Frequently Asked Questions

Once a valid ONE form and any required supporting documentation is received, our team will ensure all paperwork is submitted quickly. Each fund has a different processing time but we can expect a fund to process and confirm your agreement within 2-3 weeks. Our team will be monitoring your progress and follow up with the fund as needed. Once your provider number/s have been confirmed and activated in our billing system, we can commence billing any uploaded cases! 

OpBill is now one of Australia’s fastest growing billing services. Originally for Surgical Assistants, we now offer all inpatient billing including surgeon and physician claiming. So if you are starting your billing as a Primary Surgeon and do not have a PA, or are part private and part public, OpBill is the easiest way for you to bill without the overhead costs.

Yes! You can upload your case as you would a regular case but you will need to add a note for our team. Please advise us of the insurer name or organisation to be invoiced along with an email address for invoice submission. Our team will send you a copy of the manual invoice by email for your records.

If you have never billed before our registration team will apply for a Bupa Practice ID on your behalf. This is a Bupa billing requirement and will link all of your banking and contact information to your locations. If you are switching to OpBill and would like a new Bupa Practice ID, simply enter, ‘Please apply for new ID’ when filling in the ONE form. Our team will also apply for a new ID if you are registering in a new state of practice.

Health funds are continuing to improve their security and protect your information so we are required to submit various verification documents such as redacted bank statements and medicare confirmation letters to verify your identity.  Although this is a lot of effort for everyone involved, this means the risk of billing errors and fraud are greatly reduced.

Unfortunately, Medicare do not accept any electronic signatures and this is a requirement to link our software to your provider number for billing. Please print, sign, scan and return your forms at your earliest convenience so that there is no delay to your medicare only and DVA claims.

Yes. Medicare and all health funds will accept claims up to 2 years following the service date as long as the provider number you are billing with was open at service date and you have an agreement in place with the health fund. If you are uploading claims for a location you have not previously registered, backdating policies will apply from the health fund. Please see backdating for further information.

Each health fund has a different backdating policy but generally all health funds will backdate at least 3 months with some backdating 6, 12 or 24 months. Our team will apply for the maximum backdates within each fund’s policy. If your earliest date of service is prior to the granted backdate, you will still be eligible to bill Medicare for 2 years after the service date.

Yes. Medicare regulations state that each provider should have a unique provider number for each location at which they offer services. Each provider number should also be linked to the correct street address for the facility for which the service took place.

Yes. If you decide to register as a known gap provider, your fees claimed with Bupa and HCF will be lower than a No Gap provider. These two health funds require all providers to nominate their gap choice in advance whereas all other health funds will allow providers to opt in and out on a per episode basis. Maximum gap charges apply. To learn more, we recommend reviewing each fund’s terms and conditions which are available on their website.

No. Medicare only allow one billing organisation to be linked to a provider number at one time. If you have given the same provider number to two different organisations for billing purposes, this will likely cause billing issues. Two or more different organisations may bill on your behalf but they must be using different provider numbers. In some circumstances, Medicare may be able to grant a second provider number for the same location. You can speak with the Medicare registration team on 132 150 (option 6) to discuss further.

Yes. An ABN is a requirement for all workcover, ADF and other third party billing. You must also link you personal ABN and business infrimaiton to your provider number with Medicare so that you are eligible for claiming. If you do not have one, we recommend applying for one as soon as you can. For further advice, please consult with your accountant.

All health funds (except Bupa) will link details such banking and contact details to each location rather than the provider. This means that to use a provider number for billing, we must first link all of the vital information required. The ONE form generates all of the required forms so our team can take care of this on your behalf.

Please advise our registration team of your intention to start charging gaps and they will be able to fill in the necessary paperwork with Bupa and HCF to change your gap nomination. Please be aware there is a notice period so you will not be able to commence gap charging for your Bupa and HCF patients until, this has been complete and your effective date confirmation by the fund. You can charge a gap at anytime with all other health funds. Please check each fund’s terms and conditions before charging a patient a gap.

Yes. Our team can generate a billing report either for easier reconciling or tax purposes upon request.

If you have recently registered your provider number, there will be an initial 2-3 weeks wait time whilst we register your details with all health funds and Medicare. For Surgical Assistant cases, we have a two-week hold from the service date to allow for the primary surgeon to finalise their billing. Please also ensure that your case is not ‘flagged’ – if your case ID appears as red in your uploaded folder, this means our team has either rejected your case or requires further information. You will need to select the case, edit and resubmit so that it appears in our ready to bill queue for our team.

This means our team have flagged your case and it requires some attention. This may be some missing information, a rejection from the health fund or we may have a query. The team notes will be shown in red so you can easily find the reason for the flag and respond to our team from within the app. You will also be notified by email outside of the app.

For any queries we have not answered here, please do not hesitate to contact us at support@opbill.com.au