Private Health Fund Provider Eligibility
Important prerequisite insight
In order for an association to be able to facilitate private health insurance rebating, it has to maintain contractual agreements with the various Nutrition recognising private health insurance funds. These contractual agreements set out the minimum requirements for a practitioner to be eligible for provider status and can include stipulations around level of and type of qualification, educational delivery method, criminal background checks, professional insurance, first aid and continuing professional development. Different funds have different requirements for eligibility and it is up to the association to be the gate-keeper, and ensure only members who meet the criteria are advanced to a given health fund provider list. It’s important to acknowledge that while no individual fund dictates whether a practitioner is qualified for association membership, they do dictate who is an eligible provider of rebates.
Contractual requirements
The contractural requirements from the most conservative of these funds currently caps online learning (live streaming and pre-recorded lectures / tutorials) at 50% of the degree theory component – and clinical practicum must be face-to-face supervised on campus. In alignment with evolving teaching and learning practices, AARPN’s own eligibility criteria for AARPN association membership permits between 50 to 75% of the theory component of a degree to be completed online. This means that an AARPN member who has completed 50% or less of the theory component of their degree online will have access to all Nutrition recognising funds – and an AARPN member who has completed between 51 -75% of their theory online will have provider access to Nutrition recognising private health insurance funds that do not engage the 50% online theory cap.
Additional stipulations (downstream from our contractual agreements) include: no clinical practicum hours or student clinical training may be outsourced to private clinics and must be conducted at the educational provider’s on-campus clinic facilities.
Why does AARPN gate-keep health fund provider access so rigorously?
First and foremost, AARPN – as a professional body – takes our contactual obligations seriously. Additionally, we gate-keep rigorously to protect our members. While the association curates and advances the list of eligible providers to the fund, it is the practitioner – as the financial beneficiary of rebated claims – who holds the monies a fund may seek to reclaim, where incomplete compliance has been found.
There is no win present for a practitioner who has found themselves advanced by an association to a list they are not eligible to be on. The contractual agreements for the advancing of practitioners to Nutrition rebate provider lists do not vary across associations. If you require further information regarding these matters, please contact AARPN.