*Formerly known as Enhanced Primary Care (EPC) Plan*

If a patient has a chronic medical condition, they may be eligible for up to 5 rebated sessions per calendar year with allied health care visits under a Chronic Disease Management Referral (previously known as an EPC or Enhanced Primary Care plan).

To start the process of obtaining a Chronic Disease Management Referral, you first need to see your GP who will confirm if you are eligible. If you are eligible, the GP will set up the required documentation with you.

Please inform our receptionist when making a booking on the phone that you have a CDM Plan and bring along all necessary forms with you to your first appointment or email them prior to your visit to the following email address:
info@essp.com.au

The Medicare rebate for these sessions is usually $56 per session, or if you’ve exceeded the Medicare safety net for the year, it will be rebated at a higher rate depending on the individual circumstances.

At the time of billing, we will request payment in full for the service you received. You will then need to submit your claim directly to Medicare, so that they can process and refund your rebate into your nominated bank account. You can find more information on how to claim Medicare services online here

Please note that you are not able to claim with both Medicare and Private Health Insurance for the same service. However, when you have exhausted your allocated Medicare sessions, you can generally switch to using your private health insurance – if you have cover for the speech pathology discipline. Please contact your private health fund to see if you are eligible.

Private speech pathology is covered under many private health fund plans. Your eligibility for a rebate and the specific amount will depend on your specific health coverage. Coverage also has annual limits that you will need to check with your private health fund.

Please directly get in touch with your private health fund prior to your initial appointment to confirm if your specific level of cover entitles you to a rebate for speech pathology services.

The item codes for speech pathology are:

• 320 | item number for a Speech Pathology Assessment.

• 340 | item number for a Speech Pathology therapy consultation.

ESSP is delighted to be a registered provider for the National Disability Insurance Scheme. Delivering services for Agency Managed, Plan Managed and Self-Managed Participants, we are grateful for the opportunity to deliver therapeutic supports for a broad range of people living with swallowing and/or communication challenges in the context of disability.

Please speak with a member of the ESSP team to discuss appropriate cases and have an NDIS Service Agreement drawn up.

For further information regarding the NDIS please visit their website:
https://www.ndis.gov.au/

ESSP accepts all patients who hold a:

• Veteran Gold Card; or

• Veteran White Card and your treatment is for an accepted service-related condition

Please request a DVA referral (D904 Form) from your GP for speech pathology services, and provide a member of the ESSP team with your relevant DVA details. DVA will cover the full fee for your sessions.

Bupa Health Services Pty Ltd (Bupa) was recently awarded the Contract to support integrated health services for the Australian Defence Force. The provision of health services under the Contract commences from 1 July 2019 for six years, with possible extensions. The ADF Health Services Contract (ADFHSC) supports health provision for over 85,000 Eligible Personnel (EP’s) across Australia.

Eligible Personnel (EP) means Defence personnel, Reserve members serving on continuous full-time service, Reserve members serving on other than continuous full-time service, and General Reserve-Special Reserve and any other personnel approved by the Commonwealth.

Appointments will be booked by Bupa on behalf of Defence. If your specialist has recommended ESSP for your speech pathology services, please request a referral for us via your defence medical officer.