|Title:||COMPENSABLE PATIENT ADMISSION Ė 2009 UPDATE|
|Document ID:||Operational Directive OD 0181/09|
|Date of issue:||Thursday, 26 March 2009|
|Status:||NO LONGER APPLICABLE|
|Description:||This updated operational directive details current policy on classification of compensable patients on admission to all public hospitals and health services in Western Australia. A compensable patient does not have an election choice at admission to be a public or private patient and they must be admitted as a compensable patient. There is no election choice to be re-classified as public unless the compensable insurer determines they have no liability.|
|Legal requirements:||Hospitals and Health Services 1927.
Hospitals (Services Charges) Regulations 1984.
Hospitals (Services Charges for Compensable Patients) Determination 2005.
|Applicable to:||All Health Services.|
|Category:||Accountability & Audit|
|Period of effect:||from 20 March 2009|
|Review date:||20 March 2014|
|Authorised by:||Dr Peter Flett, DIRECTOR GENERAL, WA HEALTH, 24-Mar-2009|
|Print version:||View print version|
|Supersedes in part:||
COMPENSABLE PATIENT ADMISSION Ė 2009 UPDATE
This operational directive provides instruction on the classification of compensable patients on admission to all public hospitals and health services in
On admission, the classification of a patient as a compensable patient is established either by the patient knowing that they are eligible, or they are likely to receive compensation, or that an officer within the hospital believes that a “prima-facie” case for compensation is likely to exist.
Legal advice states unequivocally that a compensable patient does not have an election choice at admission to be a public or private patient and they must be admitted as a compensable patient.
It is the responsibility of compensable insurers such as the Department of Defence, the Insurance Commission of Western Australia (covering motor vehicle third party insurance) and Work Cover (covering worker’s compensation) to determine liability of a compensable patient.
The only legitimate circumstances where a formerly admitted compensable patient can exercise their election choice to be (re)-classified as a public or private patient, is when a compensable insurer determines that the patient does not meet the insurers’ liability criteria and they indicate this formally to either the patient and/or hospital.
Hospital staff are advised to use the relevant financial election or funding source codes that are used in reporting inpatient records to the Hospital Morbidity Data System (HMDS). The current HMDS values for compensable episodes are:
25=Motor Vehicle Third Party Personal Claim
28=Department of Defence
Please note that hospital employees are not to be coerced into changing the classification of a compensable patient at admission to a public patient, by either the patient or any other third party.
Dr Peter Flett
This circular last updated: Thursday, 26 March 2009 at 2:28pm