Member health programs & services
Benefits are available for certain treatments in the following extras service categories
(Temporary telehealth benefits for Podiatry introduced on 1 April 2020 ended as of 31 December 2021.)
Physiotherapy
Mental health
Dietetics & Nutrition
Exercise Physiology
Occupational Therapy
Speech Therapy
So how do you get telehealth cover?
Many HBF extras policies include benefits for telehealth.
If you’re an HBF member, just keep reading. We’ve got frequently asked questions and coverage details for you below.
If you’re thinking of taking out new cover, select an extras policy that includes any of the above services you need. Note: New members must serve usual waiting periods before claiming for telehealth services.
What is telehealth?
Telehealth is the method of delivering health care or health education through a phone call or videoconference.
Do all health providers offer telehealth services?
No. The choice to deliver services via telehealth or face-to-face remains with your health provider. We recommend you speak to your provider to find out the best service method for your individual circumstances.
How much can I get back on telehealth services?
Benefits for telehealth services are the same as the benefits you would ordinarily be entitled to for face-to-face services and are subject to waiting periods and limits. Out-of-pocket costs may apply.
Please be aware that benefits are not payable by HBF if:
- Medicare benefits are payable for the treatment; or
- The requirements for telehealth benefits to be paid are not satisfied. To see these requirements the following article on Telehealth treatments.
What is the member eligbility criteria for telehealth services?
You need to check if your extras health cover includes the relevant treatment type. For example, you must have cover for Physiotherapy if you wish to claim for Physiotherapy telehealth treatment.
You also need to have satisfied any relevant waiting periods and not reached your annual limit for the relevant treatment type for HBF benefits to be payable. In addition, please ensure your invoice meets the Telehealth Account Requirement including duration of sessions.
To find out if you're eligible to receive benefits for certain telehealth treatments or to check what your limits are, you can go to myHBF or call us on 133 423. Out-of-pocket costs are likely to apply.
How do I submit a claim for a telehealth treatment?
You can submit your claims to HBF by:
- Opening the HBF App
- Logging in to myHBF
- Visiting your nearest branch
- Returning a claim form by mail to HBF, GPO Box 1440, Perth WA 6845
How do I know if I can claim on a particular telehealth treatment?
To be able to claim on telehealth treatment, your extras health cover must cover you for the relevant treatment type. For example, you must have cover for Physiotherapy if you wish to claim for physiotherapy telehealth services. You also need to have satisfied any relevant waiting periods and not have reached your annual limit for the relevant treatment type for HBF benefits to be payable.
To find out if you can receive benefits for certain telehealth treatments or to check what your limits are, simply login to the HBF App, visit myHBF or call us on 133 423.
Coverage details
Eligible members may receive HBF benefits for the treatments specified, and in the circumstances described, in the table below. Please see Frequently Asked Questions for member eligibility criteria.
For HBF benefits to be payable, the treatment must be delivered by an HBF Approved Provider and Medicare benefits must not be payable for the treatment. The telehealth treatment must also be delivered via synchronous communication (i.e. in real time).
Normal waiting periods, benefits, limits and exclusions apply. Some additional exclusions (including group consults and classes) also apply. Out of pocket costs are likely to apply.
The telehealth provider has to render/provide the service from Australia and cannot be rendered from a different location/overseas.
| Service Category | Required Delivery Method | Treatments for which HBF benefits are payable | Session Duration |
|---|---|---|---|
|
Phone or Video conference |
|
At least 30 minutes |
|
Video conference |
|
|
|
Phone or video conference |
|
|
Information for Providers
Account requirements
In addition to account requirements outlined in the HBF Approved Provider Terms & Conditions, the account must clearly indicate:
- Required Delivery Method – i.e. phone call or video conference
- Treatment start and end times (e.g. 1pm to 1.30pm)
- Duration (e.g. 30 minutes)
HBF staff and systems will be utilising the following item numbers and descriptions.
Service delivery requirements
The choice to use particular telehealth technologies rests with individual providers and is dependent on suitability for individual patients. Telehealth treatment must only be provided where clinically necessary to do so in order for HBF benefits to be payable. Providers should be mindful of the likelihood of foreseeable limitations when using technology and have procedures in place for detecting, diagnosing and fixing equipment problems.
Providers should also ensure that there are additional procedures in place for conducting the consultation ensuring that the basic requirements of telehealth are met. This also should include the clinical aspects of privacy, confidentiality, patient consent and risk management.
Telehealth treatment must be delivered in accordance with the relevant association and/or industry guidelines.
HBF does not require the member to be undergoing an existing course of treatment or to have an existing relationship with the provider to be eligible for telehealth benefits. HBF does not require telehealth treatment to be recommended by the member’s GP.
HBF benefits for telehealth treatment are only payable where the treatment is delivered via synchronous communication (i.e. in real time). Questions?
Contact the HBF Ancillary Provider Relations team via ancillaryproviders@hbf.com.au.
Clinical Psychology
| Code | Description | Session duration |
|---|---|---|
|
Y701 |
Individual initial assessment telehealth |
At least 30 minutes via phone or video |
Y801 |
Individual treatment and management telehealth |
At least 30 minutes via phone or video |
|
Y301 |
Couple or family treatment telehealth | At least 30 minutes via phone or video |
Psychology
| Code | Description | Session duration |
|---|---|---|
|
SPSTE |
Individual initial assessment telehealth |
At least 30 minutes via phone or video |
|
SPSFM |
Couple or family treatment telehealth | At least 30 minutes via phone or video |
Physiotherapy
| Code | Description | Session duration |
|---|---|---|
|
T811 |
Individual initial assessment telehealth |
At least 45 minutes via video |
|
T812 |
Individual subsequent treatment telehealth | At least 30 minutes via video |
Exercise Physiology
| Code | Description | Session duration |
|---|---|---|
|
U710 |
Individual initial assessment telehealth |
At least 45 minutes via video |
|
U712 |
Individual subsequent treatment telehealth | At least 30 minutes via video |
Occupational Therapy
| Code | Description | Session duration |
|---|---|---|
|
H601 |
Individual initial assessment telehealth |
At least 45 minutes via video |
|
H602 |
Individual subsequent treatment telehealth | At least 30 minutes via video |
Speech Therapy/Pathology
| Code | Description | Session duration |
|---|---|---|
|
S501 |
Individual initial assessment telehealth |
At least 45 minutes via video |
|
S502 |
Individual subsequent treatment telehealth | 30-45 minutes via video |
|
S503 |
Individual subsequent treatment telehealth | Over 45 minutes via video |
Dietetics
| Code | Description | Session duration |
|---|---|---|
|
E301 |
Individual initial assessment telehealth |
At least 45 minutes via phone or video |
|
E302 |
Individual subsequent treatment telehealth | At least 30 minutes via phone or video |
Nutrition
| Code | Description | Session duration |
|---|---|---|
|
NUTR4 |
Initial consult telehealth |
At least 45 minutes via phone or video |
|
NUTR5 |
Subsequent consult telehealth | At least 30 minutes via phone or video |
