Elective surgery is clinically necessary, non-emergency surgical treatment performed by a suitably qualified medical practitioner.
Prior written approval from the Agent is required for elective surgery.
Refer to policy for Elective Surgery including information about:
- information required for prior approval
- what costs will and will not be paid for.
See: Cost of services
Other policies related to elective surgery include:
Elective surgery fact sheet
An elective surgery information fact sheet has been created for workers to provide them with information post-receipt of their request for surgery.
Post-surgery support needs
Some workers may require post-surgery support services. This may include a short-term household help package, equipment or a three month gym membership. To facilitate the timely provision of these services, the treating medical practitioner may request anticipated post-surgery support services prior to the worker having surgery.
Some workers may also be suitable for Rehabilitation at Home to assist in their rehabilitation and can be discussed prior to surgery commencing.
The surgery approval letter has a post-surgery request form which surgeons can use to request anticipated post-surgery support services. Agents may approve these services prior to the worker having surgery to ensure the worker has immediate access to the services upon discharge from hospital.
Should post-surgery support services be approved, the approval letter should stipulate an approved commencement date for services that reflects when the worker is actually expected to start requiring these services.
For example Whilst a gym program may be approved prior to surgery, the commencement of a gym program following surgery would only be expected after sufficient recovery has taken place. The approval date for the gym program should reflect this.
A hospital operation report is required from the principal surgeon following the elective surgery. Payment of the surgery invoice cannot be processed if the surgery report is not received.