Assessor's Checklist: Procedures for registering and paying for SHCS treatment

Action required

Responsible area

Step 1A

Group 1 Registration

Registration form received from person who has never applied for Tier 1, 2 or 3 classification.

• Send letter advising of the need to lodge a tier application in order to determine SHCS Group 1 eligibility. Include Factsheet F111-08 and D9021 Tier classification form.

Group 2 Registration

Family members of Group 1:

• Check that their F-111 family member is classified as Tier 1, 2 or 3 or Group 1.  If their family member is not a Tier 1, 2 or 3 or Group 1, send letter advising that their family member needs to initially lodge a tier application and have SHCS Group 1 eligibility approved.  Notify them to ask F-111 family member to contact the Department to lodge a tier application.

Worker on Base:

Registration form received from person who has never applied for Tier classification.

• Send letter advising of the need to lodge a tier application in order to determine SHCS Group 2 eligibility. Include Factsheet F111-08 and D9021 Tier classification form.

F-111 Health Care Team

Step 1B

Group 1 Registration

Registration form received from approved Tier 1, 2 or 3 classified personnel.

• Send letter informing that eligibility for SHCS (and BHP if requested) has been approved and they can access SHCS (and BHP) services. Include the Factsheets F111-07 (SHCS services) and F111-09 (BHP services).

Enter contact details on SHCS payment database.

Group 2 Registration

Registration form received from eligible Group 2 participant.

• Check POI to verify relationship to F-111 worker
• Send letter informing that eligibility for SHCS has been approved and they can access SHCS services.

Enter contact details on SHCS payment database.

F-111 Health Care Team

The following steps only relate to Group 1 participants requesting treatment. Counselling for Group 1 and Group 2 participants is provided through VVCS.

Step 2

If person requests treatment, check 'Pick and Patch' database to see if compensation claim for SHCS condition has been lodged.

If a compensation claim hasn't been submitted – send letter advising that SHCS can't cover interim treatment unless compensation claim lodged and include Fact Sheet F111-04 Compensation under subsection 7(2) of the SRCA for F‑111 workers..

F-111 Health Care Team

Step 3

If eligible for treatment under SHCS, pay reasonable treatment invoices for SHCS conditions until compensation claim is determined.  SHCS does not pay for investigations or testing for diagnostic purposes:

• If claim is under investigation – approve treatment.
• If claim is accepted – cease providing treatment as it will be paid through compensation.
• If claim is rejected – continue providing ongoing treatment unless claim is 'rejected no condition', 'no incapacity found' or 'claim withdrawn'.  Consider whether retrospectively eligible for coverage of treatment. 

F-111 Health Care Team

Step 4

If treatment is for GP consultation or pharmaceuticals, no prior approval is required.

If treatment is for specialist consultation (excluding Psychiatrist), hospital, allied health (eg Physiotherapist) or appliances, prior approval is required:

• Participant has to contact the SHCS and request prior approval, providing details of treatment date, medical provider, reason for the treatment, provider's contact details.
• Fax prior approval form to provider.

Step 5

Process payment through the F-111 health care payment database.

F-111 Health Care Team