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Delivering hospital based care
Last updated:
22 January 2021
Find out how to work with us and deliver hospital based care to our clients.
Who can deliver hospital base care
This information is for our contracted:
- public hospitals
- private hospitals
- private mental health hospitals
- day procedure centres
Referrals and admissions for hospital treatment
If you need information on hospital admission and treatment see our Hospital admission and discharge page.
Public hospitals
We have arrangements with all state and territory governments to provide care in public hospitals.
In most cases, you do not need prior approval before you admit a Veteran Gold Card holder to a public hospital. If you are unsure if we will pay, please contact us as soon as possible before you admit the client.
Quality reporting
Public hospital quality reporting is managed by state and territory health departments. Public hospitals are not required to submit anything extra to us.
If you have any specific queries please contact dva.public.hospitals [at] dva.gov.au
Funding arrangements in public hospitals
We provide funding to public hospitals providing:
- an activity-based payment for each episode. This includes the cost of surgically implanted prostheses.
- non-admitted services, in Tasmania to the Tasmanian Department of Health and Human Services.
For all queries regarding public hospitals please contact dva.public.hospitals [at] dva.gov.au
Private hospitals and private mental health hospitals
Our private hospital information guide provides information for hospital staff.
Our contracted private hospitals:
- Contracted Private Hospitals (DOCX 50 KB) — updated 10 September 2020
- Contracted Mental Health Private Hospitals (DOCX 30 KB) — updated 10 September 2020
Quality reporting
All of our contracted hospitals are required to complete and submit an annual quality report (QR).
QRs must be submitted for each financial year by 31 October.
The single report template enables you to report on the following services:
- private hospital services
- private mental health services
- better discharge planning services
- client feedback and complaints
- any issues
Download the Private Hospital quality report template
- Private Hospital quality report template (XLSX 47 KB) — updated 17 November 2020
The completed private hospital quality report must be emailed to dvaprivatehospitalqualityreports [at] dva.gov.au
Program proposals for private hospital services
We invite hospitals to submit proposals for programs that may improve health outcomes in the veteran population.
We have created guidelines to help you draft your proposal:
- Guidelines for proposals for same day and sessional rehabilitation programs (DOCX 20 KB)
- Guidelines for proposals for innovative or best practice programs (DOCX 20 KB)
- Guidelines for clinical mental health day programs (DOCX 30 KB)
- Guidelines for proposals for innovative mental health programs (DOCX 20 KB)
- Guidelines for proposals for trauma recovery programs (DOCX 30 KB)
Please refer to the relevant guidelines when you write your proposal.
Send your completed program proposal to resp.priv.hospitals [at] dva.gov.au
Discharge planning
We believe that effective discharge planning has many benefits for patients. We work closely with hospitals so that transferring from hospital to home is as seamless as possible.
You can can find the broad range of health services available to our clients in our two publications:
We also introduced a Better Discharge Planning (BDP) Program to provide more coordinated support to clients. Only hospitals contracted to provide this additional service are able to claim for it.
The BDP information guide (PDF ### KB) explains service delivery requirements for providers.
Day Procedure Centres
The DPC Information Guide (PDF ### KB) provides important information for Day Procedure Centres (DPCs) working with us.
A list of our contracted DPCs are available from the following document:
- Contracted Day Procedure Centres (DOCX 45 KB) — updated 10 September 2020
Quality reporting
All of our contracted Day Procedure Centres must complete and submit an annual quality report (QR).
QRs must be submitted for each financial year by 31 October.
The QR template captures both:
- quality measures
- the organisation’s Safety and Quality Accreditation Outcome status
The single report template enables you to report on the following services:
- Day Procedure Centre services
- client feedback and complaints
- any other issues
Download the DPC quality report template
- DPC quality report template (XLSX 31 KB) — updated 12 October 2020.
The completed DPC quality report template must be emailed to dvaprivatehospitalqualityreports [at] dva.gov.au
Online schedules and hospital related information
The Group Accommodation and Theatre Banding (GATB) Schedules and tables
As per our private hospital agreements, accommodation and operating theatre charges must be claimed based on the GATB Schedule.
Please note that interim banded items are denoted by a hash (#) symbol and items where the theatre band does not include robotic consumables are denoted by an asterisk (*) symbol.
The GATB Schedule comprises 2 tables:
- 1 based on the Commonwealth Medicare Benefits Schedule (CMBS)
CMBS-Based Group Accommodation and Theatre Banding (GATB) Schedule (XLSX 281 KB)
Latest version 1 March 2021 republished 17 March 2021. - 1 based on ICD 10 Medical Group Accommodation Banding Schedule diagnosis/ disease codes:
Medical Group Accommodation Banding Schedule (XLSX 80 KB) — updated 1 July 2019.
Hospital data submission
Hospital Casemix Protocol (HCP) data must be submitted by all:
- private hospitals
- mental health private hospitals
- day procedure centres
The Hospital Casemix Protocol (HCP) Data Upload link connects to our secure services login page.
Surgically Implanted Prostheses Schedule
The Department of Health provides a listing of the Surgically Implanted Prostheses Schedule.
Refer to 'July 2020 Prostheses List' where you will find the schedule.
Certificates and forms
- Hospital Admission Form
- Discharge Advice and Hospital Claim Form
- Acute Care Certificates to certify patients need acute care continuously 35 days or more
Critical Care Certificates
These certificates are used to:
- clinically verify the need for accommodation in a Critical Care Facility
- list the required interventions and level of nursing care
There are two critical care certificates:
The Rehabilitation Program certificate
The Rehabilitation Program Certificate (PDF ### KB) is used when a patient is admitted for any of the following:
- inpatient rehabilitation
- admitted same day
- non-admitted sessional rehabilitation program
The Rehabilitation Program certificate should be signed by a rehabilitation physician.
Keeping the patient certificate
You must keep the original certificate on the patient file for audit purposes. This includes:
- coronary care certificate
- intensive care patient certificate
- rehabilitation program certificate
Do not send these documents to us or Services Australia.
If you need any help with forms, call our provider helpline on 1800 550 457