Extras providers: what we need to pay a benefit

Latrobe Health Services pays a set benefit for extras services delivered in Australia by an approved provider in private practice.

The benefit amount depends on the treatment. This page covers who counts as an approved provider, what must appear on the patients invoice, and how to claim.

Getting this right ensures a seamless claims process for everyone.

Who counts as an approved provider?

Approved ancillary providers include:

• Allied Health Providers who are registered with Medicare and meet relevant professional standards.
• Alternative Health Providers who are registered and accredited through Australian Regional Health Group (ARHG), which facilitates provider registration on behalf of Latrobe Health Services and ensures all accreditation requirements are satisfied.

When won’t Latrobe Health pay a benefit?

Latrobe Health Services doesn’t pay a benefit when a provider treats someone connected to their own practice. That means we can’t pay a benefit when a provider treats:

• themselves
• their partner or their dependants
• their business partner
• the partner or dependants of their business partner
• anyone else who isn’t independent of the practice, including employees, contractors, locums and their families.

What standards apply if you work in mixed business premises?

If you deliver services in mixed business premises, as defined in the Latrobe Health Services Fund Rules, you need to show that minimum quality standards are being met. These standards include, but aren’t limited to:

• infection control and hygiene procedures where invasive techniques are used
• premises that meet minimum physical standards and all state, territory and local council laws, including reception, waiting rooms, toilets and work rooms
• clinical notes taken at each consultation, written in English, and stored securely and confidentially under the Privacy Act and any other relevant law
• informed clinical consent, written or verbal, from the patient for any procedural treatment
• informed financial consent, written or verbal, from the patient before treatment starts.

What must be on the patients invoice or receipt?

Latrobe Health Services can only pay a benefit on an invoice or receipt that carries a set list of details. If one is missing, the claim won’t be processed.

What must appear on the invoice

• official letterhead or official provider stamp
• the provider’s full name, provider number, qualification and address
• the patient’s full name and address
• date of service
• description of service
• tooth numbers for dental services
• amount charged
• any amount the member paid
• any other information as required and amended by the fund from time to time

All documents submitted to Latrobe Health become the property of Latrobe Health and will not be returned.

How do massage, myotherapy, acupuncture and Chinese medicine providers get recognised?

Latrobe Health Services pays benefits on alternative and complementary therapies when the provider is registered with an association recognised by the Australian Regional Health Group (ARHG). The therapies this applies to are massage, myotherapy, acupuncture and Chinese medicine.

Not sure whether your association is on the list? Check with your association first (they’ll know straight away).

Members claim these services by submitting a claim through the Latrobe Health app or members portal. The invoice still has to meet every criterion in "What must appear on the invoice" above before we can pay a benefit.

Can a patient claim electronically through HICAPS or HealthPoint?

Latrobe Health Services accepts electronic extras claims through HICAPS and through HealthPoint for the following services:

• Acupuncture (HICAPS ONLY)
• Chinese medicine (HICAPS ONLY)
• Chiropractic
• Exercise physiology
• Dental
• Dietitian
• Massage (HICAPS ONLY)
• Myotherapy (HICAPS ONLY)
• Occupational therapy
• Optical
• Osteopath
• Physiotherapy
• Group physiotherapy
• Hydrotherapy consultations
• Podiatry
• Psychology
• Speech therapy

Who do I contact at Latrobe Health Services?

Our extras provider team handles provider numbers, invoice questions and electronic claiming. Email ancillaryservices@lhs.com.au, or call Latrobe Health Services on 1300 362 144.

For anything else, see our contact details and branch locations.