Requesting a revalidated service
This page provides information on the process of revalidating a service.
If a client has used the Assessment/Reassessment service on their current voucher but the provider believes they require another assessment, or if the client has used any available fitting service but the provider believes they need refitting, the provider may apply for an additional (revalidated) assessment or fitting service from the program.
Revalidated services should only be claimed if the client’s circumstances in hearing or health have changed significantly or if there is immediate risk of harm or danger to the client if they are required to wait until the service becomes available to them again.
Click here for the link to the Request for a Revalidated Service form.
How to request a revalidated service
Process effective from 1 July 2021
From 1 July 2021, providers must submit an online revalidation request and wait for program approval before they can deliver and claim an approved service. Providers will be notified whether their application has been approved or rejected by email within 7-10days of submission of their application.
The online revalidation request form is dynamic and you will only be required to answer specific questions related to your request. For example if the request is for Reason A – client requires a reassessment, you will only receive prompts to complete questions relating to a reassessment.
You are required to retain a copy of the submitted application form and supporting evidence on the client’s file to meet the Program’s record keeping requirements. Note, the copy of the form or similar must be signed by the client or their power of attorney (on behalf of the client) and the practitioner. This demonstrates their acknowledgement of the service request. The practitioner cannot sign on the client’s behalf.
Your practise may continue to complete the Request for a Revalidated Service form for in-house record keeping purposes only. However, it will not be accepted as by the program for assessment.
Providers must include a written summary in the mandatory* fields on the online revalidation form of why a revalidated service is required to enable submission. Practitioners must select the most appropriate reason and indicate what service item they intend to provide and if approved, subsequently claim. There are two reasons for requesting a revalidated service
- Reason A – Reassessment is required due to a significant deterioration in hearing
- Reason B – Client is eligible for refitting under the Eligibility Criteria for Refitting (ECR) guidelines and a device fitting has already been claimed against the current voucher.
Required information for Reason A
Reason A should be selected if the client’s hearing thresholds have permanently deteriorated by15dB or more at two or more frequencies between 500Hz and 4000Hz in at least one ear.
The following information is required for Reason A and should be detailed on the request form.
- Results of the previous audiogram (item 600/800)
- Results of a recent audiogram/screening test
- Tympanometry results if bone conduction testing was not completed
Successful submission example
Required information for Reason B
Reason B should be selected if your client is eligible for refitting under the current ECR guidelines but has already received a fitting on their current voucher. The following information is required for Reason B and should be detailed on the request form.
- Indicate what item you will be claiming - 820, 830, 825, 820 with 770 (no monaural maintenance agreement in place), 820 with 760 (monaural maintenance agreement in place).
- If the client was previously fitted with an ALD and the application is for hearing aids, the application form should include a refit and subsequent initial fit, i.e. 820/760 or 820/770.
- Select the ECR met for this refitting
- Clinical explanation why a refit is required
- Providing evidence to support the refit
A letter from a medical practitioner is required when selecting ECR 2 or 3 for a revalidated service to provide evidence of a deterioration in health, dexterity or cognitive ability or change in physical condition of ear or ear health.
Successful submission examples
Refitting requirements under the program
When determining if a client is eligible for refitting under the ECR, practitioners are responsible for using their clinical judgement and clearly documenting their decision-making process.
It is a legislative requirement that the client meets a current ECR. Revalidated services provided due to exceptional circumstances, where a client does not meet an ECR, will be recovered.
Service providers should also be aware that a refitting to have matched devices is not a valid ECR.
Fitting the opposite ear when an item 820 has already been claimed
A request for a revalidated service is not required when an item 820 has already been claimed against the current voucher and the client is eligible for a fitting on the opposite ear. Please email email@example.com for client specific advice on how to claim in this situation.
Example 1: Your business claimed an item 820 left, your business has now fitted the right - recover the 820 left and submit an item 830. Note: the Date of Fitting for the left will be different to the right as they were fitted at different times.
Example 2: A previous service provider claimed an item 820 left, your business has now fitted the right, against the individual client record manually submit an item 820 right.
Submitting your Revalidated claim in the Portal
For more information about requests for revalidated service please email firstname.lastname@example.org.