Become a recognised provider

Ensure your clients can claim a rebate by becoming a Recognised Provider.

 

CBHS provides exceptional member care by ensuring that the claims process is simple and streamlined. CBHS can only pay benefits for services provided by ‘recognised providers’. On this page you will find information about the types of providers that are deemed to be recognised providers and the services for which they are considered to be recognised providers.

CBHS and recognised providers

Please note that as an insurer, we do not recommended practitioners to members and we do not participate in the clinical relationship between member and provider. CBHS is not responsible for clinical outcomes for services provided or not provided by recognised providers. The extent of CBHS’s responsibility, as a health insurer, is to decide whether to pay or not to pay fund benefits. In doing so, we act in accordance with the CBHS Health Benefit Fund Rules and the applicable Government regulations.

 

Providers registered with Medicare Australia
If you are a provider registered with Medicare Australia for services that are payable under our Extras levels of cover, you are considered a Recognised Provider by CBHS. Therefore, there is no requirement for you to make a separate application for Provider Recognition.

The services that are payable under our Extras cover products under this category
  • Audiologist
  • Chiropractor
  • Dental Prosthetist
  • Dentist
  • Dietician
  • Exercise Physiologist
  • Occupational Therapist
  • Optometrist
  • Osteopath
  • Physiotherapist
  • Podiatrist
  • Psychologist
  • Speech Pathologist

Providers registered with the Australian Health Practitioner Regulation Agency
If you are a provider who is registered with the Australian Health Practitioner Regulation Agency (AHPRA) for services that are payable under CBHS’s Extras cover products, you are considered to be a recognised provider by CBHS. As such, a separate provider recognition application is not necessary.

The services that are payable under our Extras cover products under this category
  • Acupuncture
  • Chinese Herbal Medicine

Complementary and alternative therapy providers
CBHS recognises many complementary and alternative therapy associations and boards as either meeting or exceeding CBHS’s criteria for recognised providers. Providers that belong to associations and/or boards that meet CBHS’s criteria are deemed to be recognised providers.

These are CBHS’s recognition criteria:
  • Relevant qualifications for the service provided
  • Current Professional Indemnity Insurance Certificate of Currency
  • Current Senior First Aid Certificate

In addition, Rule 10 of the Private Health Insurance (Accreditation) Rules 2011 applies to complementary or alternative providers. This rule requires the provider or treatment to meet each of the following criteria.

  • The standard for treatment is that the complementary or alternative therapy health care provider (among others) providing the treatment must be a member of a professional organisation which covers health care practitioners who provide that type of treatment (the profession).
  • The professional organisation must be a national entity which has membership requirements for the profession.
  • The professional organisation must provide assessment of the health care provider in terms of the appropriate level of training and education required to practise in that profession.
  • The professional organisation must administer a continuing professional education development scheme in which the health care provider is required, as a condition of membership, to participate.
  • The professional organisation must maintain a code of conduct which the health care provider must uphold in order to continue to be a member.
  • The professional organisation must maintain a formal disciplinary procedure, which includes a process to suspend or expel members, and an appropriate complaints resolution procedure.

(i) Massage therapies:

  • Alexander Technique
  • Aromatherapy
  • Bowen
  • Deep Tissue
  • Feldenkrais
  • Lymphatic Drainage
  • Myotherapy
  • Remedial
  • Rolfing
  • Sports
  • Swedish
  • Therapeutic

(ii) Oriental Therapies 

  • Acupressure
  • Chinese Massage
  • Kinesiology
  • Reflexology
  • Shiatsu

(iii) Natural Therapies 

  • Buteyko
  • Herbal Medicine (consultation)
  • Homeopathy (consultation)
  • Naturopathy (consultation)
  • Nutrition (consultation)
 

 

 

 

 



Provider recognition and other services
The following services are outside the scope of Rule 10 of the Private Health Insurance (Accreditation) Rules 2011 but must meet CBHS’s Recognition Criteria in order for benefits to be payable.
  • Dental Hygienist
  • Dental Technician
  • Diabetes Educator
  • Lactation Consultant
  • Optical Dispenser
  • Orthotist
  • Orthoptist

If you have any questions about a provider that you wish to use, or wish to find out more about the process of becoming a recognised provider with CBHS, contact Member Care on 1300 654 123 or send us an email at help@cbhs.com.au.