Funding and Payment Options

At NAPA Centre, we offer families a variety of different payment options. You can claim through your private health fund, or there are various funding plans available through Medicare and specialised funding.

funding

PRIVATE HEALTH INSURANCE

NAPA Centre therapists are registered providers with most of the leading private health care insurers. Allied health services tend to be an added extras option on your policy and coverage between providers can vary.

How to Claim with Private Health:

HiCaps is available for immediate claims. NAPA Centre can provide a receipt for rebates if your provider is not registered with HiCaps. Please contact your health fund to find out whether your policy covers physiotherapy and occupational therapy.

Payments are also accepted via EFTPOS and Visa/Mastercard.

MEDICARE

Medicare has a few health plans that your child may be able to access. Each therapist at NAPA Centre is a registered provider of Medicare Australia. Please speak to your GP for more information on plans and eligibility.

Chronic Disease Management Plan (CDM)

The Chronic Diseases Management Plan (CDM), previously known as the Enhanced Primary Care Plan (EPC), is a Medicare-rebated funding program for people who have chronic medical conditions (classified as a condition that has been present for at least six months). The CDM provides eligible clients with a partial rebate for up to five (maximum) visits across a calendar year for Allied Health services. The five visits can be allocated across the Allied Health therapists if you need to access more than one type of therapy.

How Can We Access This Funding?

To access this type of funding, please meet with your GP to discuss eligibility. Your child may be eligible for this funding package if they have had a chronic medical condition for six months or more. You can inform your GP of how you would like to allocate the five visits, and for which therapists. Your GP will give you a form for you to bring to your appointment. After you receive this form, you are entitled to claim under the CDM.

Appointments are paid for as usual. NAPA will provide you with a receipt to submit to Medicare for a rebate. CDM-funded sessions cannot be paid for through your private health fund.

PERVASIVE DEVELOPMENTAL DISORDER PLAN (PDD):

The Autism Initiative is a Medicare-rebated funding scheme that has been put in place to help fund assessment and therapy for children with autism spectrum disorder (ASD) or pervasive developmental delay (PDD). The funding scheme provides funding for eligible children to access four sessions for assessment and 20 sessions for therapy with speech pathologists, occupational therapists, or psychologists.

Who is Eligible for This Plan?

This funding is eligible to be used for children up to the age of 13 but can be used only once (cannot be claimed again). Children up to the age of 15 may be eligible for treatment funding if they have a prior diagnosis of ASD or PDD.

How Can We Access this Funding?

Your GP will need to provide you with a referral to a consultant paediatrician. If the paediatrician decides further investigation is required, they may refer you to one or more allied health professionals (psychologists, speech pathologists, or occupational therapists) to assist their diagnosis. Once the diagnosis has been confirmed, your paediatrician or psychiatrist will provide you with paperwork to bring to your appointment at NAPA.

Can We Pay with Both This Funding and Private Health?

For every session at NAPA, you can choose which type of funding you would like to use each session. However, you cannot use both for a single session.

THE BETTER ACCESS TO MENTAL HEALTH CARE PLAN

The Mental Health Plan (MHP) is a Medicare-rebated funding program for people who have mental health conditions (anxiety, depression etc.) It consists of up to 10 rebates per calendar year for occupational therapy and psychology services. An extension of four further sessions can be applied for by your occupational therapist in extreme circumstances.

Who Is Eligible for This Plan?

Your child may be eligible for this funding if they have a diagnosis of autism spectrum, anxiety disorder, ADD /ADHD, or have a mental health condition and it is being managed by a mental health provider or your GP. When visiting your GP to discuss eligibility for the Mental Health Plan or other Medicare initiatives, ask for an extended appointment time, as there may be considerable paperwork involved.

If Eligible, How Do We Access This Funding?

Your GP will determine if your child is eligible, and will complete the relevant paperwork. Please bring this form to your appointment at NAPA. This will then entitle you to claim under the MHP.

How Is the Session Paid?

Sessions can be paid for using cash or a credit/debit card. Submit your receipt to Medicare for a rebate. You are not able to pay for MHP-funded sessions through your private health fund.

BETTER START INITIATIVE:

Better Start is a funding scheme that allows children with developmental disabilities to access funding for early intervention services.
The initiative includes the following components:

  • Funding for early intervention services and treatments for eligible children under the age of six
  • Medicare items for the development of a treatment and management plan for eligible children under the age of 13
  • Medicare items for up to four allied health diagnostic services and for 20 relevant allied health services in total for eligible children up to the age of 15 (provided the treatment and management plan is in place before the age of 13)
  • Parents or carers of eligible children will need to register their child for the Better Start initiative before they turn six in order to access the early intervention funding.

Who Is Eligible for This Plan?

Eligible children are those diagnosed with Down syndrome, cerebral palsy, fragile X syndrome, or a moderate or greater vision or hearing impairment, including deaf-blindness, Prader Willi syndrome, Williams syndrome, angelman syndrome, kabuki syndrome, Smith-Magenis syndrome, CHARGE syndrome, Cornelia De Lange syndrome, Cri du Chat syndrome, microcephaly, or Rett syndrome will have access to funding and new Medicare items under the Better Start for Children with Disability initiative.

If Eligible, How Can We Access This Funding?

Your state will have an overseeing body for the Better Start Program. You can contact the carer line on 1800 242 636 to ask about the Better Start Program or email betterstart@carersnsw.org.au (email address depending on your state). Your paediatrician will need to provide paperwork confirming the diagnosis to the carers in your state as part of the application. Once you are approved, you will be provided with paperwork to bring to your session at NAPA.

How Do We Use the Funding?

Better Start funding can be used to access physiotherapy and occupational therapy services at NAPA. By paying through Better Start, there will be no out of pocket therapy expenses up to the $6,000 threshold each financial year. All services utilised at NAPA Centre are paid for by your Better Start funding. This means, you have no out of pocket therapy expenses up to the $6,000 threshold each financial year (as per funding description). If you reach your $6,000 threshold, you will need to pay via other means (see other funding options listed).

You are also entitled to use a portion of your funding to purchase approved equipment or tools used as part of your childs therapy.

Better Start funding cannot be used to pay for late cancellations, missed appointments, or for subsidising a gap in a Medicare-funded service.

HELPING CHILDREN WITH AUTISM EARLY INTERVENTION (HCWA):

HCWA is a funding scheme for children who have been diagnosed with autism spectrum disorder (ADD) or pervasive developmental delay (PDD). You are eligible to access this funding if your child is between the ages of 0-6 years. Children must be approved for this funding prior to their sixth birthday, but the funding can be accessed until the child turns seven.
The funding is up to $6,000 per financial year (up to a total of 12,000) and is specifically for early intervention for the eligible child. You can use this funding only with registered health providers. NAPA is registered to provide these services to eligible children.

How Can We Access This Funding?

Autism Spectrum Australia (ASPECT) is the overseeing body for the HCWA funding in New South Wales and can be contacted on 1300 978 611. If your child already has a formal diagnosis of ASD or PDD you can contact ASPECT to apply for this funding. They will discuss the requirements, including diagnosis and paperwork, which you need to submit with your application. Once your funding has been approved, submit your acceptance letter to NAPA. Our staff will further explain the process once your child starts therapy under this funding.

If your child does not yet have a formal diagnosis of ASD or PDD, you will need to speak with your GP who will provide you with a referral to a consultant paediatrician or psychiatrist. If the paediatrician or psychiatrist decides further investigation is required, they will refer you to one or more Allied Health professionals (occupational therapists, speech pathologists, and/or psychologists) to assist their diagnosis. After the diagnosis is confirmed, your paediatrician or psychologist will provide paperwork to submit to ASPECT as part of your application for funding.

Once your funding has been approved, ASPECT will provide paperwork for you to submit to NAPA at your first session.

How Do We Access the Funding?

HCWA funding can be used to access occupational therapy services at NAPA Centre. This means, you have no out of pocket therapy expenses up to the $12,000 threshold ($6,000 threshold each year). If you exceed your $6,000 threshold, you will need to start paying via other means (see other funding options listed).

You are also entitled to use a portion of your funding to purchase approved equipment or tools used as part of your childs therapy.

HCWA funding cannot be used to pay for cancelled/missed appointments or for subsidising a gap in a Medicare-funded service.

THE NATIONAL DISABILITY INSURANCE SCHEME (NDIS):

For the latest information on the NDIS for NSW please visit the following sites:
The FAQs on NDIS: https://www.dss.gov.au/our-responsibilities/disability-and-carers/publications-articles/early-intervention-transition-to-the-national-disability-insurance-scheme-disabilitycare-australia-frequently-asked-questions
Where and when it is going to roll out in NSW: http://www.ndis.gov.au/about-us/our-sites/nsw
EFTPOS:
NAPA Centre accepts payment from all major bankcards, both credit and debit.

Call (02) 9420-5080 or   Request a Tour



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