2. Application to bulk bill accommodation. Go to our website www.iptaas.health.nsw.gov.au or call us on 1800 IPTAAS (1800 478 227). an IPTAAS Application Form or click on the link to ‘Apply online’. Patient ID (if known) 2.our name Y Given name Surname 3.our date of birth Y D D/M M/Y Y Y Y 4.our residential address Y State Postcode Part B. Treatment details 5. 3. Submit the form via email to the patient's local IPTAAS office to apply for a bulk bill approval ID (as per the details below). FORM SUBMISSION. Phone: 1800 478 227 + select Option 2 Fax: (02) 5524 2996 Email: MNCLHD-TFH-IPTAAS. IPTAAS is a subsidy program which provides financial assistance to help with travel and accommodation costs for people (and eligible escorts) who need to travel long distances to access specialist treatment not available locally. Part A. Accessing specialist health services. Patients must submit a registration form (F o rm A ) if this is their first IPTAAS claim referral if treatment is ongoing or if referred to a different treating specialist or P atients are required to submit a completed application form for their first visit to a treating (Form C). patient complete Form 3. PAGE 2. Effective Date: 27 February 2018 Version: 2.0 pg. @health.nsw.gov.au Post: IPTAAS Coordinator | PO Box 126 Port Macquarie NSW 2444. NIPTAAS Claim Form Port Macquarie. Isolated Patients Travel and Accommodation Assistance Scheme (IPTAAS) Information for referring practitioners • Private vehicle travel • Public transport (trains, The form is available online by visiting our website at www.iptaas.health.nsw.gov.au or call your local IPTAAS office on 1800-IPTAAS(1800 478 227). The Patient Assistance Transport Scheme – called PATS for short – is a subsidy program funded by the Government of South Australia and administered through the six regional local health networks by the Rural Support Service in SA Health.. NIPTAAS Information for Patients and Escorts. Collect any tickets or receipts for travel and accommodation and keep a … ONLINE APPLICATIONS. The facility should include their declaration at Part F of this form. Email: HNELHD-IPTAAS@health.nsw.gov.au Post: IPTAAS Coordinator | Locked Bag 9783 Tamworth NEMSC NSW 2348. You can submit your IPTAAS application online at www.iptaas.health.nsw.gov.au Alternatively, you can submit a paper application by mail, fax, email or in person. Failure to do this may lead to non- Any Australian, State or Territory government scheme other than NIPTAAS? Where can I get IPTAAS forms? No Yes 3. 4 PART 4 – DECLARATION BY PATIENT OR GUARDIAN I certify the information in this form is correct, the expenditure shown in Part 2 … 2. Patient details 1. Applying online will allow you to scan or photograph your travel and accommodation invoices … Click on the below for further information: NIPTAAS is a subsidy rather than a full reimbursement scheme. Far West – Broken Hill . Claim Form ** Must be accompanied by a current NIPTAAS Doctor Authority Form PART 1 – PATIENT AND ESCORT DETAILS 1.1 ELIGIBILITY DETAILS Have you claimed, or are you entitled to claim, travel and/or accommodation benefits from any of the following: 1. When you visit your specialist, take the form with you and ask that they complete Form C (and Form B if applicable to be completed by your referring doctor*). Patient Assistance Transport Scheme (PATS) On this page. Non-urgent transfer to a mainland hospital or recognised treatment facility (with escort where deemed necessary); and. 2. outside of the IPTAAS guidelines •Before the patient leaves the accommodation facility, Parts 2 and 3 of the IPTAAS Claim form is required, along with an accommodation invoice and any other claimable receipts. •Invoices must include the conditional approval number, along with both the patient & escort name.
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