To send claims to the health funds electronically you will need first register with the health funds.
If you are already sending claims to a health fund, either via software, in the mail or via a medical billing service, then you are already registered with that health fund.
If you are not yet registered with the health funds, yes you will need to register with EACH health fund, there is no one form that registers you with all health funds.
The good news is, the Alliance group (AHSA) is a group that consists of approx 30 funds such as HBF, Aust Unity, Teachers Health, when you register with one fund, you are instantly registered with all the health funds in the AHSA group. View all funds within the AHSA group.
We recommend you register with at least the most common funds first, such as:
- Alliance group
- Medibank / AHM (when you register with one, you get registered with both)
You can then get around to registering with the other funds when you have time, or when the need arises. However you don’t want to wait too long, some health funds do not back pay. This means, let’s say you saw a patient 5 months ago, and you haven’t got around to sending your claim and in fact you have not even registered with the health fund. Naturally you register with the health fund and then submit your claim, the health fund might reject the claim as you were not registered with them when the service was provided! Not all funds do this, we’ve heard BUPA does this, but you should be able to explain and get this amended. I would suggest if this is your scenario, when registering, let the health fund know you have some claims to backdate.
When registering with the health funds, we recommend giving the health fund a call after 4-7 business days (of submitting the paperwork) if you have not heard from them. They don’t always email you to let you know they have registered you.
For the few Medicare/DVA claims
For Medicare or the Department of Veterans Affairs to process your claims, Medicare needs to have your provider number linked to a Minor Id and your bank account. Altura Health will issue you with a minor id, think of it like a customer number. This is a process required by Medicare not Altura Health.
To link a provider number to a Minor ID:
- If you are already sending claims electronically to medicare (perhaps you are using existing software)
- Completing a banking form
- If you are not currently sending claims electronically to medicare (you have not starting billing yet or you send claims by paper or via the proda website)
- Completing a provider agreement
We will send you this Medicare form via email, once we issue you with a Minor ID.
How long does it take for this form to get processed? (either the banking form or the provider agreement)
It takes medicare approx 2-3 weeks from when they receive the paperwork. We request you:
- Send us the paperwork
- We send it to Medicare on your behalf
- Then we call Medicare after 4 business days to confirm they received the paperwork and have added it to their queue.
That’s right, they have a queue of about 2-3 week of paperwork to get through.
But I already send claims to Medicare and get paid? They already have my bank account, do I still need to complete the above and wait 2-3 weeks?
Yes, unfortunately you do. The reason is, Altura Health must issue you with a new Minor ID. So we need to link your provider number/s to this new Minor ID.
So since you primarily send claims to the health funds and provided you are registered with the health funds already, we can book you in for training to submit your health fund claims and then book you in for a follow up training session and show you how to submit your Medicare / DVA claims once your Medicare paperwork has been processed.
To send claims to Medicare/DVA or the health funds, you will need the following about the patient:
- First and last name
- Date of birth
- Gender (only if a DVA claim)
- Medicare number or DVA number
- Health fund name (only if health fund claim)
- Health fund membership number (only if health fund claim)
You will also need the following about each claim:
- Date of service
- Item number/s
- Referring doctor details (if applicable)
- Referring doctor first and last name
- Referring doctor provider number
- Referral date
- Referral period e.g 3 months, 12 month or the referring doctor type GP or Specialist
Our Sales Team will work with you get the import file in the correct format.