Privatehealth.gov.au Website Bulletin #7
20 May 2013
1. Website Statistics Usage
The website has recorded over 400,600 unique visitors in the year to date, compared to over 440,000 in the whole of 2011-12. Analysis of the available data suggests that general growth of the site’s usage can be attributed to the site becoming better known via recommendations and search results, as well as regular reminders of the site’s existence in annual mailings of Standard Information Statements and Lifetime Health Cover letters.
In June 2012, the website experienced an extremely high level of traffic. Changes to the Australian Government Private Health Insurance Rebate and the Department of Health & Ageing’s annual Lifetime Health Cover mailing to new migrants and Australians turning 31 resulted in a very high level of PHI awareness among consumers. In March 2013, a similar spike in traffic occurred as a result of media coverage regarding private health insurance premium increases and industry developments.
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In 2011-12, we received over 1300 enquiries about the website by email and telephone. In the 2012-13 year to date, we have received over 930 enquiries.
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Unique Visitors to Privatehealth.gov.au
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Contents 1. Website Statistics2. Single room, public hospital 3. Midwifery and PHI
4. Agreement Hospitals list 5. SIS Data Release Authorities 6. Dental items and ADA changes
Privatehealth.gov.au Website Bulletin #7 2
User Survey
776 users completed the survey in 2011-12, compared to 604 users in 2012-13 to date. Since the
website relaunch went live in July 2010, feedback has been high in general.
2. Cover for a single room in a public hospital
Some insurers are now capping the benefit paid for a single room in a public hospital. A gap may be payable by the member if the hospital chooses to charge higher than the benefit set by the fund. This may need to be addressed on the Standard Information Statement if consumers start to be affected by this change.
So far, industry feedback indicates that most public hospitals are choosing not to pass on a gap to patients. Those hospitals that do pass on the gap are obtaining Informed Financial Consent and in some cases health insurers are providing a discretionary benefit to cover the extra cost.
To help inform consumers, PHIO will be reviewing the information provided on the website. PHIO welcomes any feedback on this matter.
3. Midwifery and Private Health Insurance
From 2010, “eligible midwives” have been able to access Medicare for certain item numbers and there are now 85 eligible midwives. Currently midwives can practice independently, in collaboration with a doctor; and from 1 July 2013, midwives will also be able to collaborate with hospitals.
Some of the services provided by midwives are for admitted services and have the potential to be covered by private hospital insurance. Although insurers are not required to provide cover for these items, consumers are very interested in these services and it is anticipated that consumer uptake will increase.
The Department of Health & Ageing will be providing the Private Health Insurance Ombudsman with more information about midwifery and the applicable item numbers, for distribution to health insurers – if you would like to receive this information please contact Alison Leun
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Ease of use Visual appeal Location of
information information Quality of
Website User Survey 2012-13 YTD
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4. Agreement Hospitals List
All insurers are able to choose which hospitals they have agreements with using the CMS for PrivateHealth.gov.au. This information is then used in the Agreement Hospitals tool on the public site to show private hospitals at or near a particular location that have agreements with the selected health fund. Currently there are 587 hospitals listed on the site.
The list of agreement hospitals is maintained by Human Solutions based on information provided by the Department of Health and Ageing through their PHI circular. An annual verification of the full list of agreement hospitals has been undertaken in previous years. As new hospitals are added, insurers are notified of the changes. Insurers can also contact Human Solutions to add new agreement hospitals as needed.
Human Solutions will explore options to allow insurers to extract and re-upload agreement hospital lists more easily, and encourage insurers to audit the lists more frequently.
5. SIS Data Release Authorities
Currently, if a third party is granted access by a health fund to the CMS and Web Services for Privatehealth.gov.au via a Data Release Authority, this means they have access to the whole of a fund’s SIS database including unpublished and draft SISs.
In response to feedback from health insurers, Human Solutions have implemented a new option which allows funds to grant access only to SISs for products currently available for purchase.
The SIS Data Release Authority has been updated to reflect this change, as well as some other minor changes suggested by health insurers including: the removal of an ‘end date’ to authorisations; and the ability to authorise more than one party on a single form.
If health insurers wish to revoke access at any time, they can simply contact PHIO by email at
through CMS.
A copy of the new authority form is attached and will also be made available on the website resources page at the PHIO website:
6. Dental Items and ADA Changes
The Australian Dental Association (ADA) has undertaken a review of their Australian Schedule of Dental Services and Glossary (the Schedule). The amendments to the Schedule include changes to the billing procedure for dental item 811, allowing sequential presentation of accounting to enable progressive billing for this item.
Regarding dental item 811, the ADA has noted that its description on the SIS as ‘Braces for upper & lower teeth, including removal plus fitting of retainer’ whereas ADA’s description for this item is ‘complete course of orthodontic treatment’ in the Schedule.
In principle, ADA agrees that the description on the SIS is more meaningful for consumers. However, ADA’s view is that there could be some clinical issues to cloud this, which are best assessed on an individual basis.
Privatehealth.gov.au Website Bulletin #7 4 Where ADA dental items are described, ADA would prefer that the Schedule’s Glossary be used so as to avoid any issues which may arise.
Health and PHIO welcome feedback on item 881 and its description on the general treatment SIS, and whether the description should be changed or the item should be replaced with another dental item.
Note on Distribution
This bulletin is distributed to members of the PHIO Website Reference Group (including insurers, consumer groups and government) and the primary insurer contacts as listed on the
To unsubscribe or add another email address, please email For previous issues and other website resources, please see:
PrivateHealth.gov.au – Data Release Authority Form
Health Insurer Declaration:I am authorised to approve the release of data to the parties listed below. Please tick one option below only:
I authorise access to allcurrently available for purchase Standard Information Statement data entered into the
PrivateHealth.gov.au Content Management System (ReadCurrent);
OR
I authorise access to all Standard Information Statement data entered into the PrivateHealth.gov.au Content
Management System (Reader).
I understand that if I wish to revoke this authority I am required to email or write to the Private Health Insurance
Ombudsman requesting the cancellation of this authority.
Health Insurer Authorising Officer (must be insurer’s CEO or equivalent)
Health Insurer Name
Authorising Officer Name
Position Email Telephone Signed Date
Party (1) Authorised to Access Insurer Data
Organisation Name Organisation ABN Website
Authorised Recipient Name
Position Email Telephone
Party (2) Authorised to Access Insurer Data
Organisation Name Organisation ABN Website
Authorised Recipient Name
Position Email Telephone
Please return completed form
