Claim requirements

Latrobe Health Services provides “Known Gap” cover under an Medical Practitioner Provider Agreement (MPPA). It is a legislative requirement for all Simplified Billing Claims to include evidence of Informed Financial Consent (IFC), even if you are not charging ‘gap’ to our member. If your claims come to us without this information, or without a declaration, we may return the claim to you for further clarification and/or completion.

All practitioners submitting claims via Simplified Billing must be registered with Latrobe Health Services. Any new provider numbers issued by the Health Insurance Commission must be registered accordingly. At any time, you can alter details such as contact numbers and postal addresses by accessing the Simplified Billing Provider Registration form.

Please refer to the below forms:

Eclipse - Medical online claiming

Latrobe participates in the Eclipse online medical claiming system. We accept Agreement (AG) and Scheme (SC) claim types via this system. Please note that Simplified Billing Eclipse claims cannot be accepted without registration. Please ensure you have registered with our Known Gap Scheme prior to submitting your first Simplified Billing claim to ensure correct benefits are paid, and to avoid claims being rejected (refer to Simplified Billing Provider Registration).

Simplified Billing Provider Registration for Latrobe

From Thursday 1 August 2019, the Australian Regional Health Group (ARHG) will process all provider applications on behalf of Latrobe Health Services.

This means that from this date, ARHG member funds will not accept provider registrations directly from medical providers. Simply log onto ARHG’s Simplified Billing Provider Registration form and complete registration online.

If you have a question regarding Latrobe Health Services Known Gap Scheme, please contact our Simplified Billing team by emailing sbenquiry@lhs.com.au or call 1300 362 144.

If you have any enquiries in relation to the change to provider registrations, please contact ARHG by emailing medicalproviders@arhg.com.au or visit www.arhg.com.au.

Payment of claims

All payments will be made by direct credit to your nominated account, as per your registration. Non-Eclipse remittance advices will be forwarded to the email address also nominated on your Simplified Billing Provider Registration Form. If you require a change in banking details please complete a new online registration via the Simplified Billing Provider Registration.

Please allow 24 hours to enable the changes to take effect.

For further information or assistance, please contact us.

Amount of benefit you will receive

This is detailed on our medical Practitioners Guide To Simplified Billing. Our payments are a percentage in addition to the Medicare Scheduled Fee based on the specialty of the practitioner. Because we provide a percentage-based benefit we do not produce our own schedule of fees. To calculate the amount you will receive from Latrobe Health Services, simply use the current Medicare Benefits Schedule and add the applicable percentage to the Scheduled Fee.

Privacy

At Latrobe Health Services, our commitment is to handle personal information in a way that is consistent with our Privacy Statement and our obligations under the Australian Privacy Principles. If you would like more information concerning our information handling practices, please contact our Privacy Officer.