HEALTH FUND NEWS
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 allow another practitioner , student or staff member to use their provider details , as this constitutes health fund fraud . Misrepresenting the service ( s ) provided on the invoice also constitutes health fund fraud . Health fund fraud is a criminal offence which may involve a police investigation and expulsion from the ATMS Register of Members .
It is of note that the health funds require practitioners to be in private practice . Some health funds will not recognise claims where accommodation , facilities or services are provided or subsidised by another party such as a public hospital or publicly funded facility . Rebates are only claimable for the face to face consultation ( not the medicines or remedies ); however this does not extend to mobile work including markets , corporate or hotels .
MOBILE SERVICES ARE NOT RECOGNISED FOR HEALTH FUND REBATES . Health Funds that do not allow mobile services for rebates are : AHM , ARHG , BUPA , HCF and Medibank .
ONLINE OR PHONE CONSULTATIONS ARE NOT RECOGNISED FOR HEALTH FUND REBATES .
Please be aware that whilst a health fund may indicate that they provide a rebate for specific modalities , this rebate may only be claimable if the client has the appropriate level of health cover with that fund and has not exceeded any limits on how much they are eligible to claim back over a certain period of time .
Please note : All health funds require a minimum of $ 5 million Professional Indemnity Insurance and $ 10 million for Public Liabilities Insurance for all Acupuncture & Chinese Herbal Medicine practitioners .
Australian Health Management ( AHM )
Please note details at the beginning of the section regarding telehealth consultations .
Names of eligible ATMS members will be sent to AHM each month . AHM ’ s eligibility requirements are listed on the ATMS website www . atms . com . au . ATMS members can check their eligibility by checking the ATMS website or by contacting the ATMS Office on 1800 456 855 . Please contact AHM on 13 42 46 for your provider number .
Australian Regional Health Group ( ARHG )
This group consists of the following health funds :
• ACA Health Benefits Fund Ltd
• CUA Health Limited
• Defence Health▼▼
• HBF ( Including GMF Health ) ▼▼
• GMHBA ▼▼ ( Including Frank Health Fund & Health . com . au )
• Health . com . au
• Health Care Insurance Limited
• Health Partners
• HIF WA
• Hunter Health ( previously known as Cessnock DHBF )
• Latrobe Health Services ( Federation Health )
• Mildura District Hospital Fund
• AIA Health ▼▼ ( previously known as MyOwn Health ) ▼
• Navy Health Fund
• Nurses & Midwives Health
• Onemedifund
• Peoplecare Health Insurance
• Phoenix Health Fund
• Police Health Fund ( Including Emergency Services )
• Queensland Country Health Fund Ltd
• Railway and Transport Fund Ltd
• Reserve Bank Health Society
• St Luke ’ s Health
• Teachers Health
• Teachers Union Health
• Transport Health
• Westfund ▼▼ Special condition applies for Remedial
Massage
Details of eligible members , including member updates are sent to ARHG by ATMS monthly . The details sent to ARHG
112 | vol27 | no2 | JATMS