Provider Factsheet - Claiming information when selling or buying a hearing service business
This factsheet provides information for contracted service providers (providers) about claiming when a provider sells their business to another provider.
This page should be read in conjunction with the Claiming page.
There are often claims that need to be submitted outside of the normal methods and systems when a provider sells their business to another provider. The information below can assist providers to navigate the correct systems of submission to ensure claims for services provided through the Hearing Services Program (the program) are valid, approved and paid.
Selling Provider
The selling provider must ensure their claiming system remains open until all claimable items are submitted successfully. Additionally, the selling provider must ensure all claims have been submitted no later than 20 business days after the date of closure. All assessment claims should be submitted as soon as possible, through the selling providers practice management software.
The selling provider should review client files and if you identify any invalid claims they must be processed as a recovery. Wherever possible, any valid claims to replace a recovered claim should be submitted immediately through the Hearing Services Online Portal (HSO portal) before your business closure date and transfer of clients. The selling provider will not be able to access client information on the HSO portal from the date of closure.
The selling provider must ensure the following.
Assessments
Selling providers must submit claims for any assessments performed prior to the transfer of their business promptly to ensure claiming by the new service provider is not affected.
Fittings, unless a follow-up can be completed prior to closing
Selling providers must only commence a fitting service if they are able to complete the follow-up service prior to closure.
In the rare case that a selling provider is unexpectedly unable to complete the follow-up service and it is instead completed by the buying provider, the selling and buying provider will need to submit split payment claims.
There are two parts to a split payment:
- Part 1 is submitted by the selling provider where the fitting date is prior to the Date of Transfer and no follow-up has occurred (see table 1), and
- Part 2 is submitted by the buying provider where a follow-up has been completed on the devices fitted by the selling provider (see table 2).
The selling provider should contact the program as soon as possible if they require assistance understanding the process. The Claim for Payment form for the non-follow-up appointment must be emailed to hearing@health.gov.au within the 20 business days of the closure date. Please refer to Claiming through the portal for information on submitting claims correctly.
Maintenance and Batteries
The selling provider must not accept battery and maintenance payments or ask clients to sign maintenance agreements if the start date of the agreement is after the sale of the business.
Information on the actions for managing claiming for a selling business are outlined in Table 1.
Table 1 - Claiming when a service provider transfers their contract or sells their business
Submitting Claims |
Sellers action |
Item Number |
|
The assessment date is prior to the Date of Transfer |
Submit claim |
600 or 800 |
|
The fitting and follow-up dates are prior to the Date of Transfer
|
Submit claim |
Monaural Item: 650, 630 or 820 Binaural: 660, 640 or 830
|
|
The fitting date is prior to the Date of Transfer where the client has not attended a follow-up appointment and a follow-up service has not been provided. Note: the date of service must match the fitting date. |
Attach the claim form and email it to hearing@health.gov.au
The subject line should be displayed as: voucher # – client name – item # – SP business transfer Pt1 - closure date DD/MM/YYYY |
Monaural Item: 651, 771 or 821 Binaural Item: 661 or 831
|
|
The assessment date is after the Date of Transfer |
No action |
N/A |
|
The fitting and follow-up date are after the Date of Transfer
|
No action |
N/A |
|
The follow-up date of service is after the Date of Transfer |
No action |
N/A |
Buying Provider
Buying providers must be familiar with the requirements related to a transferred business.
Fitting Services
Once the selling provider has submitted the non-follow-up fitting claim successfully and the buying provider has completed the follow-up/rehabilitation service, the buying provider can submit an Item 6 claim. The follow-up date of service must be after the Date of Transfer. To cover the costs of the follow-up/rehabilitation component of the fitting, send the Item 6 claim form by email to hearing@health.gov.au. Once reviewed and approved, the buying provider will receive a confirmation email.
Email the program to find out the split payment amounts for fitting services submitted as item 6 claims.
Novated Maintenance Arrangements
As part of the termination agreement, the buying provider must not claim for relocated maintenance (item 711 or 722) or when a follow-up is completed and item 6 is claimed by the buying provider. It is a condition of approval of transfer of contractual rights through the program that the buying entity agree to novate any existing batteries and maintenance agreements.
Please refer to the Table 2 to assist you with submitting your claims correctly.
Table 2 - Claiming when buying an existing hearing service business
Submitting Claims |
Buyer’s action |
Item Number |
|
The assessment date is prior to the Date of Transfer |
No action |
N/A |
|
The fitting and follow-up dates are prior to the Date of Transfer
|
No action |
N/A |
|
The fitting date is prior to the Date of Transfer where the client has not attended a follow-up appointment and follow-up service has not been provided. |
No action |
N/A |
|
The assessment date is after the Date of Transfer |
Submit claim |
600 or 800 |
|
The fitting and follow-up dates are after the Date of Transfer |
Submit claim |
Monaural Item: 650, 630 or 820 Binaural Item: 660, 640 or 830 |
|
The follow-up date of service is after the Date of Transfer |
Attach the claim form and email it to hearing@health.gov.au The subject line should be displayed as: voucher # – client name – item 6 – SP business transfer Pt2
|
Exception Item 6: (follow-up completion)
|
Note: Item 6 claims should
be submitted by attaching and emailing the completed claim form to hearing@health.gov.au
. The subject line should
be displayed as: voucher # – client name – ite
Claiming information when selling or buying a hearing service business