Funding Options We acknowledge that healthcare can place additional strains on your financial situation. These funding options may provide you with the opportunities to connect with other healthcare providers who will assist in your achievement program with us. Please make sure you let us know which funding you are eligible for and if you wish to access this funding so that we can make arrangements to you. Funding Options available are:
NDIS Learning to Shine is a registered provider under the National Disability Insurance Scheme and in 2022 completed Third Party Verification with 100% compliance. In 2019 we were certified to provide Occupational Therapy to children and adolescents who have an NDIS plan.
Our Occupational Therapists provide services for all types of NDIS Participants - self-managed, plan-managed, and NDIA-managed Participants. All approved clients who have received their plan and funding amounts will need to complete a service agreement before commencing sessions. Our sessions with NDIS clients are review sessions, this allows extra time in sessions to provide education and training around the therapy/intervention and contributes to a sustainable approach to capacity-building service delivery.
Our therapists will also provide additional capacity-building services for all members of your informal/formal support network with regular communication and updates on successful strategies.
We acknowledge our strengths in Therapy/Interventions and choose to refer all complex equipment prescriptions and home modifications to other services that have greater skills than our team can provide you with.
FEE FOR SERVICE / PRIVATE HEALTH INSURANCE Occupational Therapy is covered in most policies under "top level" cover. You do not need a referral to attend Learning to Shine. Our Service Model Agreement, terms and conditions and policies are sent out to all those that access our service. Within our Service Model agreement, you will find our fee schedule which outlines costs of sessions. This will also be explained to you by our admin team before your first appointment is made. We have EFTPOS facilities and receipts are issued on the day or emailed so you can easily claim against your private health insurance - if you have Occupational Therapy in your extras cover – please check with your private health fund.
We do not have access to Hi-Caps; however, we do issue receipts which will allow you to claim online with your private health insurance provider and/or in person at their offices. Payment is required on the day of service with access to a Square Payment facility.
Simply let us know you wish to claim at your initial appointment and their provider number will be added to your receipts after each appointment.
MEDICARE - GP MANAGEMENT PLAN / TEAM CARE ARRANGEMENT Item 10958 This PLAN is available when diagnosed with a chronic medical condition (either, has been or is likely to be present for at least six months) or having complex care needs (requiring ongoing care from a multidisciplinary team consisting of their GP and at least two other health or care providers). Reporting, in summary, is required after the initial appointment, after the 5th or final session
A copy of the referral letter is required to be kept on file at LTS and MUST be provided prior to the commencement of your first appointment. Telehealth options are available
Item 82010
For children aged 13 years and younger with a new diagnosis of Autism and/or DSM-V eligible disabilities can receive up to twenty (20) rebated sessions in total with an appropriate referral from a medical practitioner. Up to four (4) assessment sessions are available if a diagnosis had not yet been made. For more information on the item - click here
The rebate benefits are outlined on the link above and will be higher for individuals/families once the SafetyNet Cap is reached. A copy of the referral letter is required to be kept on file at LTS and MUST be provided prior to the commencement of your first appointment.
MEDICARE - MENTAL HEALTH CARE PLAN Providing "Focused Psychological Interventions" required additional approval from Occupational Therapy Australia as well as current professional registration. At present, our senior Occupational Therapist has gained this approval. This funding is for the support of eligible clients who are working closely with their primary healthcare provider around mental health concerns. More information on the item -
Reporting, in summary, is required after the 6th session, and after the final and/or 10th session. Occupational Therapy specific information - http://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=80135&qt=ItemID The rebate benefits are outlined on the link above and will be higher for individuals/families once the SafetyNet Cap is reached. 80125 - clinic setting, 30-50mins 80130 - consultation outside a clinic setting, 30-50mins 80135 - clinic setting, 50+ min 80140 - home visit setting 50+ mins 80145 - group sessions 60+ mins Telehealth options are available
A copy of the referral letter is required to be kept on file at LTS and MUST be provided prior to the commencement of your first appointment.