Information for extras providers

A set benefit is paid depending on the treatment for services provided in Australia by a Latrobe approved provider in a private practice.
"Approved provider" means a provider of services registered with the appropriate association or organisation to render services to insured persons and approved by the Fund to render services to its insured persons.

Benefits will NOT be payable for treatment rendered by a provider to their:

  • the provider’s partner, dependants, or business partner; or
  • the partner or a dependants of any business partner of the provider
  • the provider themselves
  • any other person not independent from the practice including but not limited to employees, contractors, locums and their families

Any extras provider providing services in a mixed business premises (as defined in the Fund Rules) must be able to demonstrate that minimum quality standards are being met, these include but are not limited to

  • infection control, and hygiene procedures and protocols are in place where invasive techniques are used
  • premises (patient reception, waiting rooms, toilet facilities, workrooms etc) that meet minimum physical standards and expectations and all state, territory and local council laws
  • clinical notes taken at each consultation, that are written in English, and maintained and stored in a confidential and secure environment in accordance with the Privacy Act and any other relevant legislation
  • informed clinical consent (either written or verbal) obtained from patients for any procedural treatment offered
  • informed financial consent (either written or verbal) obtained from patients before commencing treatment

Latrobe will not pay benefit for a treatment that is not provided as part of a "face to face" consultation rendered in person, including telephone, internet and other electronic media consultations.

Provider invoice/receipt – requirements

Latrobe Health Services requires ancillary providers to use a specific set of criteria which must be included on invoices/receipts before a benefit will be paid on the service or item.

The following criteria must be supplied for a benefit to be paid:

  • Provider number
  • Practice address (not PO Box) and contact telephone number
  • ABN (if applicable)
  • Name of provider who provided the service
  • Patients full name (first name and surname)
  • Date of service
  • Date of payment
  • Itemised treatment/s provided (appropriate classification codes) and products supplied
  • Costs for each relevant service and/or product (state GST if applicable)
  • All invoices/receipts must be pre-numbered and in numerical order
  • All invoices/receipts should be printed on personal or association stationery
  • All invoices/receipts should be signed on when issued by the provider/provider representative
  • There can only be one original invoice/receipt. All duplicates must be endorsed as "duplicate"
  • Invoices/receipts will NOT be accepted if hand written

Alternative therapy provider recognition

Alternative or complementary therapies include the following modalities:

  • Massage
  • Myotherapy
  • Acupuncture

For a Latrobe benefit to be paid on services rendered by a provider for an alternative therapy service, the provider must be registered with an association recognised by the Australian Regional Health Group. If you are unsure whether you are recognised by the Australian Regional Health Group please check with your association.

Claims for services rendered by a recognised provider can be made by presenting or mailing the invoice/receipt to our offices. The invoice/receipt must meet Latrobe's criteria before a benefit can be paid (refer Provider invoice/receipt – requirements).

Electronic claiming – HICAPS and HealthPoint

Latrobe currently accepts electronic claims via HICAPS and HealthPoint for the following modalities:

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

Please contact us for further information. Email: ancillaryservices@lhs.com.au