Registration - overview

Providers are required to register with each Health Fund to be eligible to claim the higher Health Fund rebate for inpatient service claims processed through ECLIPSE.
ECLIPSE is an integrated electronic billing system where the money is paid directly to the doctor.
ECLIPSE is integrated with your Practice Management Software (PMS)
Claiming options are:

1. No Gap (Agreement)
2. Known Gap (Scheme)
3. Patient Claim

https://www.servicesaustralia.gov.au/organisations/health-professionals/services/medicare/simpli
fied-billing-and-eclipse

If you choose not to register with health funds, your options are limited:

1. To accept full payment for surgery before or after surgery OR
   
2. To process the unpaid account as a Patient Claim and wait the 4 - 8 weeks for the patient to return the cheques from Medicare and the Health Fund to you. This is known as a Pay Doctor Via Claimant (PDVC) cheque.
   The higher rebate will not be available to you and patients will have a higher out of pocket expense.
   

Resubmission - overview

When a claim is rejected through ECLIPSE, providers are required to resubmit an amended claim to receive payment. Fully rejected claims can be resubmitted via ECLIPSE, whereas partially rejected claims need to be submitted manually directly to the Health Fund. Reasons for rejecting claims may vary, so if the reason is unclear it is best to contact the Health Fund for further details.
Some Health Funds require the inclusion of the ECLIPSE adjustment claim form ( )

Medicare - PRODA

Providers must have a Medicare Provider Number to be able to register with Health Funds.
It is also recommended providers apply for a PRODA account. Practice Managers and admin staff can apply for their own PRODA account then request delegations from their provider. This can assist them in managing online claims and new provider numbers, online bulk bill claims and
outpatient claims.

Fee Schedules - overview

Most Practice Management Software has the Health Fund Fee Schedules integrated and should be available for download.

Links

PRODA link

• https://proda.humanservices.gov.au/

Medicare Forms

• https://www.servicesaustralia.gov.au/organisations/health-professionals/forms/hw029
• https://www.servicesaustralia.gov.au/organisations/health-professionals/forms/hw052

Resubmission

Consider setting up a template in your software to avoid filling the provider and practice details each time you need it.

• https://www.servicesaustralia.gov.au/organisations/health-professionals/forms/hw023

Health Fund Groups

Groups or Alliances include a number of Health Funds under the one representative body.
Providers register with the Group, who then distribute their information out to all their associated Health Funds. This streamlines the registration process making it easier for providers to reach all Health Funds.

AHSA (*)

Email: [email protected]
Access Gap Cover Freecall: 1800 664 277 (option 1)
Fax: 1800 670 898

Postal Address: 979 Burke Road, Camberwell VIC 3124
Provider Portal:  https://www.ahsa.com.au/web/doctors
Registration: Email completed form to [email protected]

https://www.ahsa.com.au/web/doctors/forms/registration__direct_credit_authority 
List of AHSA funds - https://www.ahsa.com.au/web/doctors/agc/participating_fund_contact_list  

(download the PDF copy)  https://www.ahsa.com.au/web/fundlist

Resubmission

AHSA Batch Header is required for AHSA associated Health Funds but the amended invoice and batch header form need to be delivered to the fund and NOT the AHSA

https://www.ahsa.com.au/web/doctors/forms/account_summary 

ARHG(#)

Email: [email protected] 
Ph: N/A as of April 2021
Contact: https://arhg.com.au/contact-us/ 
Registration: https://providerregistration.arhg.com.au/ 
Funds: St Lukes, CDH, La Trobe, Mildura Health.

BUPA(^)

Email: Medical Gap Scheme - [email protected] 
Ph: Providers 134 135 (For Providers, press 3)
Fax: 1300 130 623
Postal Address Medical Claims, GPO Box 9809, Brisbane QLD 4001

Partner Portal Access Form: https://partnerlogin.bupa.com.au/templates/BUP17214_Bupa%20Partner_Portal_Access_Form.pdf
Email to: [email protected]
For Providers: https://www.bupa.com.au/for-providers

Health Fund Information

AAMI~

AAMI Health Insurance is underwritten by NIB. Please see NIB for all contact, enquiries, registrations, and resubmissions details.

Code:                     NIB

ACA*

Code:                     ACA

Email:                            [email protected], [email protected]

Ph:                          1300 368 390

Postal Address:              Locked Bag 2014, Wahroonga, NSW, 2076

Registration               See AHSA

Resubmission                 Ph As above to determine reason for rejection

Email:                      [email protected]

Include:                        https://www.ahsa.com.au/web/doctors/forms/account_summary

AIA Health Insurance*

Code:                    MYO

Website:                  http://www.aia.com.au/

Phone:                         1800 333 004 - Press 3

Postal Address:             PO Box 7302, Melbourne VIC 3004

Registration               See AHSA

Resubmission               Email [email protected]

Include:            https://www.ahsa.com.au/web/doctors/forms/account_summary formerly MyOwn Health

AHM+

Code:                     AHM

Email:                        [email protected]

Ph:                            CLAIMS 1300 309 438 - Press 4, 1, 2

PROVIDER SERVICES 134 246

8am-7pm Mon-Fri

Fax:                        1800 852 030

Postal Address:                AHM Gapcover, Locked Bag 4, Wetherill Park NSW 2164

Registration                See Medibank

Resubmission                     Call CLAIMS 1300 309 438 - Press 4, 1, 2 to discuss rejections and process

information

APIA~

APIA Health Insurance is underwritten by NIB. Please see NIB for all contact, enquiries, registration, and resubmission details.

Code:                     NIB

Australian Unity*

Code:                     AUF

Email:                         [email protected]

Ph:                          1800 035 360

Open 8:30am-5pm Monday-Friday

Postal Address:            Australian Unity Health, Reply Paid 91943, Melbourne VIC 3000 Provider Portal   Call to register: https://www.australianunity.com.au/ProviderPortal/Account/LogOn

Registration           See AHSA

Resubmission              Via Provider Portal

Original & amended invoice required, no batch header required

BUPA(^)

Email:                          Medical Gap Scheme - [email protected]

Ph:                              Providers 134 135 (For Providers, press 3)

Fax:                         1300 130 623

Postal Address Medical Claims, GPO Box 9809, Brisbane QLD 4001

Email to:                         [email protected]

For Providers: https://www.bupa.com.au/for-providers

Registration and Submission

Medical Gap Scheme: https://www.bupa.com.au/-/media/dotcom/files/pdfs/08980-bupa-medical-g ap-scheme-application-form.pdf

Ph:                             Claim Payments enquiries 1300 367 877

8am-8pm Mon-Fri. Max 5 patient enquiries per call.

Fee Schedules: Bupa Healthcare Management 1800 060 239

Funds:             BUPA, ANZ Health, HBA, Health Cover Direct, MBF, MBF Alliances

Submission:    New claims unable to go via ECLIPSE must be sent by post or fax.

                        All new accounts must be forwarded to [email protected]  (one batch per email, maximum of 20 claims per batch)

Resubmission: Call 134 135 (Press 3) and discuss the problem. BUPA will provide a claim ID that needs to be included in the subject line of the email.

                         All reviews, adjustments or payment enquiries must be forwarded to Dr.Billing@bu pa.com.au (maximum of five accounts per email)

Email:              [email protected] (for previously submitted claims only)

Subject Line:   ECLIPSE MEDICARE adjustment

Body:               Eg Item xxxxx accidentally left off original claim

Please send attached amended invoice to Medicare to reassess

Can take 3 - 6 months

Attach amended invoices with completed resubmission form https://www.bupa.com.au/-/media/Dotcom/Files/pdfs/09140-06-1_provider-resubmission-form.pdf

All Provider Registration, Change of Detail Forms, and Bupa Partner Portal Access queries must be forwarded to [email protected]

Please ensure all attachments are in a PDF format where possible, with a maximum file size of 4mb. Word documents will be accepted; however, any other file types will not be successful.

Other Document Links

Medical Gap Scheme Batch Header https://www.bupa.com.au/-/media/Dotcom/Files/pdfs/batch_h eader_form.pdf

Medical Gap Scheme Change of Details Form https://www.bupa.com.au/-/media/Dotcom/Files/pdf s/change_of_details.pdf

BUPA-ADF

Email:                        [email protected]

Ph:                          1800 316 915

Invoices:                           Email [email protected] if not submitted via iRBS

CBHS Corporate Health Pty Ltd*

Code:                     CBC

Email:                       [email protected]

Ph:                           1300 586 462 (Press 3)

Postal Address:                CBHS Corporate Health, Attention: Provider Relations

Locked Bag 5098, Parramatta NSW 2124

Provider Centre: https://members.cbhscorporatehealth.com.au/providers

Registration           See AHSA

Resubmission   Phone 1300 586 462 (Press 3) to make enquiries Email: [email protected] with amended claim

CBHS Health Fund Limited*

Code:                     CBH

Email:                       [email protected]

Ph:                           1300 654 123 (Press 2)

Postal Address:              Locked Bag 5014, Parramatta NSW 2124

For Providers:                 https://members.cbhs.com.au/providers

Provider Claims: https://www.cbhs.com.au/for-providers/provider-claims Provider Benefit Statement Registration:

https://provider.cbhs.com.au/Home/ProviderBenefitStatementRegistration_fillable_v2.pdf

Registration           See AHSA

Resubmission                Call above phone number for enquiry

Email:                         [email protected] with amended claim

CUA*

Code:                     CHF

Email:                      [email protected]

Ph:                          1300 499 260

Postal Address:            GPO Box 100, Brisbane QLD 4001 Registration See AHSA

Resubmission               Email [email protected]

Include                          https://www.ahsa.com.au/web/doctors/forms/account_summary

Defence Health*

(Previously: Army Health Benefits Society)

Takes 21 days to process payment

Code:                     DHF

Email:                         [email protected]

Ph:                            1800 656 329 for providers

Postal Address:                Claims Department, PO Box 7518, Melbourne VIC 3004

Registration           See AHSA

Resubmission

For claim review: Email: [email protected]

Include:                        https://www.ahsa.com.au/web/doctors/forms/account_summary

Doctors Health Fund Pty Ltd*

(Previously: AMA Health Fund)

Code:                    AMA

Email:                        [email protected]

Ph:                              1800 226 586 - Press 2 (Hospital/Medical Claims)

Postal Address:                PO Box Q1749, Queen Victoria Building, Sydney NEW 1230

Registration           See AHSA

Resubmission                 Call 1800 226 586 - Press 2 To discuss rejections

DVA corrections

https://www.dva.gov.au/providers/claiming-and-compliance/provider-claims

Ph:                               Provider enquiries: 1800 550 457 (Confirming registration)

General enquiries: 1800 555 254

Payment confirmations: 1300 550 017 (Option 1)

Email:                       None provided as of April 2021

Postal Address:              GPO Box 9869, Capital City, Postcode

Registration          Apply for a Medicare Provider Number https://www.dva.gov.au/providers/become-dva-health-care-provider

Provider Forms:              https://www.dva.gov.au/providers/provider-forms

Resubmission                 Invoicing & billing enquiries Ph: 1300 550 017

All GENTU resubmissions are processed through DVA Webclaims in PRODA 

Submissions of MT04 numbers.

All GENTU custom item submissions are processed through DVA Webclaims in PRODA 

Emergency Services Health*

(Operating under Police Health Limited)

Code:                     POL

Email:                        [email protected]

Ph:                           1300 703 703 - Press 3

Postal Address:            Reply Paid 6111 Halifax St, Adelaide SA 5000 Registration See AHSA

Resubmission                 Email [email protected]

Include:                        https://www.ahsa.com.au/web/doctors/forms/account_summary

Frank Health*

(Operating under GMHBA)

Code:                    GMH

Email:                           General enquiries: [email protected]

Ph:                           1300 437 265 - Press 3

Postal Address:     PO Box 69, Geelong VIC 3220 https://www.frankhealthinsurance.com.au/providers

Registration           See AHSA

Resubmission   Complete the account form linked below https://www.frankhealthinsurance.com.au/documents/GMHBA-Medical-Gap-Claim -Account-form.pdf

Include:                   Amended invoice

Email:                       [email protected]

Subject line:               ‘Resubmission of rejected Eclipse claim’.

GU Health ~

(Underwritten by NIB)

Code:                     FAI

Email:                         [email protected]

Ph:                             1800 411 633, registration, update details

1800 249 966, provider claims

Postal Address:             GPO Box 2988, Melbourne Vic 8060

Registration

Online Form:   https://providers.guhealth.com.au/register/#/ Batch Header/Account Form: https://providers.guhealth.com.au/docs/provider-batch-account-for

Provider Forms:           https://www.guhealth.com.au/forms-and-publications/for-providers Email Medical Gap Network Form: [email protected] Postal Address for Medical Gap Network:

GU Health, Reply Paid 2988, Melbourne VIC 8060

Resubmission: Email: [email protected] with Membership Number in subject

GMHBA*

Code:                    GMH

Email:                               Medical Account & Billing: [email protected]

Ph:                          1300 301 437

Postal Address:             PO Box 761, Geelong VIC 3220

Registration           See AHSA

Resubmission                   Submit amended invoice to [email protected]

Include:                        https://www.ahsa.com.au/web/doctors/forms/account_summary

HBF of WA*

Code:                     HBF

Email:                       [email protected]

Ph:                            1300 810 475 or 133 423 (Press 4)

Claims Department: 08 9625 3644

Postal Address:             GPO Box 1440, Perth, WA 6845

For Providers:                  https://www.hbf.com.au/about-hbf/for-providers

Registration           See AHSA

Email:                           [email protected]

https://www.hbf.com.au/~/media/files/pdfs/HBF_Provider_Rego_Form_1

Invoice Email:               [email protected]

Note:                    Send email in one of the following formats: PDF, JPG, TIF, PNG, DOC, XLS, or CSV. Make sure the account is not password or print-protected. If the account is received in a different format or protected they will be unable to process it.

Resubmission                Medical Relations team: 08 9265 6378

Email:                       [email protected]

Include:                        https://www.ahsa.com.au/web/doctors/forms/account_summary

HCF

Will not backdate contract date on registrations.

Will not accept claims for services paid prior to the date of registration

Code:                     HCF

Email:                       [email protected]

Ph:                          131 334 - Press 4

Postal Address:             PO Box 4242, Sydney NSW 2001

Provider Portals: https://www.hcf.com.au/provider-portals/

Registration Medicover: https://www.hcf.com.au/pdf/provider-portals/HCF_Medicover_How_to_register.pdf

Medicover Application Form:

https://www.hcf.com.au/pdf/provider-portals/HCF_Medicover_application_form_for_registering_pr ovider_locations.pdf

Email address for registration forms is [email protected] as of 7-9-2023 Resubmission

Invoice & letter of explanation posted to HCF Medical Claims PO Box 4242, Sydney NSW 2001

HCI*

(Previously: APPM Council)

Code:                     HCI

Email:                      [email protected]

Ph:                            03 6432 1199   OR    1800 804 950

Postal Address:             PO Box 931, Burnie TAS 7320

Registration           See AHSA

Resubmission               Email [email protected]

Include:                        https://www.ahsa.com.au/web/doctors/forms/account_summary

Health Partners*

Code:                     SPS

Email:  [email protected] Ph:        1300 113 113 - Stay on the line. Postal Address:            GPO Box 1493, Adelaide SA 5001 Provider Portal:

https://webserv.healthpartners.com.au/ProviderServices/Home/Login.aspx

For Providers:                  https://www.healthpartners.com.au/for-providers

Registration           See AHSA

Resubmission                 Email [email protected]

Include:                        https://www.ahsa.com.au/web/doctors/forms/account_summary.

Phone:                       As above

health.com.au*

Now Frank Health. See Frank for more details.

Ph:                           1300 199 802 - Press 3

 

HIF *

(Previously: Health Insurance Fund WA Limited, Government Employees Hospital and Medical Benefit Fund Inc)

Code:                     HIF

Email:                      [email protected]

Ph:                           1300 134 060 - Press 5

Postal Address:             GPO Box X2221, Perth WA 6847

For Providers:                https://www.hif.com.au/help/providers

Registration               See AHSA

Resubmission                    Phone 1300 134 060 - Press 5 to discuss rejection. Resubmit via post.

Hunter Health #

(Previously: Cessnock District Health Benefits Fund)

Code:                     CDH

Email:                       [email protected]

Ph:                          02 4900 1385

Postal Address:             PO Box 183, Cessnock NSW 2325

For Providers:                https://www.hunterhi.com.au/providers/

Registration               See ARHG

Resubmission   Email [email protected] with amended invoice Subject line: ‘Resubmission of rejected Eclipse claim’

IMAN Australian Health Plans~

IMAN Australian Health Plans is underwritten by NIB. Please see NIB for all contact, enquiries, registration, and resubmission details.

Code:                     NIB

Use the online claim form batch header and email to [email protected]

Latrobe Health Services #

Must register prior to submitting first claim

Code:                     LHS

Email:                       [email protected]

Ph:                           1300 362 144 -  Press 3

(03) 5128 9200

Postal Address:            PO Box 41, Morwell VIC 3840 Registration     See AHRG

Batch Header: https://www.latrobehealth.com.au/globalassets/healthcare-providers/general-documents/sbkbatc hheader.web.pdf

Resubmission               Email [email protected]

Include:                      Amended invoice. No batch header required

MBF^

(Bought out NRMA Health, SGIC/SGIO Health) MBF is now Bupa. Please see Bupa for details.

Mildura #

Code:                     MDH

Email:                        [email protected]

[email protected]

Ph:                          03 5021 7091

Members Ph:             03 5023 0269

Postal Address:             PO Box 5046, Mildura, VIC 3502

Registration           See ARHG

Resubmission                Call 03 521 7091 To discuss rejections

Email:                            [email protected] no batch header required.

myOwn Health*

(Operates under AIA)

Navy Health *

(Previously: Naval Health Benefits Society)

Code:                     NHB

Email:                       [email protected]

Ph:                          1300 217 736

General Ph:                  1300 306 289 - Press 3

Postal Address:             PO Box 172, Box Hill VIC 3128

Registration               See AHSA

Resubmission               Email [email protected]

Include:                Amended invoice and https://www.ahsa.com.au/web/doctors/forms/account_summary

NIB~

NIB DOES NOT ALLOW GAPS to be charged for inpatient services

Code:                     NIB

Email:                      [email protected]

Provider Ph:           1300 853 530

Postal Address:                NIB Health Funds, Locked Bag 2010, Newcastle NSW 2300

Provider Portal:               https://www.nib.com.au/providers/hcp-portal/user/login

Registration                https://www.nib.com.au/providers/medigap-form/#/

Resubmission       Email [email protected] with amended invoice and https://www.nib.com.au/docs/provider-batch-header-form

It is important to remember that NIB does not allow gaps to be charged for their members for inpatient services. All claims must be processed as a NO GAP claim.

If the NIB rebate amount is not an acceptable amount for the procedure, your options are limited to:

Providing a quote and accepting the FULL payment for the procedure. The claim will need to be processed as a fully paid Patient Claim via ECLIPSE and the patient receives the inpatient rebate from Medicare and up to the schedule fee from the Health Fund.

Providing a quote and accepting the GAP payment for the procedure. The claim will need to be processed as an unpaid Patient Claim via ECLIPSE and the patient receives a cheque for the inpatient rebate from Medicare and a cheque for up to the schedule fee from the Health Fund. The practice will need to wait for the patient to return the cheques and there is no way to receive the money electronically or if the cheques ARE NOT given to the practice.

Nurses & Midwives Health*

Code:                    NMW

Email:                        [email protected]

Ph:                           1300 344 000 - Press 3

Postal Address:             GPO Box 3874, Sydney NSW 2001

Provider Portal:               https://providercomms.teachershealth.com.au/ 

Registration           See AHSA

Resubmission            Phone:          1300 344 000 (Press 3) To discuss rejections.

Email:                       [email protected]

Include:                Amended invoice and https://www.ahsa.com.au/web/doctors/forms/account_summary

onemedifund*

Code:                    OMF

Email:                       [email protected]

Ph:                          1800 148 626

Postal Address:              Locked Bag 25, Wollongong NSW 2500

Registration           See AHSA

Resubmission: Email [email protected]

Include:                Amended invoice and https://www.ahsa.com.au/web/doctors/forms/account_summary

Peoplecare Health*

(Previously: Lysaghts Peoplecare)

Code:                     LHM

Email:                       [email protected]

Ph:                          1800 808 690

Postal Address:              Locked Bag 33, Wollongong NSW 2500

Registration           See AHSA

Resubmission               Email: [email protected]

Include:                   Amended invoice and

https://www.ahsa.com.au/web/doctors/forms/account_summary

Phoenix Health Fund*

(Previously: Phoenix Welfare Association)

Code:                     PHF

Email:                         [email protected]

Ph:                           1800 028 817 - Press 3

Postal Address:             PO Box 156, Newcastle NSW 2300

Registration           See AHSA

Resubmission                   Call 1800 028 817 - Press 3 to determine why claim was rejected

Police Health*

Code:                     SPE

Email:                         [email protected]

Provider Ph:           1300 057 054

General Ph:                1800 603 603

Postal Address:             PO Box 6111, Adelaide SA 5000

Registration           See AHSA

Resubmission                 Email [email protected]

Include:                Amended invoice and https://www.ahsa.com.au/web/doctors/forms/account_summary

Qantas Assure~

Qantas Assure Health Insurance is underwritten by NIB. Please see NIB for all contact, enquiries, registration, and resubmission details.

Qld Country health*

(Previously: MIM Employees Health Society)

Code:                     QCH

Email:                         [email protected]

Ph:                           1800 813 415 - Press 1

Postal Address:             PO Box 42, Aitkenvale QLD 4814

Registration           See AHSA

Resubmission   Email:  [email protected] Include: Amended invoice

rtHealth

(Previously: Railway & Transport Health Fund Limited)

Purchased by HCF as of the 15th November

Code:                     RTH

Email:                       [email protected]

Ph:                           1300 886 123 - Press 3

Postal Address:              PO Box 545, Strawberry Hills NSW 2012

Provider Portal:                 https://members.rthealthfund.com.au/providerarea/home/login.aspx

Resubmission                 Call 1300 886 123 - Press 3 To discuss rejections

Email:                       [email protected]

Reserve Bank Health Society*

(Previously: Reserve Bank Health Fund)

Code:                     RBH

Email:                      [email protected]

Ph:                          1800 027 299

Postal Address:              Locked Bag 23, Wollongong NSW 2500

Registration           See AHSA

Resubmission               Email [email protected]

Include:                Amended invoice and https://www.ahsa.com.au/web/doctors/forms/account_summary

St Lukes#

Code:                    SLM

Email:                       [email protected]

Ph:                           1300 651 988 - Press 4

Postal Address:             PO Box 915, Launceston TAS 7250

Provider Portal:             https://stlukes.com.au/for-providers

Eligibility Check: https://www.thelma.com.au/logon/login.jsp

Registration           See ARHG

Resubmission                 Call 1300 651 988 - Press 4 To discuss rejections

Email:                       [email protected]

Subject:                   Att: Medical Department

Separate emails per patient.

Suncorp Health~

Suncorp Health Insurance is underwritten by NIB. Please see NIB for all contact, enquiries, registration, and resubmission details.

Code:                     NIB

Teachers Health*

(Previously: NSW Teachers Federation Health Society, NSW Teachers Federation Health)

Code:                     TFH

Email:                         [email protected]

Ph:                           1300 728 188 - Press 3

General Ph:                1300 727 538

Fax:                        1300 728 388

Postal Address:             GPO Box 9812, Sydney NSW 2001

For Providers:                 https://www.teachershealth.com.au/for-providers/

Registration           See AHSA

Resubmission                 Phone:1300 728 188 - Press 3 to discuss rejection

Upload at https://providercomms.teachershealth.com.au

Territory Health*

(Operates under Queensland Country)

(Previously: Mount Isa Mines Employees Health Society)

Code:                     QCH

Email:                       [email protected]

Ph:                                 1800 623 893 - Press 1 or 2 and ask to speak to Claims Department

Postal Address:             GPO Box 1265 Darwin NT 0801

Registration           See AHSA

Resubmission                 Email [email protected]

Include:                Amended invoice and https://www.ahsa.com.au/web/doctors/forms/account_summary

Transport Health

(Previously Transport Friendly Society)

Purchased by HCF as of the 15th November

Code:                    TFS

Email:                        [email protected]

Ph:                          1300 806 808

Postal Address:              PO Box 545 Strawberry Hills NSW 2012

Resubmission                Email [email protected]

TUH*

(Previously Queensland Teachers Union Health Fund Ltd)

Code:                     QTU

Email:                      [email protected]

Ph:                          1300 360 701

Postal Address:            PO Box 265 Fortitude Valley QLD 4006 Registration See AHSA

Resubmission                Email [email protected]

Include:                Amended invoice and https://www.ahsa.com.au/web/doctors/forms/account_summary

UniHealth*

(Operates under Teachers Health)

Code:                     TFH

Email:                         [email protected]

Ph:                           1300 728 188 - Press 3

Fax:                        1300 728 388

Postal Address:             GPO Box 9812 Sydney NSW 2001

For Providers:                  https://www.unihealthinsurance.com.au/for-providers/

Registration           See AHSA

Resubmission                 Call 1200 728 188 - Press 3 to discuss rejection

Upload at https://providercomms.teachershealth.com.au

Westfund*

(Previously Western Districts Health Fund Ltd)

Code:                     WFD

Email:                        [email protected]

Ph:                           1300 937 838 - Press 4

Postal Address:             PO Box 235 Lithgow NSW 2790

Provider Portal:             Email above address to register

Include:                         Doctor Prov. No, contact person, phone number & email address

Registration           See AHSA

Resubmission   Phone 02 6352 0749 or Email [email protected] Include: Amended invoice and

https://www.ahsa.com.au/web/doctors/forms/account_summary

International Health Funds

Allianz Global Assistance OVHC

Email:                       [email protected]

Ph:                          1800 884 526

Postal Address:          Allianz Care

OVHC Provider Billing

Locked Bag 3004

Toowong QLD 4066

Registration:   https://www.allianzcare.com.au/en/medical-provider.html https://www.allianzcare.com.au/en/medical-provider/join-our-medical-network.html Submission:

Email [email protected] with member number in the subject line. No batch header required but explanation preferred.

Attach the invoice.

Resubmission: Provider Portal:

https://medical.allianzcare.com.au/member_medical/login.aspx#_ga=2.64643759.1267419087.162

7431399-154192532.1627431399&_gac=1.48635348.1627431455.Cj0KCQjw3f6HBhDHARIsAD_i3D-

9u09uDokkF8HYy5xnL9UfZKlGx5falSFwuwlVh0eHa5250OL6ijwaAgbdEALw_wcB

Allianz Overseas Student OSHC

Email:                       [email protected]

Ph:                          1800 884 526

Postal Address:          Allianz Care

OSHC Provider Billing

Locked Bag 3001

Toowong QLD 4066

Registration:    https://www.allianzcare.com.au/en/medical-provider.html https://www.allianzcare.com.au/en/medical-provider/join-our-medical-network.html

Resubmission: Provider Portal:

https://medical.allianzcare.com.au/member_medical/login.aspx#_ga=2.64643759.1267419087.162

7431399-154192532.1627431399&_gac=1.48635348.1627431455.Cj0KCQjw3f6HBhDHARIsAD_i3D-

9u09uDokkF8HYy5xnL9UfZKlGx5falSFwuwlVh0eHa5250OL6ijwaAgbdEALw_wcB

BUPA Global^

Email:                        [email protected]

General enquiry: [email protected]

Ph:                            New customers: 1800 287 141

Existing & further info: +44 (0) 1273 323 563

 

Postal Address:     Bupa Global, Victory House, Trafalgar Place Brighton, BN1 4FY, United Kingdom

 

Provider Portal:             https://www.bupaglobal.com/en/provider

Registration

Email above to register interest and for further correspondence https://www.bupaglobal.com/en/provider/working-with-bupa

Submission/Resubmission

Access 24-hour customer service in regards to your claims

BUPA OSHC^

A Direct Billing provider provides inpatient and outpatient services for Overseas Health Cover members. The invoice is sent to BUPA OSHC and then payment will follow in the weeks to come.

Check the contract that your provider has set up with BUPA OSHC - request Direct Billing for both Inpatient and Outpatient [email protected]

It is better for the doctor to expect full payment from the patient and to NOT participate in direct billing. The patient can claim their reimbursement from BUPA OSHC at their convenience. Otherwise remove any Medicare Reference and email with Batch Header to [email protected] m.au

Ph:                                1800 888 942 - Press 3 (Provider Operations is the destination)

NIB OSHC/SVC~

NIB OSHC is underwritten by NIB. Please see NIB for all contact, enquiries, registration, and resubmission details.

Code:                     NIB

Ph:                          1800 775 204

02 4914 1245

 

Use the online claim form batch header and email to [email protected]

UnitedHealthcare Global~

UnitedHealthcare Global is underwritten by NIB. Please see NIB for all contact, enquiries, registration, and resubmission details.

Code:                     NIB

Communicating with Health Funds

Re Provider registration

May I speak to someone from the Provider Relations Department?

Re Claim

May I speak to someone regarding an ECLIPSE Claim?

May I speak to someone regarding a patient claim?

May I speak to someone regarding a claim payment status?

Registration

What’s the best process to register a Provider?

May I confirm a Provider registration?

May I check a patient’s/member’s eligibility?

Resubmission

Can you tell me the reason for a claim rejection?

What’s the best process to resubmit this claim?

Do you require a Batch Header?

Do you require both the original and amended invoice?

Workcover/3rd Party

ADF Health Services

Email: [email protected]

Phone:       1800 316 915

Allianz

Email: [email protected]

Phone:       03 9224 3379

EML

Email: [email protected] Phone:

EnAble

Email: [email protected] Phone:

Gallagher Bassett

Email: [email protected] Phone:

QBE

Email: [email protected] Phone:

SA Health

Email: [email protected]

Phone:       1800 317 333