Provider Factsheet - Private Services and Devices

This page contains information about Private Services and Devices effective from 1 October 2019.

Hearing Services Program (program) clients have the right to choose when and where they access hearing services, including purchasing services and devices

• that are not available to them on their current voucher
• not available under the program, and/or
• from a non-program provider.

Prior to 1 October 2019, Contracted Service Providers (providers) were not allowed to deliver and charge clients for services except for maintenance, replacements and partially subsidised devices, even if the service wasn’t available to the client through the program. New legislation came into effect on 1 October 2019 that allows for client choice to purchase private services and devices from their providers.

In delivering private services, providers must give clients sufficient information to enable clients to make informed choices about their hearing services. In almost all cases, the program offers suitable services and devices to meet client needs. This includes a wide range of devices with varying technological features.

However, some clients may still wish to obtain additional services or purchase devices that are not available through the program (for example wax removal, tinnitus treatment, vestibular testing etc), or that are not available to them on their current voucher.

A client’s decision to obtain additional services or purchase devices privately does not affect their eligibility for the program, but may affect their eligibility for some services under the program. For example, a private device that is not on a Schedule of Approved Devices cannot be maintained through the program.

Program Requirements

The Hearing Services Program (Voucher) Instrument 2019, Section 49 states that a provider must not provide or arrange for the provision of any private service or device if the same or a substantially similar service or device is available to the client on their voucher.  

If a client intends to obtain private services or purchase device/s privately, providers must ensure that the client understands

• the current services available to them under the program, including the fully and partially subsidised device options
• the services and device options that may be available to them through the program in the future and
• the device support (maintenance and client reviews) they may forfeit if the device/s are not on a Schedule of Approved Devices.

Providers can be required to repay a client if they are unable to demonstrate that the client fully understood the decision to purchase services or devices privately.

Maintenance on Private Devices

Non Approved Devices

A client cannot enter into a program maintenance agreement, and providers cannot claim maintenance from the program, if a client chooses private device/s which are

• not on a Schedule of Approved Devices, and/or
• not their primary device/s.

However, if a provider sells a client private device/s that are not on a Schedule of Approved Devices, the provider must be able to maintain the device/s privately. There is a risk if a client moves to a new provider that the new provider may not maintain the non-approved devices and the device/s will not be able to be repaired under a program maintenance agreement. The client is also not eligible to receive Client Review services with these devices. This must be explained to the client and evidence of the discussion documented on the client file.

Providers have the right to refuse to maintain devices supplied to a client outside the program by another provider and which are not on a Schedule of Approved Devices.

Approved Devices

Existing or Previous Fitting and Maintenance

If a client, who has previously been fitted with a device through the program, wishes to have their private device adopted by the program, providers may claim maintenance (item 700/710) if

• the client has an expired maintenance agreement and signs a new agreement
• the private device/s will be the primary device/s and
• the private device/s are on a Schedule of Approved Devices.

No Previous Fitting or Maintenance Agreement

Maintenance (item 790/791) may be claimed for the initial year of maintenance provided

• the client has never been fitted under the program
• the client enters into a maintenance agreement
• the private device/s will be the primary device/s, and
• the private device/s are on a Schedule of Approved Devices.

An item 790/791 can only be claimed if the device/s are suitable to the client’s needs, still in good working order and can be maintained for at least the remainder of the voucher period. The client must have received an assessment prior to the item 790/791 claim. Once the initial maintenance claim expires, subsequent annual maintenance (item 700/710) can then be claimed as usual.

Client Review Services – if a 790/791 claimed for a device, clients will be eligible for claimable client review services. Refer to the Schedule of Service Items and Fees for maintenance service and client review service and claiming requirements.

Replacement of Private Devices lost or damaged beyond repair

If a client loses or damages their private devices beyond repair, they are entitled to receive the services still available to them on their current voucher, including fittings.

• If the client has not previously received a fitting under the program, they are entitled to receive an initial fitting service with device/s from a Schedule of Approved Devices.
• If the client has previously received a fitting under the program, and the lost/DBR device:
• is on a Schedule of Approved Devices, the device should be replaced with the same device.
• is no longer on a Schedule of Approved Devices, the device should be replaced with a similar device.

The program requirements for a replacement service apply (i.e. the client must complete a Statutory Declaration for a lost device, or the manufacturer must provide written confirmation that the device is irreparable). The Statutory Declaration or manufacturer’s letter must be received before the device is replaced.

• If the client has received a fitting under the program and they meet one of the Eligibility Criteria for Refitting they are entitled to receive a refitting service, provided they accept device/s from a Schedule of Approved Devices.

Record Keeping

The client record must contain evidence that the client understood their rights under the program and consented to pay for private services and/or devices. This includes:

• notes documenting the advice given by the qualified practitioner to the client regarding the program services available on their current and future voucher  
• notes confirming that a same/similar service or revalidated service was not available to the client on their current voucher
• an acknowledgement signed and dated by the client, that includes
  • a statement that the client understands the services available to them under the program, but has decided to purchase services and/or device/s privately
  • what program services will no longer be available
  • the total cost of the service/s and/or device/s and that no program subsidy is available
• if private devices are supplied, a signed quote including:
• the model, style and type of device
• the warranty period
• the provider’s return’s policy
• arrangements for ongoing maintenance, including whether the device/s can be maintained under the program or not, and
• a statement that the client understands that if they relocate to a new provider, a new provider may not provide maintenance for non‑approved devices.

If there is a refitting, replacement or the client chooses to enter a maintenance agreement for a private device, the standard program record keeping requirements for these services apply and these form part of the client record.

Provider Records

The provider must retain copies of client payment receipts and other related documents. This does not form part of the client record but remains with the provider if a client relocates. The department can request access to this information to confirm the private service was completed in accordance with program requirements.

Recording Private Devices in the Portal

The portal should have an accurate record of the client’s primary device/s.

• If a client is fitted with a private device, the device information in the Service History accordion of the portal must be updated.
• If the client’s private device/s are listed on a Schedule of Approved Devices, also include the device code in the Service History.

Transition

Providers must have established policies and procedures to support the delivery of private services to program clients by 1 April 2020. A Private Services Acknowledgement template has been released by the department and can be used by providers to support compliance with the program requirements for private services. The template is available on the Forms and Publications webpage.

Compliance Monitoring

Program requirements are monitored in accordance with the Compliance Monitoring and Support Framework. Please note that if any invalid services and/or claims are identified, providers may be required to reimburse the Commonwealth and/or clients.