{"id":"F2007B01069","name":"Private Health Insurance Incentives (Form and Content of Claim) Determination (PHIIA 15-10(2)/1/1999)","slug":"private-health-insurance-incentives-form-and-content-of-claim-determination-phiia-15-10-2-1-1999","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"repealed","isInForce":false,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":62564,"registerId":"commonwealth-F2007B01069-current","compilationNumber":null,"startDate":"2026-04-02","status":"Repealed","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Private Health Insurance Incentives (Form and Content of Claim) Determination (PHIIA 15-10(2)/1/1999)","content":"Commonwealth of Australia\n\nPrivate Health Insurance Incentives Act 1998\n\nPrivate Health Insurance Incentive\n\n(Form and Content of Claim) Determination\n\n(PHIIA 15-10(2)/1/1999)\n\nI, Jeffrey Allan Harmer, Managing Director of the Health Insurance Commission, make the following Determination under subsection 15-10(2) of the Private Health Insurance Incentives Act 1998.\n\nDated this 23rd day of July 1999.\n\nJA Harmer\n\nManaging Director of Health Insurance Commission\n\nCitation\n\n1. This Determination may be cited as the Private Health Insurance Incentives (Form  \nand Content of Claim) Determination.\n\nCommencement\n\n  \n2. This Determination is taken to have commenced on 1 January 1999.\n\nInterpretation\n\n3. In this Determination:\n\n“Act” means the Private Health Insurance Incentives Act 1998.\n\nForm of Notification\n\n4. For the purposes of subsection 15-10(2) of the Act, the notice must be in the form  \nof either an electronic transmission or facsimile transmission.\n\n  \nContent of Claim\n\n5. For the purposes of subsection 15-10(2) of the Act, a claim from a health fund must  \ncontain the following details:\n\n(a) fund’s minor customer identification;\n\n(b) fund identification code;\n\n(c) fund name;\n\n(d) fund electronic date interchange address;\n\n(e) month of claim;\n\n(f) year of claim;\n\n(g) number of policies claimed for the previous month;\n\n(h) number of policies claimed for current month;\n\n(i) total amount claimed for previous month;\n\n(j) total amount claimed for current month; and\n\n(k) number of registered policies.","sortOrder":0}],"analysis":{"kimi_summary":{"_metrics":{"model":"kimi-k2.5","source":"moonshot-batch","completionTokens":1873},"content_quality":"ok","complexity_score":2,"scope_assessment":{"changed":false,"description":"The instrument performs exactly the function described in its title—prescribing the technical form and content of claims—without expanding into broader regulatory matters or substantive private health insurance policy."},"complexity_factors":["Only 1 defined term ('Act') in the interpretation section","Just 5 operative sections total","Simple prescriptive list of 11 data fields with no conditional logic","No exceptions, cross-references, or nested provisions","Straightforward administrative form-setting without policy discretion"],"plain_english_summary":"This Determination is essentially the **administrative rulebook** for how private health insurers claim incentive payments from the Commonwealth.\n\n**The guts of it:**\n*   **How to lodge:** Health funds can submit claims via electronic transmission or fax (this was made in 1999, after all).\n*   **What to include:** Claims must contain 11 specific data points — basically everything needed to process the paperwork: the fund's identification codes, name, and electronic address; the month and year of the claim; and the financial details (number of policies and total dollar amounts claimed for both the current and previous months).\n\n**Who it affects:**\nPrivate health insurers (health funds) claiming incentives under the *Private Health Insurance Incentives Act 1998*.\n\n**Why it matters:**\nIt standardizes the claims process, ensuring the Health Insurance Commission receives consistent, machine-readable data to process government payments efficiently."}},"importantCases":[],"_links":{"self":"/api/acts/private-health-insurance-incentives-form-and-content-of-claim-determination-phiia-15-10-2-1-1999","history":"/api/acts/private-health-insurance-incentives-form-and-content-of-claim-determination-phiia-15-10-2-1-1999/history","analysis":"/api/acts/private-health-insurance-incentives-form-and-content-of-claim-determination-phiia-15-10-2-1-1999/analysis","conflicts":"/api/acts/private-health-insurance-incentives-form-and-content-of-claim-determination-phiia-15-10-2-1-1999/conflicts","importantCases":"/api/acts/private-health-insurance-incentives-form-and-content-of-claim-determination-phiia-15-10-2-1-1999/important-cases","documents":"/api/acts/private-health-insurance-incentives-form-and-content-of-claim-determination-phiia-15-10-2-1-1999/documents"}}