Essentials for MAC Scheme providers
MAC takes several factors into consideration when assessing treatment or services as being necessary and reasonable, including but not limited to:
- the extent to which services will be of benefit, including whether the services are likely to promote or maintain recovery or independence, or improve functional autonomy
- the appropriateness of services having regard to the nature and severity of the injury, and the likely effectiveness of the services
- any alternative treatment or services that are available
- whether the service provider is appropriate to provide the services
- the cost effectiveness of providing the services
- length of time the services are to be provided for
A recommended treatment plan for a MAC Scheme participant should be submitted to TIO MAC for approval before treatment is commenced to confirm that costs will be covered and to facilitate the timely payment of services.
MAC Scheme entitlement and benefits
The eligibility criteria and benefits that are payable by the MAC Scheme, are set out in legislation.
All claims management decisions for funding of treatment, services and other supports are made in accordance with:
Service and treatment providers
As a provider you can support MAC Scheme claimants with treatments and services that:
- are safe and effective
- promote recovery, functional independence, or self-management
- are reasonable, clinically justified, outcome focused and in line with our Clinical Framework
- comply with all responsibilities relating to your profession or service
- comply with all relevant legislative requirements
Clinical framework
The Clinical-Framework-for-the-Delivery-of-Health-Services.pdf (nt.gov.au)
provides the principles and guidelines to help you deliver the right care at the right time.
How to register as a MAC Scheme provider
- If you are a health or service provider and will be providing treatment or services to a MAC Scheme client, you can register with us here
- If you are an existing service provider, you can update your bank, business or contact information here
mac@tiofi.com.au
Provider fees and charges
There is no prescribed schedule of fees and charges for providers to the MAC Scheme (other than for attendant care). Provider fees and charges are expected to be fair, reasonable and consistent with the providers existing pricing schedule.
Attendant care hourly rates
The hourly rates paid by the MAC Scheme for attendant care services are prescribed in the
Motor Accidents (Compensation) Regulations 1984 Schedule 2 - Pricing of benefits for attendant care services.
MAC approval for treatment
Before commencing treatment with a MAC Scheme client, you should contact MAC to confirm that funding for a specific number of treatments is approved for the patient. For future treatment beyond the initial treatments approved, you will need to submit a patient treatment plan.
When contacting MAC, please reference the claimant's name, and if known, their MAC claim number (which is recorded on their claim acceptance letter).
To confirm approval for treatment, please email
mac@tiofi.com.au or call MAC on 1300 493 506.
Provider invoicing
Invoices for treatment provided to MAC Scheme claimants are to be submitted to MAC for payment after treatment has been provided.
A separate invoice is needed for each patient – multiple patients cannot appear on the same invoice.
A tax invoice must include the following information (in addition to any details required under the Goods and Services Tax (GST) law, as applicable):
1. Your business details
- Registered business name
- Trading name
- ABN
- Service location (if different to billing address)
- Email address
- Bank account name
- Bank account number
- Bank BSB
2. MAC Scheme claimant details
- Claimant's MAC claim number
- Claimant's name
- Claimant's date of birth
- Claimant's address
3. Provider details
- Provider name
- Provider type
4. Service details
- Date of service
- Description of service
- If more than one service, please itemise each separately
- Duration of service (in hours) or quantity of service
- Fee
- GST
GST
Compliance with GST laws, which can vary according to the type of service being provided, is the responsibility of the provider. Please refer to the Australian Taxation Office (ATO) or seek advice from your tax advisor.
Where to send invoices
Please email invoices to mac@tiofi.com.au and include in the subject line “Invoice”, “Claimant's Name” and "client's MAC Scheme claim number" (if known).
If you need help
Please call TIO MAC on 1300 493 506 or contact the claimant's TIO MAC case manager.
Related information
MAC Scheme
Business hours are 8am - 5pm Monday to Friday
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