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Data Element Detail

Compensable/eligibility status for non-admitted patients
Identifying and Definitional Attributes
QH 040759 v1
Data Element
Data Element
Current
15-Jan-1998		Retired
30-Jun-1999
Standard
01-Jul-1993
30-Jun-1999
Eligible patients are those patients who are deemed to be eligible for Medicare Services, under the Medicare Agreement. This includes:
- Patients who reside in Australia and whose stay in Australia is not subject to any limitation as to time, imposed by law.
- Patients who are visiting Australia but who are ordinarily a resident in the United Kingdom, New Zealand, Finland, Sweden, Malta, Italy or the Netherlands, as they are covered by reciprocal health care agreements. However, patients from Malta and Italy are covered for six months only.

It does NOT include:
- Foreign diplomats or their families, except if eligibility is expressly granted to them by the terms of a reciprocal health care agreement.

C2.1 Eligible Third Party

Eligible patients (under the Medicare Agreement) who:
- are entitled to claim damages under Motor Vehicle Third Party Insurance (TPI); or
- have, or may have, an entitlement to claim under some other form of third party insurance (eg, have injuries after a vehicle accident not covered under TPI, but compensation is possible under the Criminal Offence Victims Act 1995, or some form of public liability insurance, etc);

C2.2 WCBQ Eligible Compensable

Eligible patients (under the Medicare Agreement) who:
- are entitled to claim damages under the Queensland Workers' Compensation Act or under another Workers' Compensation Act (eg, if they are an employee of the Commonwealth or employed interstate);

C2.3 Other Eligible Compensable

Eligible patients (under the Medicare Agreement) who:
- are seeking compensation for injuries under the criminal code.

C2.4 Eligible Public

Eligible Public patients are eligible patients who, elect to be public patients and satisfy the necessary criteria.

C2.5 Eligible Other

Eligible Private patients are eligible patients who, upon admission to a recognised public hospital (or soon after) elect to:
- be private patients treated by a medical practitioner of their own choice; or
- occupy a bed in a single room and be responsible for paying the appropriate charges raised by the hospital and the treating medical or dental practitioner.

C2.6 Ineligible

Ineligible patients are patients who are not deemed to be eligible for Medical Services under the Medicare Agreement.
Reporting of activity data from health facilities
Compensable/eligibility status for non-admitted patients
Representational Attributes
Permissible Values

Permissible_values

-
Supplementary Values

Supplemenary_values

-
Collection and Usage Attributes
For the purposes of the Monthly Activity Report (PH1 form), Department of Veterans' Affairs (DVA) patients who are not compensable in the strict interpretation of the word, but are patients for whom another agency (the DVA) has accepted responsibility for the payment of any charges relating to their episode of care, should be classified as eligible compensable patients.
Relational Attributes
Related Metadata References

Related Metadata References_IR

  • 1 - 3
ViewRelationshipMetadata Item TypeMetadata Item SubtypeNameIdentifier & VersionApproval Status
Is used in conjunction withData ElementCross-ClassificatoryAmbulatory clinic typesQH 040761 Version 1Superseded
Is used in conjunction withData ElementData ElementType of non-admitted patient careQH 040094 Version 1Superseded
Relates toData ElementData ElementChargeable/compensable class status changeQH 040255 Version 1Retired
Implementation in Metadata Sets

Implemented

  • 1 - 1
ViewMetadata Item TypeMetadata Item SubtypeNameIdentifer & VersionObligationApproval StatusEffective FromEffective To
Information AssetData CollectionMonthly Activity Collection (MAC)QH 020008 Version 1Superseded01-Jul-199330-Jun-1999
Source and Reference Attributes
Compensable status; Eligibility status;