Medical Practice Financial Management: A Guide for Australian Practice Managers

A practical guide to medical practice financial management for Australian practice managers: revenue streams, P&L basics, KPIs, accounts receivable, budgeting, and financial controls.

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Australian practice manager at a medical reception desk reviewing financial management data — HLT57715 | TalentMed RTO 22151

Practice Management Finance

Medical Practice Financial Management: A Guide for Australian Practice Managers

Managing the finances of a GP or specialist practice is one of the most complex and consequential responsibilities a practice manager carries, yet it is rarely covered in on-the-job training. GPs went into medicine to deliver patient care, not to run a business. In most Australian general practices, the practice manager is the person who owns the numbers: revenue reconciliation, accounts receivable, the P&L, the annual budget, and the financial controls that protect the practice from error and fraud. Without a practice manager who understands the financial architecture of the business, the clinical side cannot function sustainably.

This guide covers the core financial competencies every practice manager needs: understanding where revenue comes from, reading a profit and loss statement, tracking the key financial KPIs, managing accounts receivable effectively, and building a productive working relationship with the practice’s accountant and bookkeeper. The guidance here is educational. For specific financial or tax advice about your practice, discuss the details with a qualified accountant who understands the general practice sector.

TalentMed Pty Ltd (RTO 22151) delivers the HLT57715 Diploma of Practice Management, a nationally recognised qualification covering operational governance, billing, financial management, compliance, and people leadership competencies. VSL (VET Student Loans) funding is available for eligible students enrolled in this qualification.

Why financial management is a core practice manager skill

The practice manager is the financial backbone of an Australian medical practice, because the GPs typically are not. Clinical training covers medicine, not business. Most GPs who own or co-own a practice have limited formal exposure to financial management, and even salaried GPs in larger corporate or hospital-aligned practices are not primarily focused on the business numbers. That gap is the practice manager’s domain.

In a typical Australian general practice, the practice manager oversees all financial flows: Medicare claims and remittances, private billing and receipting, third-party payments from WorkCover and DVA, payroll, supplier invoices, and the monthly close that feeds the accountant’s work. Beyond the day-to-day transactions, the practice manager is also responsible for the financial planning cycle: the annual budget, capital expenditure decisions, staffing cost modelling, and the forward forecasts that inform decisions about GP recruitment, session expansion, or new service lines.

The financial management role spans three dimensions. First, operational finance: ensuring the daily and weekly transaction cycle runs accurately and that claims are processed, reconciled, and followed up promptly. Second, management accounting: using financial data to understand practice performance, spot trends, and advise the principal GPs or practice owners. Third, financial governance: ensuring that controls are in place to prevent error and fraud, that the practice’s financial obligations (tax, super, payroll, equipment finance) are met on time, and that the accountant has the information they need to do their job.

Practice managers who develop competence across all three dimensions are significantly more valuable to their practice and to the broader healthcare sector. For the broader skill set the role requires, see 10 skills every Australian practice manager needs.

Revenue streams in a medical practice

Most Australian general practices draw revenue from several streams simultaneously, and a practice manager who understands each stream can reconcile, monitor, and optimise the whole picture. The mix varies by practice type, location, and billing model, but the main categories are consistent across general practice, with variations in specialist and allied health settings.

Revenue stream How it works Practice manager responsibilities
Medicare bulk billing The practice assigns the Medicare rebate on behalf of the patient. No out-of-pocket cost to the patient. Remittance from Services Australia typically within 24 to 48 hours via EFT. Ensure item numbers are correct, patient eligibility is confirmed, and claims are submitted same-day or next-day. Reconcile remittances against expected amounts regularly.
Medicare gap billing (mixed billing) The patient pays a fee above the Medicare rebate. The practice may use ECLIPSE to process the patient’s rebate at the point of service, or the patient claims separately. The gap is the practice’s private fee revenue. Manage fee schedules, communicate fees to patients at booking, issue compliant accounts and receipts, and monitor unpaid gap amounts in accounts receivable.
Private (non-Medicare) fees Services not covered under the MBS: cosmetic consultations, some procedural items, non-bulk-billed Allied Health, and private specialist billing. Fees set against the AMA schedule or practice’s own schedule. Maintain fee schedules aligned with the AMA schedule or practice policy; manage private health fund claiming via HICAPS; follow up outstanding accounts promptly.
WorkCover and DVA Workers compensation (state-based: WorkSafe VIC, iCare NSW, WorkCover QLD, ReturnToWorkSA, etc.) and Department of Veterans’ Affairs claims are billed at specific schedule rates and paid by the insurer, not the patient. Processing timelines are longer than Medicare (typically 30 to 90+ days). Verify the correct form and schedule for each state scheme and for DVA Gold/White card patients; submit claims promptly; actively manage debtor ageing on third-party accounts.
Allied health billing Practices co-locating physiotherapy, psychology, dietetics, or other allied health services may share in revenue through room rental, percentage arrangements, or employment. The revenue structure depends on the service agreement. Understand the contractual arrangement for each allied health provider; ensure billing and receipting is compliant with the relevant schedule and fund requirements.
Consumables and procedures Some practices charge separately for clinical consumables (dressings, vaccines administered), pathology collection fees, or procedure-related costs. These must be disclosed to patients at the time of booking. Ensure fee schedules are current and disclosed; confirm Medicare and private health fund rules on which items may be separately charged; document charges in the clinical record.

Revenue figures vary significantly across practice types, locations, and billing models, and published benchmarks should be treated as directional guides rather than fixed targets. Industry associations such as the Australian Medical Association (AMA) and the Royal Australian College of General Practitioners (RACGP) periodically publish data on practice revenue and cost structures. Discuss benchmark comparisons with your accountant who can provide analysis specific to your practice’s situation.

Understanding the practice P&L

A profit and loss statement (P&L) summarises a practice’s revenue and expenses over a period and shows whether the business is generating a surplus or running at a loss. Practice managers do not need to prepare the P&L (that is the accountant’s work), but they do need to understand what it is telling them and be able to report against it accurately. Reading the P&L regularly is how a practice manager spots problems early: a revenue dip in a particular billing stream, an expense category trending above budget, or a GP billing pattern that has changed.

The P&L structure for a typical Australian general practice follows a straightforward pattern. Revenue sits at the top, drawn from the streams described above. Below that, operating expenses are grouped by category: staff costs, occupancy, clinical supplies, administration, and professional services (accounting, IT, legal). The gap between revenue and total expenses is the operating profit, from which the owners draw their income.

Cost benchmarks vary by practice type and location. That said, some general patterns are widely observed in Australian general practice. Staff costs (including GP contractor fees, nurse salaries, reception wages, and superannuation) are typically the largest expense category and commonly represent 50 to 60 per cent of practice revenue. Occupancy costs (rent, fit-out depreciation, utilities, cleaning) typically account for 10 to 15 per cent. Clinical supplies, administration, software, and professional services make up most of the remainder.

A practice manager who reviews the P&L monthly (rather than waiting for the annual financial statements) can catch expense drift early and give the principal GPs and owners meaningful financial updates without waiting for the accountant’s quarterly report. That habit is one of the most practical things a practice manager can develop.

Key financial KPIs for practice managers

Financial KPIs give a practice manager the visibility to manage performance proactively rather than reactively. The right KPIs turn the raw transactional data from the practice management system and accounts into indicators that are meaningful to both the practice manager and the principal GPs. For a complete KPI framework including clinical, operational, and patient experience metrics alongside the financial indicators, see GP practice KPIs and dashboards for Australian practice managers.

The financial KPIs that matter most for Australian general practice are:

KPI What it measures Why it matters
Billings per GP per session (or per day) Total billed revenue divided by GP sessions or GP days worked over a period. Tracks GP productivity and billing patterns. A change in this number often signals a billing issue (missed items, item number errors) or a clinical pattern change (more complex patients, longer consultations). Benchmarks vary by practice type and location.
Cost per patient encounter Total operating costs divided by the number of patient encounters in the same period. Monitors efficiency. Rising cost per encounter (without a corresponding revenue increase) signals that either costs are growing or patient volume is falling.
Overhead ratio Total non-GP operating expenses as a proportion of total revenue. Indicates how efficiently the practice uses its revenue base to cover fixed and variable costs. A rising overhead ratio (expenses growing faster than revenue) is a signal to review cost categories.
Accounts receivable (AR) days Average number of days it takes to collect payment after a service is delivered, weighted across all payment types. Medicare bulk-billing remittances arrive in 24 to 48 hours; WorkCover and DVA invoices can take 60 to 90 days or longer. A rising overall AR-days figure suggests third-party debts are accumulating without active follow-up.
Debtor ageing analysis Outstanding accounts receivable categorised by how long they have been unpaid: current (0 to 30 days), 30 to 60 days, 60 to 90 days, and 90+ days. Debts over 90 days are significantly less likely to be collected without active intervention. A monthly debtor ageing review is the core of accounts receivable management.
Bad debt rate The proportion of billed revenue that is written off as uncollectable over a period. Rising bad debt rates indicate systemic issues with the collection process or with the patient and third-party payment mix.

Run these KPIs monthly at minimum, and review the trend over rolling 3-month and 12-month windows. Point-in-time numbers are less useful than trends. Most practice management software can generate the underlying data; the practice manager’s role is to extract it consistently and interpret it in context.

Managing accounts receivable

Accounts receivable management is the discipline of ensuring that money the practice has earned is actually collected, and collected promptly. Medicare bulk-billing remittances are fast and reliable, but third-party billing (WorkCover, DVA, private health insurers, and self-pay patients with outstanding accounts) requires active management. Practices that do not run a structured AR follow-up process commonly accumulate significant uncollected revenue without realising it until the accountant flags the balance sheet.

The core of good AR management is a regular and structured follow-up process for each debt type:

  • Medicare remittance reconciliation. Run Medicare remittance reconciliation at least weekly, ideally daily. Every claim submitted should be matched to a remittance line. Claims returned as rejected or requiring more information need to be corrected and resubmitted promptly. Unreconciled items left sitting in the system create false revenue expectations and can compound into material write-offs.
  • WorkCover and DVA debtor ageing. Third-party billing from Workers Compensation and DVA is the highest-risk AR category in most practices. Payment timelines are longer (30 to 90+ days depending on the state scheme and claim complexity), documentation requirements are more demanding, and rejected claims require specific resubmission processes. A dedicated AR register for WorkCover and DVA accounts, reviewed weekly, is the standard approach in well-managed practices. Escalate accounts over 60 days and over 90 days to progressively firmer follow-up protocols.
  • Private patient and gap payment accounts. Self-pay patients and patients with outstanding gap amounts need a clear and consistent follow-up sequence: initial statement at the time of service, a reminder at 14 days, a second notice at 30 days, and a formal demand at 60 days before escalation to a collections agency or small claims if warranted. The practice’s patient agreement at enrolment should make payment terms clear.
  • Rejected and returned claims. Services Australia and third-party insurers return claims for a range of reasons: incorrect item numbers, provider number errors, missing documentation, exceeded schedule limits, and eligibility issues. Rejected claims need to be corrected and resubmitted within the applicable time limit (Medicare has a two-year limit for initial claims; WorkCover limits vary by state). Track rejections by category to identify systemic billing errors.
  • Private health fund billing via HICAPS. HICAPS claiming processes the patient’s health fund benefit at the point of service, which eliminates most private-billing AR for in-fund services. However, some fund types, out-of-fund claims, and overseas-visitor health cover arrangements require manual lodgement and follow-up. Know which claiming pathways your practice uses and ensure each has a clear reconciliation process.
  • Write-off policy. Every practice needs a documented policy for when to write off an unpaid debt as irrecoverable. The policy should specify the debt age, the follow-up steps that must have been taken, and the approval authority for write-offs. Undocumented write-offs create both accounting problems and governance risks.

Medicare remittance reconciliation is covered in more detail in Medicare billing fundamentals for practice managers, which also covers the billing mechanics underpinning the claims and remittance cycle.

Practice budgeting and forecasting

A practice that operates without a budget is flying blind. The annual budget is not just a financial exercise; it is the mechanism that translates the practice’s plans (hiring a new GP, adding an allied health room, upgrading clinical equipment) into financial commitments that can be tracked and managed. Practice managers who run a proper budget cycle give their principal GPs the data they need to make informed decisions.

The annual budget process for a general practice typically follows a simple structure. Start with revenue: project the number of GP sessions per week across the year, apply realistic billing-per-session benchmarks (using the practice’s own historical data, not industry averages), and layer in any anticipated changes (new GP starting, GP reducing sessions for parental leave, expansion of allied health services). Then build the expense side: staff costs (wages, super, leave provisions), occupancy (rent adjustments, lease renewals), clinical supplies (consumables, vaccines), administration and software, and professional services. The gap is the projected operating result.

  • Annual budget. Build for the full financial year (typically July to June in Australian practice, though some practices use a calendar year). Review and update at mid-year with actual results. The budget is the target; the mid-year review is the course correction.
  • Rolling 3-month forecast. Maintain a short-term forecast that updates monthly with actual results and forward projections. The rolling forecast is more responsive than the annual budget for flagging near-term cash flow pressures: a GP taking unplanned leave, a large equipment purchase, a quarterly BAS payment coming up.
  • Capital expenditure planning. Clinical equipment (ECG machines, sterilisation equipment, pathology collection equipment, consulting room fit-out) has a finite life and needs replacement planning. A simple asset register tracking purchase date, expected useful life, and replacement cost gives the practice manager the data to budget for capital expenditure rather than being surprised by it. Discuss depreciation treatment with the practice’s accountant.
  • Staffing cost modelling. Staff costs are typically the largest single line item. When considering hiring, the budget model should include not just base salary but on-costs: superannuation (currently 11.5%), leave accruals, workers compensation premium, payroll tax (if the practice exceeds the state threshold), and any allowances under the relevant Award. Undercounting on-costs is a common budgeting error.
  • Lease and occupancy review. Lease costs are a long-term commitment. When a lease renewal is approaching, model the impact on the practice’s overhead ratio before agreeing to terms. A significant rent increase that pushes occupancy costs above 15 per cent of revenue without a corresponding revenue increase will compress margins materially.

    • Working with accountants and bookkeepers

    The practice manager and the practice’s accountant play complementary roles, and understanding where one ends and the other begins is essential for both to do their jobs well. The practice manager is responsible for the day-to-day financial transactions, the accuracy of the records, and the production of management information. The accountant is responsible for statutory compliance, tax strategy, financial statements, and external reporting. The bookkeeper (if separate from the practice manager) handles the transaction recording, bank reconciliation, and payroll runs.

    A productive accountant relationship depends on the practice manager providing accurate, timely information. The accountant cannot do good work with incomplete or messy data. The month-end close discipline is the foundation of that relationship:

    • Month-end close checklist. By a consistent date each month (typically the 5th of the following month), the practice manager should have completed: bank account reconciliation, Medicare remittance reconciliation, supplier invoice processing and approval, payroll reconciliation, and a review of the AR ageing report. This information is then available to the accountant or bookkeeper for the month-end journal entries and management report.
    • What the practice manager provides. Transaction records (purchase invoices, bank statements, payroll reports, Medicare remittance reports), supporting documentation for unusual items, and a brief narrative on significant variances from budget. The more organised and consistently formatted these materials are, the less time the accountant needs to spend on reconciliation and the more they can spend on analysis.
    • What the accountant handles. Statutory financial statements, income tax returns (for the practice entity and for individual GP owners where the accountant acts for them), BAS/IAS preparation, superannuation guarantee compliance reporting, payroll tax returns (where applicable), and tax planning advice. Do not ask the accountant to perform bookkeeping tasks: the hourly rate differential is significant and the accountant’s time is better used on higher-value advisory work.
    • Financial software alignment. Most Australian practices use accounting software such as Xero, MYOB, or QuickBooks alongside their clinical practice management software. Confirm that the chart of accounts in the accounting software aligns with the reporting structure the practice manager needs to track KPIs, and that exports from the practice management system (for billing and revenue data) can be imported cleanly into the accounting software without manual rekeying.
    • Tax and financial advice boundaries. The practice manager can implement financial controls, run the budget, and manage the AR process. Tax strategy, structuring decisions, trust distributions, and remuneration arrangements for GP principals are accountant work. Be clear about that boundary, particularly in owner-operated practices where the lines can blur. For questions on specific tax obligations, the accountant is the right adviser, not the practice manager working from general information. Discuss with your accountant before acting on any specific tax or structuring matter.

    Financial controls and fraud prevention

    Financial fraud in medical practices is more common than most practice owners expect, and most instances involve trusted, long-term staff members rather than external parties. The practice manager is responsible for designing and maintaining the financial controls that make fraud difficult to execute and easy to detect. This is not about distrusting your team; it is about removing the conditions that allow fraud to occur undetected. Good controls protect staff as much as the practice: clear processes reduce ambiguity about who is accountable for what, and a documented audit trail protects good-faith staff from unfair suspicion when discrepancies arise.

    • Separation of duties. The person who processes payments should not be the same person who approves them or reconciles the bank account. In a small practice where one person handles multiple financial functions, build compensating controls: require GP principal sign-off on any payment above a set threshold, and have the accountant or principal review bank reconciliations monthly rather than having the practice manager reconcile their own transactions unsupervised.
    • Petty cash controls. Petty cash funds should be small, float-based, and reconciled at each replenishment with receipts. Every payment from the petty cash float should be documented. Petty cash should not be used as a convenient source of unrecorded payments. If the petty cash fund is regularly running out before receipts add up, investigate before replenishing.
    • Prescription pad and script security. Prescription pads are a fraud and safety risk and should be stored securely, with access restricted to clinical staff. Missing or extra prescription forms should be investigated immediately. Some states require prescription pad registers. Check your state health department’s current prescription security requirements.
    • Banking and access controls. Online banking access should be restricted to authorised users, with two-factor authentication enabled. New payees should require a second authorisation. Regularly review the list of users with banking access and remove former staff promptly. Bank statements should be reviewed by a person other than the one who processes payments.
    • Inventory controls for high-value clinical supplies. Vaccines, controlled substances, and high-value consumables should be stored and counted separately, with stock movements recorded. Unexplained shortfalls are a clinical governance concern as well as a financial one. A regular stock reconciliation is both a financial control and a medication safety requirement under RACGP Standards.
    • Regular internal reviews. The practice manager should run a simple internal review at least quarterly: review all supplier payments for unfamiliar payees or unusual amounts, check for duplicate invoices or payments, review staff expense claims against receipts, and reconcile credit card statements. This does not need to be a formal audit; it needs to be a consistent habit. Fraud most commonly persists because no one checks.

    Financial controls sit within the broader quality and governance framework that practice managers are responsible for. For the governance context relevant to clinical practice quality, see what is clinical governance, which covers how quality and accountability structures work across Australian healthcare organisations.

    The HLT57715 Diploma of Practice Management at TalentMed

    The HLT57715 Diploma of Practice Management equips practice managers with the operational governance, billing, financial management, compliance, and people leadership skills needed to run a modern Australian medical practice. Delivered fully online over 12 months (with motivated students completing in as little as 6), the qualification is recognised across GP, dental, allied health, and specialist practice settings. TalentMed Pty Ltd, RTO 22151, delivers this qualification with VSL funding available for eligible students.

    Duration

    12 months, possible in 6 for motivated students. 100% online, self-paced.

    Funding

    VSL approved. Monthly payment plans, employer-funded and upfront options available.

    Intakes

    Daily intakes, 365 days a year.

    Outcome

    Nationally recognised AQF Level 5 diploma. Applicable across GP, dental, allied health and specialist settings.

    Related practice management articles

    Medicare billing fundamentals

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    Day in the life of a practice manager

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    Frequently asked questions

    No formal accounting qualification is required to be a practice manager, but a working knowledge of financial management is essential. Practice managers are not expected to prepare tax returns or financial statements; those are the accountant’s responsibilities. What the role requires is the ability to run a billing and accounts receivable process, interpret a P&L, build and track a budget, and provide the accountant with accurate, timely information. The HLT57715 Diploma of Practice Management covers the financial management competencies the role requires. If your practice has a dedicated bookkeeper, their work and the practice manager’s work complement each other, with the practice manager taking a supervisory and management-reporting role.

    Published benchmarks vary significantly by practice type (bulk-billing, mixed billing, private), state, location (metro, regional, rural), and GP specialty. Industry data from the AMA and RACGP provide indicative ranges, but these change over time with MBS fee adjustments and practice mix. The most useful benchmark for your practice is your own historical data: track billings per GP per day or per session consistently over time and use the trend to identify changes. For sector benchmarks, discuss with your accountant, who can provide comparators relevant to your practice type and location.

    When a GP practice submits a Medicare claim electronically (via ECLIPSE or Online Claiming through the practice management software), Services Australia assesses the claim and, if accepted, pays the Medicare benefit by EFT to the practice’s nominated bank account. For bulk-billed services, remittance typically arrives within 24 to 48 hours. The remittance report (available through HPOS or the practice management software) itemises each accepted claim, the amount paid, and any claims rejected or requiring more information. Practice managers should reconcile the remittance report against submitted claims at least weekly, and address rejected claims promptly, as some have a resubmission time limit.

    Most Australian general practices use a combination of practice management software (Best Practice, Medical Director, Zedmed, or Cliniko for allied health) for clinical records and billing, alongside accounting software (Xero, MYOB, or QuickBooks) for financial management. The practice management system handles Medicare claiming, appointment scheduling, and clinical documentation. The accounting software handles the general ledger, payroll, BAS preparation, and financial reporting. Payroll functions are often handled through a dedicated payroll module within Xero or MYOB, or via a standalone payroll platform. The key integration to manage is the flow of billing and revenue data from the practice management system into the accounting software, to avoid manual rekeying and the errors that come with it.

    Start with revenue: forecast GP sessions per week over the budget year, apply your practice’s historical billing-per-session figure, and adjust for any known changes (new GP starting, current GP reducing sessions, allied health expansion). Then build the cost side in categories: staff costs (wages, super at 11.5%, leave accruals, workers comp premium), occupancy (rent, utilities, cleaning), clinical supplies, administration and software, and professional services (accounting, IT). The gap between projected revenue and projected expenses is the operating result. Build the budget in a spreadsheet or your accounting software, review at month-end against actual results, and update the rolling 3-month forecast monthly. Your accountant can assist with the structure and benchmarks for your practice type.

    Accounts receivable (AR) refers to money that the practice has earned by delivering services but has not yet received. In a GP practice, this includes: Medicare claims submitted but not yet remitted, gap-payment and private accounts issued but not yet paid, WorkCover and DVA invoices lodged but not yet settled, and private health fund claims outstanding. Good AR management means tracking all outstanding amounts by age, following up systematically, and writing off irrecoverable debts according to a documented policy. Poor AR management means revenue earned disappears into the accounts-receivable balance and is effectively lost. Run a debtor ageing report monthly at minimum.

    WorkCover billing is more complex than Medicare because each state has its own scheme with different forms, fee schedules, and payment timelines. When a WorkCover invoice goes unpaid beyond the scheme’s standard payment timeframe (which varies from 30 to 90 days depending on the state), the standard follow-up process is: confirm the invoice was received by the insurer, check for any documentation the insurer is waiting on (treatment notes, certificates, specific forms), resubmit with the required supporting documentation, and escalate to the relevant scheme’s provider contact centre if the delay is unreasonable. Keep a WorkCover debtor register that tracks each outstanding invoice, the amount, the submission date, and the follow-up actions taken. For invoices that remain unpaid after reasonable follow-up, discuss with your accountant whether a formal dispute process is available under the relevant state scheme.

    The core financial KPIs for an Australian GP practice are: billings per GP per session or per day (tracks GP productivity and billing accuracy), cost per patient encounter (monitors efficiency), overhead ratio (total non-GP expenses as a proportion of revenue), accounts receivable days (average collection time across all payment types), debtor ageing by bucket (current, 30 to 60 days, 60 to 90 days, and 90+ days), and bad debt rate (the proportion of billed revenue written off). Review these monthly, track the trend over rolling 3-month and 12-month windows, and compare against the practice’s own historical data rather than generic industry averages. For a complete dashboard framework including clinical and operational KPIs, see the GP practice KPIs and dashboards article in this hub.

    This article is part of the TalentMed practice management resource hub, covering the skills, knowledge, and career pathways for practice managers across Australian GP, dental, allied health, and specialist settings. See also telehealth in general practice for how telehealth billing fits within the broader financial management picture.

    TalentMed Pty Ltd, RTO 22151. HLT57715 Diploma of Practice Management is a nationally recognised AQF Level 5 qualification, delivered fully online. General educational information only, not financial, tax, or legal advice. Revenue benchmarks are general indicators only; actual figures vary by practice type and location. Discuss specific financial, tax, or structuring matters with a qualified accountant. WorkCover scheme rules and timelines vary by state; verify with the relevant state authority.

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