Hospital providers
HBF Member Plus hospitals
HBF offers a large number of Member Plus hospitals across Australia.
By being part of our network of Member Plus hospitals you have access to a wide range of benefits including:
Conduct online eligibility checks
Agreed benefit schedule which minimises out of pocket costs for members
Access to a rapidly growing member base
Dedicated HBF AHSA team to assist with queries
Local team to process claims and address queries
How to submit your invoices
Simply email your account to hospitalinvoices@hbf.com.au in one of the following formats: PDF, JPG, TIF, PNG, DOC, XLS, or CSV. Make sure the account is not password or print-protected.
Hospital query forms
Pre-existing query form
A pre-existing condition is where signs or symptoms of the ailment, illness, or condition, in the opinion of a third-party party medical practitioner, existed at any time during the six months leading up to, and including the day the member purchased their hospital insurance or upgraded to a higher level of hospital cover.
It's standard practice in the private health insurance industry to apply a waiting period of 12 months for pre-existing conditions and therefore if the member needs to be admitted within those 12 months the member will need to be assessed for coverage prior to their admission.
View our pre-existing query form
Submission process
Pre-booked admissions:
Members that have pre-booked for admission and are still within the 12-month waiting period will need to have their GP and specialist complete a pre-existing query form.
Emergency department admissions:
Where the member is first seen in an emergency department, the emergency department doctor will need to complete the pre-existing form.
If the pre-existing form is unable to be completed by the doctor in the emergency department, the medical referee will accept a discharge summary.
Accident injury report form
HBF Basic Hospital Plus and Basic Hospital Plus Elevate policies both include accident cover.
An accident means an unforeseen event, occurring by chance and caused by an external force or object which results in an injury to the body requiring admission to hospital for medical treatment.
Where a member has served their 12-month pre-existing wait period on Basic Hospital Plus and requires a hospital admission as the result of an accident, HBF requires an accident injury report form to confirm they are eligible for benefits.
View our accident injury report form
Submission process
To assess coverage for an accident we require the member to complete a pre-existing Accident form.
Submitting forms
Once the form(s) has been completed, it can be returned to HBF via one of the following options:
- Mail: Attention Pre-Existing Officer, Support Services, HBF, PO Box C101, Perth WA 6809
- Email: pre-existing@hbf.com.au
Pre-existing and accident queries are assessed by our Pre-Existing Officer and a third-party medical referee. General processing time is five business days from when the form(s) and/or all information has been received. In emergency situations, HBF and the medical referee will endeavour to respond within two business days. Once a decision has been made the member will be notified directly.
Eligibility queries
Hospitals can check a member’s level of cover to determine if they are eligible to claim for an upcoming procedure.
The type of provider relationship you have with HBF will determine the process you need to follow to check member eligibility.
Frequently asked questions
Which Member Plus hospital providers can access online member eligibility checks?
HBF Member Plus hospital providers with a valid Medicare provider number will have access to online eligibility checks for HBF members.
I received a member eligibility check back from HBF but I don’t understand the information provided. Who can I contact for assistance?
You can contact the eligibility team for assistance. Call 1300 810 475 from 8am-4pm WST Monday to Friday, excluding public holidays, or email eligibility@hbf.com.au.
I don’t have access to online eligibility checks. How can I request a member eligibility check?
Providers, including public hospitals, non-Member Plus hospitals and all medical providers, can submit a member eligibility check via email by completing and returning the relevant forms as listed here under ‘Eligibility queries'.
Who can I contact if HBF’s online eligibility check system is unavailable?
Please contact your organisation’s IT department as a first point of call.
If your IT department have confirmed that the problem appears to be on HBF’s end, please contact your organisation’s contracts manager to report the issue. Your contracts manager will be able to get in touch with the HBF contract manager to resolve the problem or organise an alternative method to conduct eligibility checks.
If you do not understand the information provided by the online eligibility check, please contact our eligibility team on 1300 810 475 or email eligibility@hbf.com.au. We are available 8am-4pm WST Monday to Friday, excluding public holidays.
Please note: The eligibility team is not able to provide you with a verbal confirmation until a known error has been reported by your contract manager to our contract manager.
What do the different rejection codes on the online eligibility check mean?
For a full list of rejection codes and what they mean, please check your online eligibility check manual. This list is also available to view online within the ECLPSE Online Hospital Claiming User Guide (PDF).
What should I do if the online eligibility check lists a member as unfinancial?
Please contact the member directly and advise that they are currently unfinancial at the expected treatment date.
You can direct the member to contact HBF on 133 423 and speak with one of our member experience consultants to arrange payment, as payments made online are not applied instantly to the policy.
Once the member has contacted you to confirm payment has been processed, please complete a new online eligibility check.
Will the online eligibility check advise what out-of-pocket costs the member will have?
The online eligibility check will only advise any co-payments or excess that is to be paid. It will not advise any other costs from the hospital or medical providers.
Can I get a verbal eligibility check over the phone?
Our eligibility team is unable to provide verbal eligibility checks over the phone except in the event the HBF contract manager has previously approved an exception.
Can a member check their eligibility for a treatment?
Yes, they can. We encourage members who are having pre-booked treatments to contact our membership team on 133 423 or visit their nearest branch for a quote.
Why do public hospitals have to provide an election form as well as the eligibility form?
We request a signed patient election form completed by the member to confirm they have given their permission to go into a public hospital as a pre-booked private patient. This form needs to be signed and dated within seven days before admission. No eligibility checks will be given without this consent form.
What email address should I send a member eligibility check to, and how long will it take to be processed?
All eligibility checks can be sent to eligibility@hbf.com.au. Provided that all details have been provided correctly, our eligibility team will return your email within two business days.
