Fees & rebates

Health Fund Preferred Providers

We are preferred providers for HBF, Medibank, nib, HCF, Bupa and CBHS, which usually means a higher rebate and a smaller gap.

What preferred provider actually means

Health funds negotiate set fees with clinics they partner with. Because we are a preferred provider, your fund pays a higher proportion of the cost of treatment than it would at a clinic outside its network, so the amount you pay out of pocket is generally lower.

How much comes back depends on your level of extras cover and how much of your annual limit you have already used. Ask us for the item numbers and your fund can confirm the exact rebate before you book.

It is an arrangement about price, and it is worth saying plainly that it is nothing else. It does not change what treatment is recommended, who provides it, or how long you wait for an appointment. Any practice that suggests otherwise is describing something other than a preferred provider agreement.

The six funds, and what to do about the rest

Preferred provider status is an arrangement between the practice and the fund. It can change, so if it matters to your decision, confirm it with your fund as well.
Fund	Status here	Claiming
HBF	Preferred provider	HICAPS at the desk
Medibank	Preferred provider	HICAPS at the desk
nib	Preferred provider	HICAPS at the desk
HCF	Preferred provider	HICAPS at the desk
Bupa	Preferred provider	HICAPS at the desk
CBHS	Preferred provider	HICAPS at the desk
Any other fund	Standard rate	HICAPS where the fund participates, otherwise an itemised receipt you submit

If your fund is not on that list you are still very welcome. You will claim at the standard rate instead of the preferred rate, and we can still process it through HICAPS at reception.

Where the rebate actually comes from

Three separate things decide what you get back, and only one of them has anything to do with this practice.

Your level of cover: Basic extras typically cover examinations, cleans and X-rays. Mid and top tiers add fillings, extractions and, at the higher levels, major dental — crowns, bridges, dentures and implants. This is the single largest variable and it is entirely a matter between you and your fund.
Your annual limit: A ceiling on what the fund will pay in a calendar year, usually with separate sub-limits for general and major dental. Once it is used, the rebate stops regardless of cover.
Waiting periods: New policies and upgrades carry them — commonly two months for general dental and twelve for major. A crown three months into a new policy will generally attract nothing.
Preferred provider status: The part we control. It raises the proportion the fund pays on each item, which is why the gap here is usually smaller than at a clinic outside the network.

Checking your cover before you book

Rebates vary by fund, by policy, and by how much of your annual limit you have already used. Call us on (08) 9306 2755 with the treatment you are considering and we can give you the item numbers to quote to your fund.

That conversation is worth having before major work rather than after it. It also occasionally changes the plan — where treatment is not urgent and your limit is nearly spent, splitting it across two benefit years can be worth several hundred dollars, and it costs nothing to ask.

Common questions