Commonwealth legislation

Private Health Insurance Incentives (Form and Content of Claim) Determination (PHIIA 15-10(2)/1/1999)

RepealedCTH

This Act has been repealed and is no longer in force. It is retained for historical reference.

Jurisdiction

Commonwealth

Collection

legislative instrument

Plain English Summary

2/10 complexity

This Determination is essentially the administrative rulebook for how private health insurers claim incentive payments from the Commonwealth.

The guts of it:

How to lodge: Health funds can submit claims via electronic transmission or fax (this was made in 1999, after all).
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).

Who it affects: Private health insurers (health funds) claiming incentives under the Private Health Insurance Incentives Act 1998.

Why it matters: It standardizes the claims process, ensuring the Health Insurance Commission receives consistent, machine-readable data to process government payments efficiently.

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Deep dive

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Current sections

Direct links to the current provisions in Private Health Insurance Incentives (Form and Content of Claim) Determination (PHIIA 15-10(2)/1/1999).

Private Health Insurance Incentives (Form and Content of Claim) Determination (PHIIA 15-10(2)/1/1999)

Commonwealth of Australia

Private Health Insurance Incentives Act 1998

Private Health Insurance Incentive

(Form and Content of Claim) Determination

(PHIIA 15-10(2)/1/1999)

I, 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.

Dated this 23rd day of July 1999.

JA Harmer

Managing Director of Health Insurance Commission

Citation

This Determination may be cited as the Private Health Insurance Incentives (Form
and Content of Claim) Determination.

Commencement

This Determination is taken to have commenced on 1 January 1999.

Interpretation

In this Determination:

“Act” means the Private Health Insurance Incentives Act 1998.

Form of Notification

For the purposes of subsection 15-10(2) of the Act, the notice must be in the form
of either an electronic transmission or facsimile transmission.

Content of Claim

For the purposes of subsection 15-10(2) of the Act, a claim from a health fund must
contain the following details:

(a) fund’s minor customer identification;

(b) fund identification code;

(d) fund electronic date interchange address;

(e) month of claim;

(f) year of claim;

(g) number of policies claimed for the previous month;

(h) number of policies claimed for current month;

(i) total amount claimed for previous month;

(j) total amount claimed for current month; and

(k) number of registered policies.

Source text

Sourced from the Federal Register of Legislation (legislation.gov.au), CC BY 4.0.

1 Private Health Insurance Incentives (Form and Content of Claim) Determination (PHIIA 15-10(2)/1/1999)