first two months following the product upgrade; and
                                                        * the person decides to utilise the once-off exemption and receive higher benefits for that admission.
                                                 A psychiatric care waiting period exemption is not used if all of the above do not apply. If the waiting period exemption is not applicable, then report not applicable.

Subsequent Admission                             Means subsequent admissions to a hospital for the same condition as the initial admission. To be considered a subsequent admission with waiting period exemption, a subsequent admission must have occurred within the waived period.

Specific instructions

Table 1: Movements of insured persons
Report data as at the end of the reporting period.

   Name                                            Unique identifier  Applicable to:               Valid values                                   Description