HEALTH FUND REPORT
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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 and lodge treatment claims with Bupa. These details are on our website here: www.atms.com.au/health-funds/health-fund-terms-conditions
All health funds requirements:
- Working with children – Please send your working with children check to ATMS, as health funds now require this information.
- 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 to be a health fund provider.
- Professional Indemnity Insurance – All health funds require a minimum $5 million Professional Indemnity Insurance & $10 million for Public Liabilities Insurance for all Acupuncture & Chinese Herbal Medicine practitioners. Australian Unity, ARHG, BUPA & HCF require all providers to have a minimum of $2 million Professional Indemnity Insurance and $10 million for Public Liabilities.
- Insurance and/or First Aid renewals – send to ATMS at least 2 weeks before expiry. Some health funds now have automatic cut off after the expiry date.
- Always update ATMS (info@atms.com.au) with changes to your contact details including email address and mobile number, postal and/or clinic locations.
- Patient Clinic Records: You must write and keep a clinical record of each treatment provided. Each record must be accurate, legible, and easily readable by a third party and written in English.
- Working with children – Please send your working with children check to ATMS, as health funds now require this information.
- 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 to be a health fund provider.
- Professional Indemnity Insurance – All health funds require a minimum $5 million Professional Indemnity Insurance & $10 million for Public Liabilities Insurance for all Acupuncture & Chinese Herbal Medicine practitioners. Australian Unity, ARHG, BUPA & HCF require all providers to have a minimum of $2 million Professional Indemnity Insurance and $10 million for Public Liabilities.
- Insurance and/or First Aid renewals – send to ATMS at least 2 weeks before expiry. Some health funds now have automatic cut off after the expiry date.
- Always update ATMS (info@atms.com.au) with changes to your contact details including email address and mobile number, postal and/or clinic locations.
- Patient Clinic Records: You must write and keep a clinical record of each treatment provided. Each record must be accurate, legible, and easily readable by a third party and written in English.
- Require electronically issued or printed receipts/invoices for eligible Approved Providers in order to offer a rebate to their clients
- All Therapists – Invoices/receipts must be electronically issued or printed (no handwritten or stamped receipts to be issued to clients)
ATMS published a Health Insurance Update for members on 29 January 2019. That update provided the most recent information for the major health funds on plans to introduce the health insurance rules that become law on 1 April 2019
The current Coalition Government, at the time of writing, continues to confirm that it will change the Rules for natural medicine treatments in private health insurance. ATMS will continue to champion natural medicine and advocate that this bad decision be changed.
Health funds are compelled by these Government reforms to now redesign all policies and benefit schedules, to be ready on 1 April 2019. The health funds acknowledge this is an enormous challenge.
For ATMS members we celebrate those treatments that will continue to be covered and attract potential rebates: Acupuncture; Ayurveda; Chinese herbal medicine; Chiropractic; Remedial Massage; Nutrition and Osteopathy.
Each Health Fund will make its own decisions about provider eligibility and treatment rebates. ATMS will continue to work with the funds to manage eligibility, provider registration and maintain accurate lists into 2019 and beyond.
For other ATMS members we acknowledge with deep regret that these treatments have been listed by the current Government as no longer to be covered by health insurance from 1 April 2019: Alexander technique; Aromatherapy; Bowen therapy; Buteyko; Feldenkrais; Western Herbalism; Homeopathy; Iridology; Kinesiology; Naturopathy; Pilates; Reflexology; Rolfing; Shiatsu; Tai chi; Yoga
It is with deep regret that despite an active and passionate lobby from natural medicine practitioners, the current government continues to confirm that the Business Rules for health funds will restrict a list of natural therapies from 1 April 2019. From this date onwards, health funds will not be allowed to offer treatment and rebate coverage for the listed therapies.
At the time of writing the listed therapies are:
Alexander technique; aromatherapy; Bowen therapy; Buteyko; Feldenkrais; Western herbalism; homeopathy; iridology; kinesiology; naturopathy; Pilates; reflexology; Rolfing; shiatsu; tai chi; yoga.
It is now inevitable that individual health funds will begin to implement these changes. ATMS will keep members advised as we are told what these changes will be.
The first health fund to make changes is HBF who have advised ATMS they will implement these changes from 1 January 2019, before the government commencement date of 1 April 2019.
Important Health Fund reminders
- BUPA requires $2 million in professional indemnity insurance cover, effective 1 July 2017
- BUPA has a maximum 4 clinics for all modalities
- Medibank has a maximum 3 clinics for Remedial Massage members only
- No online/Skype/email/phone consultations for rebates for all health funds
- Patient clinic Records: you must write and keep a clinical record of each treatment provided. Each record must be accurate, legible and easily readable by a third party and written in English.
- Gift vouchers or Gift cards are not entitled to health fund rebates;
- BUPA requires $2 million in professional indemnity insurance cover, effective 1 July 2017;
- BUPA has a maximum 4 clinics for all modalities;
- Medibank has a maximum 3 clinics for Remedial Massage members only;
- ARHG, AHM and Medibank do not recognise mobile treatments, only treatments within a clinic environment is acceptable (professional, clinically appropriate facilities);
- No online/Skype/email/phone consultations for rebates for all health funds;
- Always update ATMS with changes to your contact details including email address and mobile number, postal and/or clinic locations;
- Do not allow your Provider Number(s) to be used by any other person;
- Patient clinic Records: You must write and keep a clinical record of each treatment provided. Each record must be accurate, legible and easily readable by a third party and written in English.
Mobile Therapy does not meet ARHG criteria or Private Health Insurance Legislation regarding Practice Quality. This also includes any Massage or Remedial treatment provided within a corporate environment. GMHBA, including Frank Health & Budget Direct will no longer be paying benefits on Massage Therapy (Cert IV Qualification). They will only be accepting a minimum qualification for Remedial Therapists (Diploma of Remedial Therapy).
A new health fund with ARHG, they will only be accepting qualifications for Remedial Therapists (Diploma of Remedial Therapy), Acupuncture, Homoeopathy and Naturopathy.
- Need to be rubber stamped, a pre-printed receipt book, letterhead or computer generated.
- Do not allow your Provider Number(s) to be used by any other person
- Date of the service and name of the patient who received the treatment
- Address where the service was provided and the contact telephone number
- Read and understand the ATMS CPE Policy and the CPE FAQ documents (both available on the ATMS website).
- Start planning your CPE activities for 2017/2018 now, if you have not already done so.
- Ensure that the activities you have chosen to do relate to natural medicine, and more specifically for any, and all, modalities in which you have health fund recognition.
- Aim for more than 20 ATMS CPE points. It’s better to have more, than not enough.
- Ensure that you fill out the ATMS CPE Record and that you keep sufficient substantiating documentation. Points will not be awarded where the supporting evidence is not sufficient.
- All CPE Evidence must be in your name. Points will not be awarded where the supporting evidence is in someone else’s name.
- Ensure that you keep this evidence secure and easily accessible. Some health funds require members to submit their CPE within 24 hours of being audited and will not provide extensions or exemptions for members on holidays, overseas or facing personal hardship.
TCM Members who completed their studies in a non-English language, please note the IELTS Overall Band 7 requirement to qualify for BUPA recognition.