Registration ONE FORM

We are delighted to have you with us.

Completion of this form will only take a few minutes, on your behalf, we will then be able to manage the registration of your provider numbers with Health Funds and Medicare.

After completion of this form you will receive a copy so please ensure to review the information and advise us immediately should any changes need to be made.

Within 2 business days you will receive an email from us with 1or 2 Medicare Forms depending on your type of registration. Please read through the instructions outlined in the email carefully, and reply back to us with the signed Medicare Forms. It is extremely important that you action this email ASAP otherwise this will hold up the registration process which will delay us being able to process your cases.

Please note we cannot start billing for you until Medicare and the Health Funds have processed your documentation, which can take up to 4 weeks from submission of this form.

Sit back, and start billing from the convenience of your phone

I am a *

Surgical Assistant

Surgeon

Physician

Nurse PractitionerNurse Practitioner

Have you ever billed Privately?

Yes - I want to change to OpBill

No - this is my first time

Already using Opbill - Adding Provider Number

Change of Details

*Ensure you include ALL provider numbers that you have registered with OpBill that you want to change details for. Please ensure when selecting “Change of Details” that you still complete this entire form.
You MUST include ALL provider numbers that you wish to change details.

*Ensure you ONLY include provider numbers that you have NOT already registered with OpBill.

I am updating the following details (Select all that apply) *

Personal details (Address/Phone/Email)

Bank Details

Every time you change details or add details, you need to complete this entire form. This includes adding all the provider numbers you wish to change details for. When adding provider numbers to your account, add the provider numbers you wish to add in the provider number section with associated hospitals, and don't forget to complete all the bank details etc.

Billing privately - I understand that when signing up to OpBill I am assigning OpBill as my billing agent. I cannot use another billing agent for any of the provider numbers that I have registered with OpBill, provider numbers can only be linked to one software package. A result of not abiding by this will affect processing of your cases as they will be rejected if attached to multiple software packages. *

Yes I understand

No I need help

You have selected NO - I need help. Please do not complete this form until you have emailed us via billing@opbill.com.au where we will help guide you in setting up an additional provider number. Alternatively - log into HPOS/PRODA and apply for additional provider number now.

19AB Restriction - If you know you are 19AB restricted (overseas trained doctors mainly are affected by this), you may NOT be allowed to bill. *

I am unrestricted

I am 19AB restricted

If you are working under a 19AB exemption (overseas trained provider) or have restrictions on your provider number, it is your responsibility to confirm your eligibility to claim with Medicare before commencing work and uploading cases to the mobile app. Please contact Medicare if you are unsure.

First Name *

Last Name *

Date of Birth *

AHPRA Number *

MUST include MED at the start please

ABN

An ABN is required for all workcover and third party claims. It is also a medicare requirement that your personal ABN and business details are linked to your provider number/s with Medicare. Failure to action this may result in rejected claims. For further advice regarding an ABN, please speak with your accountant.

Email *

Mobile Number *

Practice Phone Number

Please note that this will be displayed on the BUPA website

Your Address *

Suburb *

State

Postcode *

BANK DETAILS

Supporting Documents AHSA who manages your registration across 30+ health funds has recently updated their requirements to help protect your personal information. To complete registration you will be required to verify your provider numbers and banking details. This is a requirement each time you submit a ONE form. Please ensure your supporting documents meet the following compulsory requirements. 1. Bank Statement or other verification document - for security purposes all transaction activity should be redacted. Please ensure the bank account on your document matches the bank account in out on the ONE form. 2. A Medicare letter of confirmation or PRODA screenshot is required to authenticate your provider number for each location before we proceed with registration. How to retrieve a Medicare Confirmation Letter for provider numbers: Login to HPOS > Services > My programs > My details > Messages/Mail box centre - You should have a message in your inbox with a copy of the letter when you created the provider number. A PRODA screenshot may be submitted instead but only if it includes the following: • date and time stamp • the Health Professional Online Services (HPOS) or Medicare Australia header • the doctors name • provider number • practice address

Bank *

Branch Address (Suburb Only) *

Account Holders Name *

BSB *

Account Number *

Please do not use spaces

Bank Statement

Maximum file size: 134.22MB

Don't know your Provider numbers or BUPA Practice ID? CLICK HERE

Please include all provider numbers you wish to add, including all the corresponding hospital locations. This is required even if you are just updating your bank details, as the provider numbers listed here will be the ones added or updated.

Select STATE of practice *

Please note there is a limit of 11 locations on this form. If you are registering more than 11 locations, please submit a second ONE form with the remaining locations.

PROVIDER NUMBERS - ACT / NSW

If you know your Provider numbers, please enter them here. Click below to see our guide on how to obtain your provider numbers. Do not enter previously OpBill registered provider numbers UNLESS there is a change of details ie banking, address etc. In which case you will need to also select ‘change of details’ and add all registered provider numbers. Entering a provider number here that does not require any changes will DELAY the registration of your account or potentially delay billing dates whilst the details are being updated.

Provider Number *