Do you need a referral to see a physio?
In most circumstances the answer is no. Physiotherapists are sufficiently qualified to be first contact practitioners, and you do not need a GP referral to be able to claim rebates through private health insurance.
However if you are a patient requiring treatment under Veteran’s Affairs you will need a GP referral specifying which area of your body requires treatment. This referral will be valid for 12 months.
If you have no or limited private health insurance extras cover you may want to talk to your GP about whether you are eligible for treatment under a Managed Care Plan, otherwise known as the Enhanced Primary Care (EPC) scheme. Under this scheme your GP can refer you for up to 5 physiotherapy consultations per calendar year with a Medicare rebate which covers approximately 2/3s of the cost of the appointment.
What is involved in a physio consult?
At the first appointment we’ll want to find out exactly how we can help you. In many cases it is to assess why you are sore and to help fix it. In this case we will perform a thorough assessment through targeted questioning and a physical examination, and try to reach a provisional diagnosis which we will explain to you in easy to understand terms. We can then discuss the treatment options and go from there. Our treatments or interventions may involve techniques such as:
- hands-on stretching, massage and joint mobilization,
- exercise programs for stretching, strengthening, and control,
- education and advice about the condition, management, posture, prevention of recurrence,
- taping or bracing,
- warm up & cool down techniques
You may however be looking for an exercise program to improve your flexibility, strength, or posture, or perhaps some advice and education on a particular problem. We can help with this too.
As physios we are taught to assess – treat or intervene – reassess. At each appointment we will therefore assess to establish how you are progressing, make necessary adjustments to the management plan or try new options, and then reassess that effect.
Every customer’s situation and needs are different, so your program will be customized to you. We will document for you what is required, but we don’t use any generic exercise sheets.
How long is an appointment?
Treatment time varies depending on your issue. But as a general guide an initial appointment will last 45-60 minutes, and a review appointment around 30 minutes.
What should you bring?
For your first appointment please arrive on time so that we can complete some basic registration paperwork. It would be helpful if you could bring any X-rays or previous scans to the appointment, as well as any letters from other practitioners. If you would like to claim from your private health insurance fund on the spot, please also bring your membership card.
With regard to clothing, please wear something that will allow the physiotherapist to directly see the area which you’d like help with.
Can I claim from my health fund on the day?
Yes. If you have private health insurance with extras cover, we can claim this on the spot through our HICAPS machine and you only need to pay any applicable gap. Please note that each health fund has different levels of cover, so we are unable to predict the amount that you will get back. We will also require your membership card at each appointment as the rebate cannot be processed with the number alone.
Do you do home visits?
We understand that sometimes it is difficult for you to come to us. Perhaps you’ve just had surgery and are immobile, or maybe your friends or family can’t provide transport. We can certainly provide our service in the comfort of your home, provided the travel time from our clinic in Prahran is reasonable (preferably under 30 min each way). Please call or email to discuss whether a home visit is available.
How often will you need to see a physio?
We can only answer this question after the initial appointment once we have determined what the condition is and what your needs and goals are. After that we can recommend what treatment frequency will lead to the quickest recovery possible, and also provide an estimate as to how long the process may take for resolution.
Can a physiotherapist refer you for scans?
Physiotherapists are allowed to refer you to private radiology clinics for certain Xrays and MRI scans if they are clinically necessary. We can also refer for ultrasound scans, however the out of pocket expenses will be higher than if referred by a doctor.
Our training allows us to make recommendations to you about what is the most appropriate investigation for your particular condition.
Radiology clinics will sometimes bulk-bill (ie no out of pocket expense) patients who have a referral from an orthopaedic specialist, however you should factor in the cost of the GP visit (for the specialist referral), the cost of the specialist consultation, and the time taken between the GP visit and the second specialist appointment where you discuss the findings.
Can a physiotherapist refer you to a specialist?
At this stage we cannot, although this is something our association is working hard to rectify. The system currently requires that in order to obtain a Medicare rebate for your consultation with an orthopaedic specialist you must have a referral from a GP.
However over the years we have worked with many different surgeons and can provide you with some recommendations on who would be best to see for your particular condition.
Is there a gap payment when you have an accepted claim through Workers Compensation insurance, or under TAC or DVA?
No, if you have an accepted claim through Workers Compensation insurance or the TAC, or have a DVA referral from your GP, there is no gap or out of pocket expenses for treatment received for your injuries. We will liaise with your insurer / the TAC / DVA to arrange direct payment to the clinic for any treatment that you receive.
Is physiotherapy covered by Medicare?
Usually the answer is no, however there is a scheme whereby patients can access up to 5 physiotherapy consultations per calendar year with a Medicare rebate. It is called the Enhanced Primary Care (EPC) scheme, and your GP needs to first determine whether you are eligible or not. Its intention is to provide some financial assistance to people with chronic or long-term conditions who require the help of multiple practitioners.