HEALTH FUND NEWS
Medibank and AHM : Changes to billing standards
ATMS , along with all other provider associations , has been advised that Medibank and AHM will no longer accept handwritten or stamped accounts from 1 April 2021 . If providers do not comply with this notice by 1 April 2021 , their status as a recognised provider of Medibank and AHM may be reviewed and they may be suspended or cancelled .
Members have until 1 April 2021 to move to electronically issued invoices ( emailed or printed ). Invoices must meet Medibank requirements for Ancillary Billing Standards . These details are on our website here : https :// www . atms . com . au / health-funds / health-fund-termsconditions /
BUPA : Revised Ancillary Provider Terms
BUPA has updated its Ancillary Provider Terms , and these will come into effect from 1 February 2021 . These Terms will apply to all ATMS members who are recognised by and lodge treatment claims with Bupa . These details are on our website here : https :// www . atms . com . au / health-funds / health-fund-termsconditions /
All health funds : Clinic telephone numbers
Please update your clinic telephone number / s with ATMS . Claims will be rejected if no telephone number is available at your active clinic location / s . This is one of the requirements of the health funds .
Health Funds
ATMS is a ‘ professional organisation ’ within the meaning of section 10 of the Private Health Insurance Accreditation Rules 2011 . This potentially allows ATMS accredited members to be recognised as approved providers by the various private health funds . Approved health fund provider status is , however , subject to each individual health fund ’ s eligibility requirements .
Consequently , membership of ATMS does not automatically guarantee provider status with all health funds . Please also note that several health funds do not recognise courses done substantially by distance education , or qualifications obtained overseas .
Additional requirements for recognition as a provider by health funds include :
• Clinic Address ( Full Street Address and telephone number must be provided – Please note that some health funds may list your clinic address on their public websites )
• Current First Aid Cert ( HLTAID003 or HLTAID011 )
• Current Senior First Aid
• Current Professional Indemnity Insurance ( some health funds require specific minimum cover amounts . Please refer to the individual health fund terms and conditions for further information )
• Compliance with the ATMS Continuing Education Policy along with any additional continuing education requirements stipulated by the health fund
• Current National Registration ( where applicable )
• Compliance with the Terms and Conditions of Provider Status with the individual health funds .
ATMS must have current evidence of your first aid and insurance on file at all times .
ATMS now recommends all members renew First Aid or insurance at least 14 days before the expiry date . It is important that you notify ATMS of these changes promptly so that the information is updated to the health funds and claims can continue to be paid out to your clients without interruption .
Additional Information : If you are treating minors in your clinics , health funds require a copy of your Working with children / Working with vulnerable people card . Please forward these details to ATMS so this information is updated to the health funds .
When you join or rejoin ATMS , or when you upgrade your qualifications , you will need to fill out the ATMS Health Fund Application and Declaration Form available on the ATMS website . Once this is received , along with any other required information for health fund eligibility assessment , details of eligible members are sent to the applicable health funds on their next available listing . The ATMS office will also forward your change of details , including clinic address details to your approved health funds on their next available list . Please note that the health funds can take up to one month to process new providers and change of details as we are only one of many health professions that they deal with .
Lapsed membership , insurance or first aid will result in a member being removed from the health funds list .
As health funds change their provider eligibility requirements at any given time , upgrading qualifications may be necessary to be re-instated with some health funds .
TERMS AND CONDITIONS OF PROVIDER STATUS
Many of the Terms and Conditions of Provider Status for the individual health funds are located on the ATMS website . For the Terms and Conditions for the other health funds , it will be necessary to contact the health fund directly .
BEING A PROVIDER IMPLIES ACCEPTANCE OF THE TERMS AND CONDITIONS FOR THE HEALTH FUNDS .
Please note that whilst there is no law or regulation requiring patient clinical notes to be taken in English , many of the major health funds do require patient clinical notes to be taken in English . Failure to do this will be a breach of the Health Funds Terms and Conditions and may result in the practitioner being removed as a provider for that health fund .
For health funds to rebate on the services of Accredited members , it is important that a proper invoice be issued to patients . The information which must be included on an invoice is also listed on the ATMS website . It is ATMS policy that only Accredited members issue their own invoice . An Accredited member must never
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