Australian Medical Billing Service: PRIVACY POLICY

Australian Medical Billing Service Pty Ltd is committed to the protection of a person’s personal, sensitive and health information as defined in the Privacy Act 1988.

In this Privacy Policy: ‘we’, ‘us’, and ‘our’ refer to Australian Medical Billing Service Pty Ltd. “You” and “your” refers to the doctor, the medical practitioner or the medical specialist who is an applicant and/or a successfully registered user of our services.

Australian Privacy Principles:

Australian Privacy Principle 1-open and transparent management of personal information

We will take reasonable measures to implement practices, procedures and systems to ensure that we comply with the Australian Privacy Principles.

Personal information is collected from you, our clients, during registration. It is used for identification and administrative purposes in the function of the delivery of our services to you. The information is then forwarded on to the Relevant Health Organisation for the purposes of registration, and to facilitate direct provider payments to you.

The kind of personal information that is collected from you includes name, address, contact details, provider number(s) and location address, ABN, medical registration number, AMA number, banking details and letterhead details.

This information is collected via on-line registration using a secure link with SSL Certificate, or by email in pdf format. This information is collected and held securely.

You, our clients, collect personal information from patients, and then email or fax this information to us. This patient personal information includes name, date of birth, address and contact details, Medicare number, Health fund and member number, DVA number, TAC number, WorkCover claim number, as well as Commonwealth Medicare Benefits Scheme Item number(s), comments and fees relating to the medical claim.

It is your responsibility to take such steps as are reasonable to notify the individual to ensure the individual is aware that this information is being forwarded to us for the express purpose of medical billing.

The information collected is used solely for the purposes of processing medical claims and payment. We will then facilitate the electronic submission of patient details and information relating to services rendered by you to the Relevant Health Organisation which results in payment of a claim.

Australian Privacy Principle 2- anonymity and pseudonymity

It is impracticable for us to deal with individuals who have not identified themselves or who have used a pseudonym.

Australian Privacy Principle 3- collection of solicited personal information

When you register to use our services, your personal information will be collected with your consent, and will be held in the strictest confidence at all times in accordance with and subject to the Privacy Act 1988.

Your personal information retrieved at registration will be used for identification, and to assist in our administration and operation.

We will not collect personal information unless the information is reasonably necessary for, or directly related to the function of medical billing.

The patient must consent to the collection of personal information. It is your role to gain this consent.
We will collect personal information only by lawful and fair means.

Australian Privacy Principle 4- dealing with unsolicited personal information

If we receive personal information and we did not solicit this information, we will, within a reasonable period after receiving the information, determine whether or not we could have collected the information under Privacy Principle 3 if we had solicited the information. We may use or disclose the personal information for the purpose of making this determination. If we determine that we could not have collected the personal information and the information is not contained in a Commonwealth record, then we will, as soon as practicable, but only if it is lawful and reasonable to do so, destroy the information or ensure that the information is de-identified.

Australian Privacy Principle 5- notification of the collection of personal information

It is your responsibility to take such steps as are reasonable to notify the individual to ensure the individual is aware that this information is being forwarded to us for the express purpose of medical billing. This personal information is then collected and submitted electronically to the Relevant Health
Organisation(s).

At or before the time, or if that is not practicable, as soon as practicable after, we collect personal information about an individual, we will take reasonable steps (if any) in the circumstances to notify the individual where we collect personal information from someone other than the individual.

Australian Privacy Principle 6- use or disclosure of personal information

Personal information that we collect from you is strictly confidential.

We will not reveal, disclose, sell, distribute, licence, share or pass on this information for a purpose other than the primary purpose of collection unless:

  • you have consented to the use or disclosure of information;
  • you would reasonably expect us to use or disclose the information for the secondary purpose where the secondary purpose is directly related to the primary purpose of collection;
  • your information may be used for the secondary purpose of direct marketing by us. It is impracticable to seek your consent prior. In our direct marketing with you, we will draw your attention to a prominently displayed notice, that you may express a wish to not receive further direct marketing communications from us. Our direct marketing information shall have contact details including a phone number and email address, where we can be directly contacted should you request to not receive direct marketing from us;
  • where we believe that the disclosure is necessary to lessen or prevent a serious and imminent threat to an individual’s life, health or safety, or a serious threat to public health or safety in relation to the use or disclosure of the information;
  • where we reasonably believe that the use or disclosure of the information is reasonably necessary for enforcement related activities conducted by, or on behalf of, an enforcement body. If we have reason to suspect that fraud or unlawful activity has been, or is being engaged in, and disclosure of information or reporting such concerns to relevant persons or authority; or
  • where the use or disclosure of information is required or authorised by or under an Australian law, or a court/tribunal order.

Australian Privacy Principle 7- direct marketing

Where we collect or hold your information, then we will not use or disclose this information to any third party for the purpose of direct marketing.

We may use personal information for the purpose of our direct marketing relating to loyalty programs, and benefits of referrals. However, you may request not to receive direct marketing communications from us at any time.

We may use or disclose your personal information (other than sensitive information) for the purpose of our direct marketing:

  • where we have collected the information directly from you;
  • where you would reasonably expect the use or disclosure of information for that purpose; or
  • where you have not made a request to not receive such marketing.
  • We shall provide a simple means where you can request not to receive direct marketing communications from us.

Australian Privacy Principle 8- cross border disclosure of personal information

Before we disclose personal information about you to any overseas recipient, we will take reasonable steps to ensure that the overseas recipient does not breach the Australian Privacy Principles. It will only occur:

  • where the disclosure of information is required or authorised by, or under, an Australian law, or a court/tribunal order;
  • where the overseas recipient is an agency and the disclosure of information is required or authorised by, or under, an international agreement relating to information sharing to which Australia is a party; or
  • where the disclosure of information is reasonably necessary for one or more enforcement related activities conducted by, or on behalf of, an enforcement body.

Australian Privacy Principle 9- adoption, use or disclosure of government related identifiers

We will not use or disclose a government related identifier of an individual unless:

  • the use or disclosure of the identifier is reasonably necessary for us to verify the identity of the individual for the purposes or our activities or functions;
  • the use or disclosure of the identifier is reasonably necessary for us to fulfil our obligations to an agency or a State, or Territory authority;
  • the use or disclosure of the identifier is required or authorised by or under an Australian law or a court/tribunal order; or
  • we reasonably believe that the use or disclosure of the identifier is reasonably necessary for one or more enforcement related activities, conducted by, or on behalf of, an enforcement body.

Australian Privacy Principle 10- integrity of personal information

We will take such steps (if any) as are reasonable in the circumstances to ensure that the personal information we collect is accurate, up to date, and complete.

We will take such steps (if any) as are reasonable in the circumstances to ensure that the personal information used or disclosed is, having regard to the purpose of the use or disclosure, accurate, up to date, complete and relevant.

Australian Privacy Principle 11- security of personal information

Where we hold personal information, we will take such steps as are reasonable in the circumstances to protect this information from misuse, interference, and loss, and from unauthorised access, modification or disclosure.

When we hold personal information about an individual, and we no longer need the information collected for the purpose of medical billing, where this information is not contained in a Commonwealth record, and where we are not required by, or under an Australian law, or a court/tribunal order to retain the information, then we will take such steps as are reasonable in the circumstances to destroy the information, or to ensure that the information is de-identified.

Australian Privacy Principle 12- access to personal information

Where we hold personal information about an individual, we will, on request by the individual, give the individual access to the information if it is reasonable and practicable to do so.

We are not required to give the individual access to the personal information to the extent that:

  • we reasonably believe that giving access would pose a serious threat to the life, health or safety of any individual, or to public health or public safety;
  • giving access would have an unreasonable impact on the privacy of other individuals;
  • the request for access is frivolous or vexatious;
  • the information relates to existing or anticipated legal proceedings between us and the individual, and would not be accessible by the process of discovery in those proceedings;
  • giving access would reveal our intentions in relation to negotiations with the individual in such a way as to prejudice those negotiations;
  • giving access would be unlawful;
  • denying access is required or authorised by or under an Australian law or a court/tribunal order;
  • where we have reason to suspect that unlawful activity, or misconduct of a serious nature, that relates to our functions or activities has been, is being or may be engaged in and giving access would be likely to prejudice the taking of appropriate action in relation to the matter;
  • where giving access would be likely to prejudice one or more enforcement related activities conducted by, or on behalf of, an enforcement body; or
  • where giving access would reveal the evaluative information generated by and for us in connection with a commercially sensitive decision making process.

We will respond to the request for access to the personal information within a reasonable period after the request is made.

We will give access to the information in the manner requested by the individual, if it is reasonable and practicable to do so.

If we refuse to give access to the personal information, or refuse to give access in the manner requested by the individual, we will take such steps (if any) as are reasonable in the circumstances to give access in a way that meets our needs and the individual’s needs.

Access may be given through the use of a mutually agreed intermediary.

Where we deem it appropriate to charge for access to the personal information, the charge will not be excessive.

Where we refuse to give access to the personal information, or refuse to give access in the manner requested by the individual, we will give the individual a written notice that sets out:

  • the reasons for the refusal, except to the extent that, having regard to the grounds for the refusal, it would be unreasonable to do so;
  • the mechanisms available to complain about the refusal; and
  • any other matter prescribed by the regulations.

Australian Privacy Principle 13- correction of personal information

Where we hold personal information about an individual, and we are satisfied that, having regard for a purpose for which the information is held, the information is inaccurate, out of date, incomplete, irrelevant, or misleading, or where the individual requests us to correct the information, then we will take such steps as are reasonable, in the circumstances, to correct that information, to ensure that having regard to the purpose for which it is held, the information is accurate, up to date, complete, relevant and not misleading.

If we correct personal information about an individual, that we had previously disclosed to another third party entity, and the individual requests us to notify the other entity of the correction, then we shall take such steps (if any) as are reasonable in the circumstances to give that notification unless it is impracticable or unlawful to do so.

Where we refuse to correct the personal information as requested by the individual, we will give the individual a written notice that sets out:

  • the reasons for the refusal except to the extent that it would be unreasonable to do so;
  • the mechanisms available to complain about the refusal; and
  • any other matter prescribed by the regulations.

If we refuse to correct the personal information as requested by the individual, and the individual requests us to associate with the information a statement that the information is inaccurate, out of date, incomplete, irrelevant or misleading then we shall take such steps as are reasonable in the circumstances to associate the statement in such a way that will make the statement apparent to users of the information.

If a request is made to correct personal information, we shall respond to the request within a reasonable period after the request is made, and we shall not charge the individual for making the request, for correcting the personal information, or for associating the statement with the personal information (as the case may be).

For more information on Australian Medical Billing Service and how we can help you, please contact us.

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Fees

We have a volume based schedule of fees:

5% + GST for billing processed 0-$100,000
4% + GST for billing processed $100-500,000
3% + GST for billing processed over $500,000

This includes health fund registration, obtaining IFC, arranging Pre-Payment of Known Gap or full amount, data entry, following up any rejected claims and resubmitting, following up any outstanding payments and monthly reporting.

There is a minimum fee of $15.00 per invoice.

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