Health Funds

ATMS Accredited Modalities & Health Fund Requirements​

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 requirements. Consequently, membership of ATMS does not automatically guarantee provider status with all health funds.

The only Modalities Health Funds currently recognise are Acupuncture, Chinese Herbal Medicine, Remedial Massage and Nutrition. Not every health fund covers every one of these.

To be eligible for health fund provider status, an Accredited Member of ATMS must:​

• Fill out the Health Fund Application & Declaration Form
  Click Here
• Be in private practice.
• ATMS and the Health Funds define Private Practice as ‘Independent private practice means a professional practice (whether sole, partnership or group) that is self-supporting. This means that its accommodation, facilities and services are not provided or subsidised by another party such as a public hospital or publicly funded facility.
• Have current Provide First Aid on file with ATMS at all times.
• Have current Professional Indemnity Insurance on file with ATMS at all times
• Comply with the ATMS Continuing Professional Education (CPE) Policy
• Have a clinic address (mobile services must have an invoice address and Full street address, no PO Box addresses are accepted)
• Hold accreditation with ATMS in the relevant modality.
• Meet the health fund provider status requirements for that modality, which may differ between funds.

The eligibility requirements are explained below. It is the responsibility of the member to provide the required information in order for ATMS to assess the members’ eligibility. ATMS reserves the right to request additional documentation as required in order to assess your eligibility for health fund provider status.

If you have existing provider numbers, please provide each provider number against each clinic and modality. ATMS will then verify with the health funds that these provider numbers are still valid.

Lapsed membership, insurance or first aid or non-compliance with continuing education requirements, will result in a member being removed from the health funds list. As health funds change their provider eligibility requirements from time to time, upgrading qualifications may be necessary to be re-instated with some health funds.

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. Rebates are only claimable for the consultation (not the medicines or remedies); however this does not extend to mobile work including markets, corporate or hotels or online or phone consultations. Home visits however are eligible for rebates.

All practitioners looking to gain health fund provider status must be familiar with the terms and conditions of provider status with all of the health funds. Being a Provider implies acceptance of the Terms and Conditions for the health funds

Please email ATMS directly for any clinic changes on info@atms.com.au

Allow approx. 6 weeks for all funds to receive and update their information with your clinic changes and also to get back to ATMS with provider numbers.

Please be advised that Medibank Remedial Massage have a minimum of 3 clinic addresses.

Bupa have a limit of 4 clinic addresses regardless of the modality.

Health Funds require a full street address, no PO BOXES as clinic addresses.

Phone number and Email address are also required.

Medibank/AHM only accept electronic receipts.

https://www.gsaib.com.au/associations/australian-traditional-medicine-society-ltd-atms

ATMS have partnered exclusively with GSA Insurance Brokers to tailor a policy for your unique business needs with:

• 15 months for the price of 12 in your first year
• Excellent Insurer security with ProRisk
• Quick and simple online policy application
• Access to 1 hour free legal advice per policy period – Australia wide
• Low $250 excess to apply for all PI and PPL claims
• Regular educational webinars
• Cover for a broader list of modalities
• Award winning claims service
• Employee Fidelity Cover1
• Statutory Liability Cover2
• 84 months free automatic run off cover3
• New ATMS Enquiries Phone Number for GSA: (02) 8274 8199

GSA Insurance email ATMS a weekly list of members who have purchased or renewed their insurance policy. Members are still required to email ATMS a copy of your insurance policy for auditing purposes.

Members may need to upgrade their qualification if there is a 4 week gap or more in insurance, first aid, membership, or non-compliance in your CPE if you hold an older qualification.

The requirements for health fund registration do change and may have changed from the time you registered so you may need to meet them under their current educational standard.

Minimum amount of professional indemnity insurance for Remedial Massage therapists to hold is $2million.

Minimum amount of professional indemnity insurance for Chinese Medicine Practitioners to hold is $5million.

Practitioners, please renew your insurance and first aid in advance and email it email it to ATMS on info@atms.com.au to maintain continuity with the health funds.

Accredited members who wish to have health funds provider status are required to have a current Senior First Aid certificate. A copy of the Certificate must be sent with the application form.

First Aid needs to be renewed every 3 years. The course is officially called Provide First Aid HLTAID011.  Please renew it in advance and email it through to info@atms.com.au approx. 2 weeks prior to the expiry date to maintain continuity of health fund registration.

Medibank Home Clinic Application 

Members that are registered as an Acupuncturist or Remedial Massage Therapist and hold a Medibank Private provider number are eligible to apply for HICAPS registration.

Ph: 1300 650 852

You will need to supply them with proof of your ATMS membership and a copy of the Medibank letter you received from ATMS with your Medibank provider number stated for HICAPS registration.

When you become a provider for a health fund you are agreeing to abide by their terms and conditions. For the convenience of our members, we have listed those below:

Medibank

• Recognition Criteria for other ancillary health care providers
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• Recognition Criteria for AHPRA registered ancillary health care providers (Acupuncturists)
  Click Here
• Ancillary Billing Standards
  Click Here
• Patient Record Standards
  Click Here

HCF

• HCF Ancillary Click Here
• Terms and Conditions Click Here
• De-Registration Policy Click Here
• Terms and Conditions for Recognised Providers of Extras Services July 2022
  Click Here

NIB

• Terms and Conditions
  Click Here
• Acupuncture nib provider recognition criteria
  Click Here
• Chinese Herbal Medicine nib provider recognition criteria
  Click Here
• Myotherapy nib provider recognition criteria
  Click Here
• Nutrition nib provider recognition criteria
  Click Here
• Remedial Massage Therapy nib provider recognition criteria
  Click Here
• Traditional Chinese Medicine Massage Tui Na nib provider recognition criteria
  Click Here

Bupa

• • Terms and Conditions
    Click Here

HBF

• Terms and Conditions
  Click Here
• Collection Statement: Providers / Health Practitioners
  Click Here

Australian Unity

• Health Ancillary Provider Terms and Conditions
  Click Here
• De-registration Policy
  Click Here