View provider recognition requirements and information about claiming.
GMHBA/Frank Health Insurance contributes to the cost of included ancillary services for eligible members.
Eligibility for benefits is dependent on the product the member holds with the fund, waiting periods, and the financial status of the policy.
To register as a recognised Ancillary provider with GMHBA/Frank Health Insurance you must:
Have a location specific provider number from Services Australia
Be an active member of a fund approved professional organisation.
GMHBA Health Insurance/Frank Health Insurance has sole and absolute discretion in determining if someone becomes or remains a recognised practitioner and for which of their treatments GMHBA Health Insurance/Frank Health Insurance will pay benefits towards.
Services Australia Provider Numbers
If you’re registered with Services Australia for one of the below modalities, you do not need to apply for recognition with GMHBA/Frank Health Insurance:
· Diabetes Education
· Exercise Physiology
· Occupational Therapy
· Speech Pathology
Alternative Therapy Provider Numbers
Provider numbers are issued by the Australian Regional Health Group (ARHG).
GMHBA Ltd utilises the Australian Regional Health Group to maintain accreditation for the below modalities:
· Remedial Therapy
· Traditional Chinese Medicine
Please contact your association directly to discuss eligibility criteria for an ARHG Health Fund Provider Number.
Electronic Claiming: HICAPS and HealthPoint utilise Medibank Private provider numbers. Claiming via these channels for GMHBA Health Insurance/Frank Health Insurance members is enabled where a practitioner holds the relevant accreditation with ARHG for the modality.
How to update your details:
ARHG Provider Numbers: Please contact your association directly.
Electronic Claiming: Please contact vendor directly to update any payment or contact information.
GMHBA Ltd utilises the Australian Orthotic and Prosthetic Association (AOPA) for Orthotic and Prosthetic Suppliers. Please sent a copy of your AOPA membership certificate to email@example.com
Invoices and Receipts
Practitioners and businesses must include the below information on all invoices or receipts:
· The name of the patient
· The date of service
· A description of the service provided that aligns with the PHA endorsed schedule (if applicable)
· A valid ABN
· The location the service was provided.
· A valid provider number (including but not limited to):
o Services Australia provider number for the location
o ARHG Provider Number
o Health Fund Issued Provider Number
Where the client/member address is not included on the invoice/receipt the health fund member is required to complete a claim form.