Provider Registration Form


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.

STEP 1 – Print out the Provider Registration Form
(HW029 – Provider Registration Form)

Below are some tips to help you complete the form.

  1. In field 1, enter the first provider number.
  2. In field 3, make sure that you put the address that is registered for the provider number in field 1.
  3. Minor ID/Location ID – Fill in the Minor ID – your Altura Health Sales representative can give you this, starting with “ADV0….”
  4. Practice details section – Enter the address registered for each provider number.
  5. Bank Account Details section – ensure to complete this section at least once. This tells Medicare where to deposit the money for claims for all provider numbers listed in this form. Note that you can only link one software per provider number, and after this form is processed, you will no longer be able to use your old software to send claims for the provider numbers on this form.
  6. Whenever it asks for the claiming method used, note that Altura Health uses Medicare Online.
  7. If you have more than 3 practice locations, attach copies of page 3 of this form, with their details.

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

Or you may send the paperwork directly to Medicare at 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.