Health Insurance Compliance and Regulatory Requirements
The health insurance industry in Australia is subject to comprehensive compliance and regulatory requirements. These requirements, encompassing legislation, data collection, and rules and guidance, ensure the proper supervision and operation of private health insurance in the country. The legislation governing the industry includes acts such as the Private Health Insurance (Prudential Supervision) Act 2015 and […]
Health Fund Contracting and Negotiation
Health fund contracting and negotiation are fundamental processes in the healthcare industry that impact the operations of healthcare organizations and the delivery of patient care. These processes involve the agreements made between private hospitals and health insurers to determine the prices charged for services and the amount the insurer is willing to pay. By engaging […]
Health Fund Membership Types and Categories
Shopping for health insurance in Australia has become easier since the introduction of the four hospital insurance tiers in 2019. These tiers classify hospital treatments into clinical categories, and policies are sorted based on these categories. The four tiers are Basic, Bronze, Silver, and Gold health insurance. Each tier has a different number of compulsory […]