Common use of Account Requirements Clause in Contracts

Account Requirements. All accounts and receipts presented to HBF must be consolidated for a single Eligible Member for an Episode and must meet the following requirements: (a) The Practitioner must: (i) ensure compliance with the requirements of clause 3(a)-3(c); (ii) provide a Service to an Eligible Member; (iii) ensure that the account is fully unpaid; (iv) include details of a consultation in the medical records of an Eligible Member if a consultation is billed on the account; (v) ensure that in the case of an Eligible Member with overseas visitor cover a benefit would have been payable by HBF if that member had been an Australian resident; (vi) promptly lodge the claim and without limitation submit all claims within one year of the date of Service; and (vii) not without HBF’s prior written approval, amend an existing claim for Services or lodge a revised claim for Services (unless the change is made within 7 days of lodging the original claim with HBF). (b) The Practitioner must ensure that: (i) the account identifies MBS item number(s) for the Services, that are all appropriately allocated items for the Service and are items for which Medicare pays a benefit; (ii) where a Multiple Operation is performed, the fees set out on the account are calculated in accordance with the Medicare Multiple Operation Rule; (iii) the account includes the following information: (A) Eligible Member’s full name, address and member number; (B) Eligible Member’s Medicare number, Medicare card reference number and expiry date; (C) details of the Service, including date the Service was provided; (D) all fee information including the total fees charged for each Service provided; (E) any special exemptions; (F) referral details, including the date of referral, provider number and full name of the referring Practitioner; and (G) any other information relevant to assessment of the claim.

Account Requirements. All accounts and receipts presented to HBF must be consolidated for a single Eligible Member for an Episode and must meet the following requirements: (a) The Practitioner must: (i) ensure compliance with the requirements of clause 3(a)-3(c); (ii) provide a Service to an Eligible Member; (iii) ensure that the account is fully unpaid; (iv) include details of a consultation in the medical records of an Eligible Member if a consultation is billed on the account; (v) ensure that in the case of an Eligible Member with overseas visitor cover a benefit would have been payable by HBF if that member had been an Australian resident;; and (vi) promptly lodge the claim and without limitation submit all claims within one year of the date of Service; and (vii) not without HBF’s prior written approval, amend an existing claim for Services or lodge a revised claim for Services (unless the change is made within 7 days of lodging the original claim with HBF). (b) The Practitioner must ensure that: (i) the account identifies the MBS item number(s) number for the Services, ensuring that are all appropriately this is properly allocated items for the Service and are items is one for which Medicare pays a benefit; (ii) where a Multiple Operation is performed, the fees set out on the account are calculated in accordance with the Medicare Multiple Multiple (iii) Operation Rule; (iiiiv) the account includes the following information: (A) Eligible Member’s full name, address and member number; (B) Eligible Member’s Medicare number, Medicare card reference number and expiry date; (C) details of the Service, including date the Service was provided; (D) all fee information including the total fees charged for each Service provided; (E) any special exemptions; (F) referral details, including the date of referral, provider number and full name of the referring Practitioner; and (G) any other information relevant to assessment of the claim.

Account Requirements. All accounts and receipts presented to HBF must be consolidated for a single Eligible Member for an Episode and must meet the following requirements: (a) The Practitioner must: (i) ensure compliance with the requirements of clause 3(a)-3(c); (ii) provide a Service to an Eligible Member; (iii) ensure that the account is fully unpaid; (iv) include details of a consultation in the medical records of an Eligible Member if a consultation is billed on the account; (v) ensure that in the case of an Eligible Member with overseas visitor cover a benefit would have been payable by HBF if that member had been an Australian resident;; and (vi) promptly lodge the claim and without limitation submit all claims within one year of the date of Service; and (vii) not without HBF’s prior written approval, amend an existing claim for Services or lodge a revised claim for Services (unless the change is made within 7 days of lodging the original claim with HBF). (b) The Practitioner must ensure that: (i) the account identifies the MBS item number(s) number for the Services, ensuring that are all appropriately this is properly allocated items for the Service and are items is one for which Medicare pays a benefit; (ii) where a Multiple Operation is performed, the fees set out on the account are calculated in accordance with the Medicare Multiple Operation Rule; (iii) the account includes the following information: (A) Eligible Member’s full name, address and member number; (B) Eligible Member’s Medicare number, Medicare card reference number and expiry date; (C) details of the Service, including date the Service was provided; (D) all fee information including the total fees charged for each Service provided; (E) any special exemptions; (F) referral details, including the date of referral, provider number and full name of the referring Practitioner; and (G) any other information relevant to assessment of the claim.