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Refer and request provider number - private billings

Refer and request provider number - private billings

Published By HealthcareLink , 1 year ago

If you are seeking reimbursement for services eligible for Medicare benefits, it is mandatory to possess a Medicare provider number. On the other hand, a refer and request provider number does not allow you to bill Medicare, but permits you to offer services in a private billing context, recommend other practitioners to your patients, and request diagnostic tests. 

Doctors who are constrained by 19AA and/or 19AB and cannot to meet their limitations in the short term can apply for a refer and request provider number. 

To apply for a refer and request Provider Number, you must visit the Medicare website and complete a HW019 Form. On question 23 of the form, choose the option "Refer and request only (such as hospital interns)." You can access the form via this link: https://www.servicesaustralia.gov.au/organisations/health-professionals/forms/hw019. (This version of the form is as of today March 2023) 

With a Refer and request only provider number at Medicare, you can attract patients who are willing to pay for medical services without Medicare subsidies. These patients may include those who have private health insurance, those who are not eligible for Medicare benefits, or those who prefer to pay out-of-pocket for medical services. 

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