Document ID: chunk:federal_register_of_legislation:F2024C00800:front:0:p37
Version: federal_register_of_legislation:F2024C00800
Segment Type: other
Provision Reference: 
Character Range: 98892–101756

appropriate category of health care provider; and

         (c) if a claim for payment in respect of treatment:

             (i) is in the form, if any, approved by the Commission for this purpose ('approved form'); and
             (ii) contains, or is accompanied by, any information required by any direction in any approved form; and

              (iii) is lodged at an appropriate place or with an appropriate person within the period of 2 years (or such longer period as is allowed in accordance with paragraph 3.5.2A) from the date of rendering the service to which the claim relates.

             Note 1: a claim is taken to have been lodged on the day it is received.

              Note 2: 'appropriate place' means an office of the Department in Australia, the Human Services Department or a place approved by the Commission for the purpose of lodging claims.

             Note 3: 'appropriate person' means a person approved by the Commission for the purpose of lodging claims.

             Note 4: a claim may be lodged by means of an electronic transmission.
3.5.2A Upon application in writing, by a claimant, to the Commission, the Commission may, in its discretion, by notice in writing served on the claimant, allow a longer period for lodging a claim than the period of 2 years referred to in subparagraph 3.5.2(c).

    Note: 'claimant' means an appropriate category of health provider seeking payment in respect of treatment provided under the Principles.

3.5.2B In exercising its power under paragraph 3.5.2A to allow a longer period for lodging a claim, the Commission shall have regard to all matters that it considers relevant, including, but without limiting the generality of the foregoing, any hardship that might be caused to the claimant if a longer period is not allowed.

Note: 'claimant' means an appropriate category of health provider seeking payment in respect of treatment provided under the Principles.

3.5.3 Subject to paragraph 3.5.3A, the Commission will not accept financial responsibility for the cost of the following treatment by health care providers, including treatment by dentists, physiotherapists and podiatrists:

(a)  services that have been paid for, wholly or partly, by the Human Services Department, as a medicare benefit, or by a health insurance fund; or

(b) services where the cost is otherwise recoverable, wholly or partly, by way of a legal claim; or

(c) examination for employment purposes; or

(d) examination for a medical certificate for membership of a friendly society.

3.5.3A Paragraph 3.5.3(a) does not apply to treatment that is private accommodation provided to an entitled person as a private patient in a hospital where a private health insurer of the person agrees to pay the difference between the cost of shared accommodation for the person at the hospital and the cost of the