Fund Notes
New MBS Anaesthetic Items from 1 March 2024
There are several new items available to Anaesthetists from 1st March 2024 22052 Transfusion of blood by an anaesthetist, for intra-operative normovolaemic haemodilution, 6 Units (anaesthetic equivalent of 13703) 22053 Insertion of lumbar ...
DVA Claims
In Cutting Edge you can submit DVA claims electronically, much like any other claim. Simply create a new invoice, enter the patient name and DOB then select DVA as the fund. In most cases CE will look up the Veteran's File Number for you, but if not ...
BUPA schedules
BUPA has three schedule types which affect the rebate: BUPA Known Gap, which allows a gap of up to $500 BUPA No Gap, which pays a higher rebate but doesn't allow any gap MBS only, used for facilities where gap scheme rebates do not apply. Providers ...
NIB Clinical Partner Agreements
Administered by Honeysuckle Health, the NIB Clinical Partners program allows participating orthopaedic surgeons and anaesthetists to charge a loading for hip and knee joint replacements without the patient incurring an out of pocket expense. The ...
NIB Medigap versus GapSure
NIB has MediGap and GapSure billing arrangements, for more information see https://www.nib.com.au/providers/medical MediGap If you’re a medical specialist, you can register to become a MediGap provider, which means you agree not to charge NIB members ...
RT Health joins HCF
From 1 November 2021 RT health became a wholly owned subsidiary of HCF. Unlike HCF, RT Health has only two scales 100% of MBS Medicover which is the HCF Known Gap rate. See this PDF from RT Health and the HCF website Although HCF has a No Gap ...
Health Fund Contact Details
Please see the attached link for a list of contact details for a large number of health funds. https://www.privatehealthcareaustralia.org.au/resources/provider-resources/contacts-for-providers/
Cessnock District Health Fund
Cessnock District Health Fund has had a name change and is now known as Hunter District Health. See the link below regarding the fees and how they are calculated. https://www.hunterhi.com.au/providers/
Manual Claims - Health Fund Notes
AHM Manual claims can be emailed to AHM (deceased patients etc.) email is info@ahm.com.au - enter GAP COVER CLAIM in subject of email and include a batch header. https://static.ahm.com.au/files/forms/gapcover-batch-header.pdf NIB Manual claims can ...
Which funds are in AHSA?
AHSA maintains a list of member funds on their website that is updated whenever the situation changes. Cutting Edge will automatically update the list and schedules in the software, you don't need to do this yourself. ...
Additional fund updates
Here are some funds that we're often asked about. AHM - uses the Medibank Private fee schedule. AIA - See MYO APIA - is an NIB fund Budget Direct - a GMHBA fund, pays 120% of Medicare for its gapcover product. (GMHBA is otherwise and AHSA fund.) CUA ...
HBF Schedules
HBF has several different schedules. For all states except WA On 13 February 2017, HBF joined the AHSA Gap Cover system for all states except WA. Cutting Edge will load the appropriate state AHSA schedule. Copayments rules are in the the AHSA ...
ADF claims through the BUPA Defence Contract
From July 2019, BUPA has assumed management of healthcare services for Australian Defence Force personnel. Previously this was managed by Medibank Health Solutions. In Cutting Edge select the ADF fee schedules. The fund and schedule details are ...