If you are already sending claims to the health funds, either manually / via another software or have already registered with each health fund, then you do not need to register again with the health funds. If this is you, then go to straight to step 2.

If you have never sent a claim to a health fund before nor have registered with the health funds yet, then you will need to start at step 1.

Step 1 – Register provider/s with each health fund

Each fund is different in their registration process. Some will require a form to be completed and signed, while others require an online form to be completed.

Forms required

The table below lists all downloadable and online forms to register a new provider number with the funds. Depending on the fund, it takes anywhere from one to three weeks to process these. Most funds will email you once your registration is processed–just make sure to check your Spam/Junk folder as they sometimes get sent there. In case there was no notification email, we recommend that you call or email them a week after you send the forms to check if they are processed.

Fund	Type	Email
Alliance	Download Form (new registration) Download Form (adding a practice location) Download Form (to change bank details)	access@ahsa.com.au
ARHG	Online Form (for new registrations or any changes)
BUPA	Download Form (new registration) Download Form (to change bank/contact details or to add provider numbers/providers to your practice)	provopsmedical@bupa.com.auBUPA requires that you attach a bank statement or another official bank document to confirm your bank account details.
GU Health	Online Form (for new registration or any changes for GUH and NIB)
HBF (ONLY FOR WA)	Download Form (new registration or to add provider numbers) Download Form (to change bank/contact details)	medicalgap@hbf.com.au
HCF	Download Form (new registration or to add provider numbers) Download Form (to change bank/contact details)	Medicoverenquiry@hcf.com.auHospitalMedicalRegistrations@hcf.com.au
Medibank/AHM	Download Form (for new registrations or any changes)	GapCoverForms@medibank.com.au
NIB	Online Form (for new registration or any changes for GUH and NIB)
RT Health	Download Form (They come under HCF, but have their own registration form)	Medicover@hcf.com.au

Links are accurate as of 1 May 2024 but may be changed by the funds any time.

Step 2 – Get your practice ID for BUPA

BUPA is the only fund that will assign you a practice ID. We need this practice ID so we can add it to your FYDO account. It goes with the claim when it gets sent electronically to BUPA. Without it, they will reject the claim.

To get the most out of your training session, our goal is to send a few claims out to Medicare and/or Veterans and/or to the health funds (ECLIPSE), then monitor those first few claims and ensure they get paid correctly. This way, we can ensure everything has been set up correctly for you.

Below is a checklist of things to prepare and have ready for your training session.

Please make sure to have at least 2-5 patients to bill. You need the following about the patients you plan to bill:

• Patient first name, last name, date of birth, Medicare (or Veterans – if Veterans claim)
  • e.g. Michelle, Romero, 19/11/1981, 2111-11111-1 (or if a Veterans number NX123456)
• If doing ECLIPSE (i.e. billing the health fund), you will also need the patient’s health fund and membership number
  • e.g. Bupa, ABC12345
• You need the servicing provider’s details:
  • Doctor name and provider number
• If the service provided was referred, you need to have the referral details, such as referring doctor’s name and provider number, as well as the referral date
  • e.g. Dr Pete Sampras, provider number 123456AF, referral date 01/01/2017
• About the invoice itself, you will need the following
  • The item number/s performed, i.e the MBS e.g. 104, 110, 42702 etc
  • The date the patient was seen, i.e. the date of service
• If you plan to do ECLIPSE (i.e. in hospital), you will also need:
  • The hospital’s provider number. Call the hospital, hey should be able to provide this to you. However, if this proves difficult, please let us know prior to your training, so we can try to track it down for you.
• For BUPA, we will need to know the practice ID for each provider.

For more details, see https://wiki.fydo.cloud/how-to-prepare-for-eclipse-clinics/

DVA Community Nursing

Minimum Data Requirements for DVA Community Nursing Claims:

PATIENT DETAILS

• Patients Full Name
• Date of Birth
• Sex/Gender
• Veterans Number
• Referral Details – Doctor Name, Provider Number and if they’re a GP/Specialist
• Date of Admission
• First Cycle Date (First date of care)
• Discharged Date (If the client has been discharged from care)

BILLING DATA

• Cycle Date
• Overnight Care Dates (If overnight care is provided, each overnight care needs to be billed on the actual date the service was provided)
• Total number of Hours and Visits for each type of workers for the whole 28 day cycle:
• Clinical Nurse Consultant (CNC)
• Enrolled Nurse (EN)
• Nursing Support Staff (NSS)
• Registered Nurse (RN)