Privatehealth.gov.au Website Bulletin #7

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1 Privatehealth.gov.au Website Bulletin #7 20 May 2013 Contents 1. Website Statistics 2. Single room, public hospital 3. Midwifery and PHI 4. Agreement Hospitals list 5. SIS Data Release Authorities 6. Dental items and ADA changes 1. Website Statistics Usage The website has recorded over 400,600 unique visitors in the year to date, compared to over 440,000 in the whole of Analysis of the available data suggests that general growth of the site s usage can be attributed to the site becoming better known via recommendations and search results, as well as regular reminders of the site s existence in annual mailings of Standard Information Statements and Lifetime Health Cover letters. In June 2012, the website experienced an extremely high level of traffic. Changes to the Australian Government Private Health Insurance Rebate and the Department of Health & Ageing s annual Lifetime Health Cover mailing to new migrants and Australians turning 31 resulted in a very high level of PHI awareness among consumers. In March 2013, a similar spike in traffic occurred as a result of media coverage regarding private health insurance premium increases and industry developments Unique Visitors to Privatehealth.gov.au Ask A Question In , we received over 1300 enquiries about the website by and telephone. In the year to date, we have received over 930 enquiries Ask A Question

2 User Survey 776 users completed the survey in , compared to 604 users in to date. Since the website relaunch went live in July 2010, feedback has been high in general. 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Website User Survey YTD Ease of use Visual appeal Location of information Quality of information Excellent Good Average Poor Very Poor 2. Cover for a single room in a public hospital Some insurers are now capping the benefit paid for a single room in a public hospital. A gap may be payable by the member if the hospital chooses to charge higher than the benefit set by the fund. This may need to be addressed on the Standard Information Statement if consumers start to be affected by this change. So far, industry feedback indicates that most public hospitals are choosing not to pass on a gap to patients. Those hospitals that do pass on the gap are obtaining Informed Financial Consent and in some cases health insurers are providing a discretionary benefit to cover the extra cost. To help inform consumers, PHIO will be reviewing the information provided on the website. PHIO welcomes any feedback on this matter. 3. Midwifery and Private Health Insurance From 2010, eligible midwives have been able to access Medicare for certain item numbers and there are now 85 eligible midwives. Currently midwives can practice independently, in collaboration with a doctor; and from 1 July 2013, midwives will also be able to collaborate with hospitals. Some of the services provided by midwives are for admitted services and have the potential to be covered by private hospital insurance. Although insurers are not required to provide cover for these items, consumers are very interested in these services and it is anticipated that consumer uptake will increase. The Department of Health & Ageing will be providing the Private Health Insurance Ombudsman with more information about midwifery and the applicable item numbers, for distribution to health insurers if you would like to receive this information please contact Alison Leung Privatehealth.gov.au Website Bulletin #7 2

3 4. Agreement Hospitals List All insurers are able to choose which hospitals they have agreements with using the CMS for PrivateHealth.gov.au. This information is then used in the Agreement Hospitals tool on the public site to show private hospitals at or near a particular location that have agreements with the selected health fund. Currently there are 587 hospitals listed on the site. The list of agreement hospitals is maintained by Human Solutions based on information provided by the Department of Health and Ageing through their PHI circular. An annual verification of the full list of agreement hospitals has been undertaken in previous years. As new hospitals are added, insurers are notified of the changes. Insurers can also contact Human Solutions to add new agreement hospitals as needed. Human Solutions will explore options to allow insurers to extract and re-upload agreement hospital lists more easily, and encourage insurers to audit the lists more frequently. 5. SIS Data Release Authorities Currently, if a third party is granted access by a health fund to the CMS and Web Services for Privatehealth.gov.au via a Data Release Authority, this means they have access to the whole of a fund s SIS database including unpublished and draft SISs. In response to feedback from health insurers, Human Solutions have implemented a new option which allows funds to grant access only to SISs for products currently available for purchase. The SIS Data Release Authority has been updated to reflect this change, as well as some other minor changes suggested by health insurers including: the removal of an end date to authorisations; and the ability to authorise more than one party on a single form. If health insurers wish to revoke access at any time, they can simply contact PHIO by at Human Solutions will also explore the possibility of automating withdrawal of access through CMS. A copy of the new authority form is attached and will also be made available on the website resources page at the PHIO website: 6. Dental Items and ADA Changes The Australian Dental Association (ADA) has undertaken a review of their Australian Schedule of Dental Services and Glossary (the Schedule). The amendments to the Schedule include changes to the billing procedure for dental item 811, allowing sequential presentation of accounting to enable progressive billing for this item. Regarding dental item 811, the ADA has noted that its description on the SIS as Braces for upper & lower teeth, including removal plus fitting of retainer whereas ADA s description for this item is complete course of orthodontic treatment in the Schedule. In principle, ADA agrees that the description on the SIS is more meaningful for consumers. However, ADA s view is that there could be some clinical issues to cloud this, which are best assessed on an individual basis. Privatehealth.gov.au Website Bulletin #7 3

4 Where ADA dental items are described, ADA would prefer that the Schedule s Glossary be used so as to avoid any issues which may arise. Health and PHIO welcome feedback on item 881 and its description on the general treatment SIS, and whether the description should be changed or the item should be replaced with another dental item. Note on Distribution This bulletin is distributed to members of the PHIO Website Reference Group (including insurers, consumer groups and government) and the primary insurer contacts as listed on the CMS. To unsubscribe or add another address, please For previous issues and other website resources, please see: Privatehealth.gov.au Website Bulletin #7 4

5 Health Insurer Declaration: PrivateHealth.gov.au Data Release Authority Form I am authorised to approve the release of data to the parties listed below. Please tick one option below only: I authorise access to all currently available for purchase Standard Information Statement data entered into the PrivateHealth.gov.au Content Management System (ReadCurrent); OR I authorise access to all Standard Information Statement data entered into the PrivateHealth.gov.au Content Management System (Reader). I understand that if I wish to revoke this authority I am required to or write to the Private Health Insurance Ombudsman requesting the cancellation of this authority. Health Insurer Authorising Officer (must be insurer s CEO or equivalent) Health Insurer Authorising Officer Signed Date Party (1) Authorised to Access Insurer Data Organisation Organisation ABN Website Authorised Recipient Party (2) Authorised to Access Insurer Data Organisation Organisation ABN Website Authorised Recipient Please return completed forms to or by fax to For general assistance and enquiries, contact PHIO on For technical queries, contact Human Solutions on PHIO Office Use Verified: Delegate: Date: Suite 2, Level 22, 580 George St. Sydney NSW 2000 Complaints Hotline Website Information Phone Fax Web ABN

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