Banking Form

HW052

This form links your provider number to your Altura Health minor ID (also called the location ID). This form also tells Medicare what bank account they should pay into.

Once you have completed all your forms, send them back to Altura Health. We will review them and then submit them to Medicare Australia for you.

Timeframe: Medicare Australia is currently taking anywhere up to 2-3 weeks to process these forms.

Send your completed documents to Altura Health:
Fax: 02 9632 0096
Email: sales@alturahealth.com.au

STEP 1 – Print out the Banking Form
(HW052 – Online Banking Form)

Below are some tips to help you complete the form.

  1. Location ID – Fill in the Minor ID – your Altura Health Sales representative can give you this, starting with “ADV0….”
  2. Practice details section – Complete the Practice Details section. Fill this in with the address registered to the provider number of the hospital or with the address of the practice.
  3. Corporate Details section – only complete this section if you belong to a group of hospitals.
  4. Effective from date – Make sure to indicate the oldest date of service you will be claiming for using FYDO.

    FOR COMMUNITY NURSING: Make sure to indicate the oldest Cycle Date you will be billing for once you come onboard.
  5. Bank Account Details section – Fill this section in. This tells Medicare where to deposit your payments and tick both ‘Medicare Bulk Bill’ and ‘Australian Childhood Immunisation register’ tickboxes. Take note of the effective date in field 11. Remember that you can only link one software per provider number, and after that date, you will no longer be able to use your old software to send claims for the provider numbers on this form. You may, however, use one software for IHC and another software for IMC.
  6. Payee Providers section – List all provider numbers you would like to claim for. Note that they should all have been registered to the address in the Practice Details section in number 2 above.

    For hospitals, write the hospital’s provider number in ‘Provider 1′ and in the ‘Provider’s Full Name’ field, write the full name and position of whoever can sign in behalf of the organisation. For hospitals, you do not need to write down each surgeon on this form. The hospital provider is enough.

    For DVA Community Nursing, enter the facility’s provider number, then indicate:
    1. The name of the community nursing facility
    2. The name and position of the person who signed

STEP 2 – Registering for GST
(Recipient Created Tax Invoice [RCTI] Agreement)

This form allows you to claim for GST-applicable items. This is necessary if you will send DVA claims. If you are already claiming for GST-applicable items from DVA, then you do not need to fill this out again.

This is only required for practitioners that claim GST for some item numbers, usually by allied health providers (e.g. DVA Community Nursing, exercise physiologists, optometrists, etc.). If you fall under this category, you will need to complete an RCTI Agreement also. If you have already signed an RCTI Agreement, then you do not need to do this again.

Not required by general practitioners, specialists, radiologists or pathologists.

  1. DVA supplier identification number – Put your provider number here. If doing this for a community nursing facility, put the facility provider number. If you are going to claim for multiple providers, attach a list that shows all provider names, provider numbers, and addresses.
  2. Contact Name – Put the provider’s full name. If doing this for a community nursing facility, then put the contact person’s full name.

STEP 3 – Submit the documents

Send your paperwork back to us using one of the following methods:

Fax: 02 9632 0096
Email: sales@alturahealth.com.au

Or you may send the paperwork directly to Medicare at Provider.forms@servicesaustralia.gov.au . If you want us to follow it up for you however, then you need to send it through us or copy us in when you email Medicare. Note that Medicare takes around 2-3 weeks to process these.