HBF Member Plus Dental FAQs

This page provides general information for providers about HBF’s WA Member Plus Dental Agreement. If you have any further questions, don’t hesitate to contact us!

Reasons why members choose a Member Plus Dental Provider

Members highly value visiting a Member Plus Dental Practice so they can take advantage of:

  • A known gap, or even better, no gap on Preventative Dental services
  • One fully covered scale and clean per Eligible Member per calendar year
  • Instant, electronic claiming

Why join Member Plus?

There are a number of advantages to joining the HBF Member Plus Dental Network:

  • Ability to promote percentage benefits to Eligible Members for Preventative Services and a no gap experience on Preventative Services to Eligible Members on the highest level of extras cover. These percentages are 75%, 85% or 100% back depending on the member’s level of cover and up to their annual limit
  • Ability to promote and provide one fully covered scale and clean to Eligible Members per calendar year
  • Ability to promote the practice as an HBF Member Plus Dental Practice and ability to promote Practitioners at the practice as HBF Member Plus Dental Providers
  • Inclusion in HBF’s Member Plus provider online directory
  • Promotion via HBF marketing campaigns
  • Exposure to HBF’s more than 800,000 members across WA (According to APRA data at 30 June 2020)

Who can apply to become an HBF Member Plus Dental Practice?

HBF invites applications from interested dental practices located in Western Australia that wish to join our Member Plus network. There is no restriction on the number of practices accepted to join the Member Plus Dental Network.  

The Agreement will be held between HBF and a Practice Representative, with the Agreement covering all practitioners at the location. The Practice Representative is generally the business owner, business partner, or the principal dentist. HBF does not accept practice managers as the Practice Representative.

A Practice Representative must be authorised by all Practitioners at the practice to enter into the Agreement on their behalf. It will be the responsibility of the Practice Representative to uphold the Terms of the Agreement with all Practitioners. If any Practitioners at the dental practice do not wish to comply with the Terms of the Agreement, then you should not apply to become an HBF Member Plus Dental Practice.

What is the Application Eligibility Criteria?

The dental practice must comply with the following criteria to be considered for an HBF Member Plus Dental Agreement:

  • All dentists and dental prosthetists at the practice must be registered with AHPRA and HBF
  • The dental practice must provide and intend to continue to provide preventative services at a minimum of scale and clean and/or provision of mouthguards (Minimal Services)
  • The dental practice must be registered for electronic claiming
  • The intended Practice Representative who will agree to the Terms of the Dental Agreement must be authorised to act for and sign on behalf of all Practitioners at the practice

Specialists (such as Periodontists and Oral Surgeons) and those who do not provide the Minimum Services are not eligible to join as Member Plus providers. However, having specialists at the practice will not prevent that practice from being eligible for Member Plus, assuming all Practitioners who are eligible provide the Minimum Services and the practice meets all other criteria required by HBF.

How do I apply?

Applications must be made via the Medipass Provider Portal, provided by Medipass Solutions Pty Ltd. You will need to register for the Medipass App. Please ensure that you read and understand the terms and conditions and the privacy statement that apply to use of Medipass, then follow the steps below:

  1. Register for the Medipass Provider Portal
  2. Once signed into Medipass, select ‘Documents’ on the left-hand side of the home page and follow the instructions provided
  3. Review the application criteria to ensure your practice meets the criteria
  4. Review and ensure you are comfortable with the terms and schedule
  5. Complete the application and submit for review by HBF (HBF will respond to applications within 5 business days)

If you do not already have a Medipass account, register here. If you already have a Medipass account, sign in here.

When will I know if my application is accepted?

HBF will email the Practice Representative within 5 business days of receiving the application to advise whether the application is accepted or declined.

What if some practitioners at a practice want to be Member Plus and some don’t?

All Practitioners at the practice who provide the Minimum Services must agree to be on the Agreement for the practice to be eligible to apply for a Member Plus Agreement. If there are Practitioners at a practice who do not wish to join Member Plus, then that dental practice is not eligible to apply to become a Member Plus Dental Practice.

What if I own multiple practices, can they all become Member Plus?

HBF invites all interested practices to apply for a Member Plus Dental Agreement. If you own multiple practices, please submit an application for each practice. HBF will review and consider each practice individually.

What if I plan to sell or purchase a Member Plus dental practice, does the Agreement continue?

The Practice Representative must inform HBF of any change in control of the practice prior to such change occurring. Any change to the control of the practice or Practice Representative will require a new application for a Member Plus Agreement to be submitted. Re-acceptance onto the Member Plus Agreement for the new owners/Practice Representative is not guaranteed.

Can I add or remove practitioners from the agreement?

The Practice Representative can request to add new and remove departing Practitioners from an Agreement. The Practice Representative is required to give HBF at least 7 days’ notice of any Practitioner who is proposed to commence or cease to provide Eligible Services at the Practice. All new Practitioners are subject to review and approval.

You cannot change the Practice Representative without triggering a termination of the Agreement. In all instances where the Practice Representative changes, the Agreement will be terminated and a new Member Plus application must be submitted.

What do I need to know about the HBF Dental Schedule and Maximum Fees?

Member Plus Practices cannot charge more than the set fees in the HBF Dental Schedule. The HBF Dental Schedule focuses on Preventative Services. It is closely aligned with the Diagnostic and Preventative categories in The Australian Schedule of Dental Services and Glossary (i.e. item numbers D011 to D171). The only exception is item number D118 which falls into HBF’s General Restorative category.

The maximum fees have been determined following a detailed review of the ADA average fees and fees identified from HBF’s claims history. A copy of the HBF Dental Schedule is available via the Medipass Provider Portal.

HBF will review the HBF Dental Schedule at its discretion, and when doing so will keep in mind the cost effect of fee changes on member’s premiums. At a minimum, HBF will review the item numbers and maximum fees on the HBF Dental Schedule when there is a change to those item numbers in The Australian Schedule of Dental Services and Glossary.

The practice is not required to offer all services on the HBF Dental Schedule. However, all Practitioners at the practice must offer the Minimum Services.

What are the Minimum Services?

The Minimum Services are a scale and clean and/or the provision of mouthguards. All Practitioners (excluding specialists) at the practice must provide the Minimum Services for the practice to be eligible to apply for Member Plus.

Can practices offer discounts/charge less than the dental schedule fees?

Yes. Member Plus Practices may offer discounts on services if they wish, including discounts on Preventative Services on the HBF Dental Schedule. However, any discounts must be subtracted from the fee prior to submitting a claim to HBF.

I will be the Practice Representative for the purposes of the Agreement. What do I need to know?

As Practice Representative, you must ensure that all Practitioners will charge Eligible Members no more than the maximum fee for all services on the HBF Dental Schedule.

Where overcharges occur, you accept all responsibility and liability for ensuring the appropriate remediation actions are taken and repayments occur as directed by HBF. 

You should read the Terms and Conditions of the Agreement to fully understand your obligations and rights, including your rights to terminate. The Terms and Conditions can be found in the Medipass Provider Portal.

Glossary

Agreement means all current HBF Member Plus Dental Agreements.
Eligible Member means a person who:

  1. Holds or is covered by an ancillary private health insurance policy issued by HBF that is financial at the time a Service is provided and that provides benefits;
  2. Receives a Service that is covered under their ancillary private health insurance policy issued by HBF; and
  3. Has served all waiting periods applicable to the Service.

HBF Dental Schedule means the schedule of maximum prices for dental services which is located in the Medipass Provider Portal app.
Medipass Provider Portal means the Medipass Provider Portal app available via www.medipass.com.au
If you do not already have a Medipass account, register here.
If you already have a Medipass account, sign in here.
Minimum Services means Preventative Services, which must include a scale and clean and/or the provision of mouthguards.
Practitioner means a qualified dentist or prosthetist who:

  1. Is registered with AHPRA; and
  2. Has been issued with a provider number by Medicare Australia; and
  3. Recognised as a provider with HBF; and
  4. Provides Minimum Services from the Practice.

Preventative Services is closely aligned with the Diagnostic and Preventative categories in The Australian Schedule of Dental Services and Glossary. Specifically, item numbers D011 to D171 with the exception of item number D118 which falls into HBF’s General Restorative category.
Service means any dental service including an Eligible Service.
Eligible Service means an item set out in the HBF Dental Schedule.
Specialist means a specialist Practitioner such as an oral surgeon or periodontist.

Contact details

For all ancillary registration queries please feel free to contact our provider registration team. For any Member Plus specific queries, please contact our ancillary provider relations team.

HBF provider registration

1300 810 475 8am-4pm AWST*
provreg@hbf.com.au

*Monday – Friday – Closed public holidays

HBF ancillary relations

1300 810 475 8am-4pm AWST*
ancillaryproviders@hbf.com.au

*Monday – Friday – Closed public holidays

General Support

1300 810 475
8am-4pm AWST*

*Monday – Friday – Closed public holidays