For providers not yet enrolled, click on 'Forms & Links' in the horizontal menu at the top of the home page to download the Provider Enrollment … The Commission has capped total commitments for upfront charges and multi-year funding commitments as part of the Healthcare Connect Fund at $150 million annually. 177 for a full list of ineligible expenses. INET Login for Registered Users. Applicants applying as individual HCPs (not as a part of a consortium) can receive funding for end-user equipment only. nib's no-gap MediGap network of registered medical specialists. See 47 USC § 254(h)(7). Pilot projects also may be required to provide additional information. Terms and conditions for HCF recognised providers of general treatment ‘Related Body Corporate’ has the meaning given in section 9 of the Corporations Act 2001. All practitioners submitting claims via Simplified Billing must be registered with Latrobe Health Services. See HCF Order, para. What will happen to the Internet Access Program? Amend Online HICAPS Accounts Online Registration Yes. For example, if the Pilot project adds ten new sites to its network, the majority of those ten new sites must be rural. See HCF Order at paras. For new applicants (either current Telecommunications or Internet Access Program participants or HCPs new to Federal Communications Commission (“Commission”) programs) the competitive bidding process will start in late summer 2013. Form 498 will be revised in accordance with the new requirements of the Healthcare Connect Fund. See HCF Order at paras. As Pilot projects and their member HCPs begin to exhaust Pilot funding, they can apply as consortia for support under the Healthcare Connect Fund. What HCPs are eligible to receive support under the Healthcare Connect Fund? If an applicant would like to set the end date of its service contract to correspond to the end of the funding year, the service contract should end on June 30. Simplified Billing Provider Registration for Latrobe. 285-289 for additional information. See HCF Orderat Sections VI, paras. Yes. nib's no-gap MediGap network of registered medical specialists. Yes. 345-350 for additional details on the SNF Pilot. Medical practitioners must maintain at all times a minimum of $1 million professional indemnity insurance coverage. ... WorkSafe Victoria reserves the right to cease a provider number if the Authority is unable to contact you (either by mail, email or phone). The first LOA is required prior to the submission of the request for services (Form 461), while the second LOA is only required prior to the submission of the request for funding (Form 462). When can Pilot Program participants seek funding from the Healthcare Connect Fund and what forms should they use to submit their funding requests? 213-215 for additional information. Such MSAs must have been negotiated pursuant to competitive bidding. Do ineligible sites on a consortium network count towards the network’s non-rural/rural percentage? Before joining GMHBA Health Insurance we recommend you read through the fund rules and our important information guide. Public and not-for-profit health care providers are eligible to receive support under the Healthcare Connect Fund. USAC will continue to use SharePoint until the existing “My Portal” site is modified for applicants seeking funding from the Healthcare Connect Fund. Provider Registration. Can an applicant receive support for a 36-month contract for eligible services if it covers a time period that spans more than three funding years? Hospital Cover 22. Please email Simplified Billing sbenquiry@lhs.com.au to submit this form, or if you have any questions regarding the Simplified Billing process. Service providers who elect the direct reimbursement option under the revised offset rule may also make the election on Form 498. Only service providers that have not already been assigned a service provider identification number (SPIN) by USAC will need to complete and submit a Form 498. Only the Doctor can sign on the form. 239-242 for additional details. However, because funding is not guaranteed, an applicant may choose to include in any contract it makes with a vendor a provision governing the effectiveness of the agreement if the applicant does not receive a funding commitment from USAC. Pilot projects should update their sustainability plans to reflect a change in membership if it results in a material change in sources of future support or management, a change that would impact projected income or expenses by the greater of 20 percent or $100,000 from the previous submission, or if the applicant submits a funding request based on a new Form 461 (i.e.,a new competitive bidding contract). Pilot projects must submit new LOAs as they transition sites into the Healthcare Connect Fund. What dates should applicants include in their contracts with vendors. Do part-time eligible rural HCPs (HCPs that receive prorated support commensurate with the amount of eligible health care services they provide) count towards a network’s rural percentage? See HCF Order at paras. The FCC Form 460 can be submitted at any time during a funding year. Section 1: Provider Details . See HCF Order at paras. “Health care provider” is defined by statute as hospitals, rural health clinics, local health departments, community health centers or health centers providing health care to migrant workers and post-secondary educational institutions offering heath care instruction, teaching hospitals, and medical schools. See HCF Order at paras. NOTE:  The FCC and USAC does not use the “Am I Rural” website maintained by the State of Missouri to determine rurality, nor does it use definitions of rurality used by other government agencies for other purposes. Yes, the Healthcare Connect Fund permits site and service substitutions in limited circumstances. WorkSafe has adopted the Medicare Australia provider numbers and registration details for medical practitioners. 360-361 for additional details. In addition, if an HCP has a contract that was designated as evergreen under the Telecommunications Program or Internet Access Program prior to January 1, 2014, it may seek support for services provided under such an evergreen contract from the Healthcare Connect Fund without undergoing additional competitive bidding, so long as the services are eligible for support under the Healthcare Connect Fund, and the HCP complies with all other Healthcare Connect Fund rules and procedures. A chart in the HCF Order, at para. See HCF Order at paras. An MSA under the Healthcare Connect Fund also may be a contract that has been negotiated by a federal, state, Tribal, or local government from which HCPs may be entitled to purchase services. When must invoices for multi-year funding commitments be submitted to USAC? Applicants in the Healthcare Connect Fund can only receive a multi-year funding commitment that covers a period of up to three funding years. Step 1: Please check that you can fill in this form digitally. It is essential that you register the associated Provider Number you are using when submitting claims. The Telecommunications Program will continue to operate alongside the new Healthcare Connect Fund. Pilot projects can use SharePoint and existing Pilot Program forms to initiate the competitive bidding process as early as April 1, 2013. at paras. See HCF Order at paras. When must an applicant submit a formal Request for Services (RFP)? Register to participate in the GU Health No Gap and Known Gap network. Any HCPs that are subject to non-recurring installation charges in excess of $5,000 may seek upfront support for eligible services and equipment if those charges independently qualify as eligible expenses (e.g., upfront charges for service provider deployment of facilities, costs for HCP-constructed and owned infrastructure, network equipment, etc.). Site Information Tab Program Type is a required field. For example, if a consortium receives a multi-year funding commitment for services that ends on May 30, 2016, the applicant must submit its invoice to USAC by November 30, 2016 (six months from the end of the funding commitment). HCPs are required to contribute the remaining 35 percent to participate in the program. The RFP also should specify the period during which bids will be accepted, and should include the scoring criteria that will be used to evaluate bids for cost-effectiveness and solicit sufficient information so that the criteria can be applied effectively. Consortia in the Pilot Program also can find out which of their HCPs are rural by accessing their Form 465 Attachment datasheet in SharePoint, exporting to Excel, and reviewing the column titled “Rural.”  Contact USAC at rhc-assist@usac.org for additional information. A site or service substitution may be permitted if: (1) the substitution is provided for in the contract, within the change clause, or constitutes a minor modification; (2) the site is an eligible HCP and the service an eligible service under the Healthcare Connect Fund; (3) the substitution does not violate any contract provision or state or local procurement laws; and (4) the requested change is within the scope of the controlling Form 461, including any applicable Request for Proposal. Contact USAC for additional details at rhc-assist@usac.org. To register, please refer to Useful Links above. For assistance in completing this registration form or to enquire about HCF’s medical arrangements for salaried doctors at public hospitals, radiologists or pathologists please contact 1800 670 302 Send your fully completed form to HCF MAIL TO HCF Medicover Registration EMAIL US GPO BOX 4242 Sydney NSW 2001 medicoverenquiry@hcf.com.au As discussed below in Question 11, non-rural HCPs may participate and receive support as part of consortia that include a majority rural HCP sites. Only the Doctor can sign on the form. See HCF Order at paras. 198-212 for information about requirements and responsibilities of Consortium Leaders. Can Pilot Projects use support from the Healthcare Connect Fund to add new sites to their networks? HCPs can use the Healthcare Connect Fund to purchase services and equipment, as well as construct their own broadband infrastructure where it is shown to be the most cost effective option. Consortium applicants must keep their Form 460s current to reflect their current membership. This form is used by Doctors to register for participation in Access Gap Cover. Access the HCF provider portal for Ancillary, Dental, Hospital or Medical services Enquiries: Phone: Fax: Email: Hospital Claims: 1300 301 437 (03) 5221 4582: service@gmhba.com.au : Medical Claims: 1300 446 422 (03) 5221 4582: service@gmhba.com.au Provider registered for the Scheme including contact details, information about your participation in the Scheme, and the location(s) at which you practice. Applicants using a request for proposal (RFP) to solicit bids must still file a Form 461. What expenses will Healthcare Connect Fund support? No. New user registration instructions for care providers and health professionals. Yes, but only if the applicant is a member of a consortium. * HCF: For Hospital Providers, we will accept for benefit registration purposes only those facilities notified through PHI circulars, as this endorses recognition through Section S121-5 of the Private Health Insurance Act 2007. 303-305 for more information on invoicing. 256-260 for more details regarding the circumstances under which HCPs may rely on MSAs. 31-43 and 318-322 for additional information. Privacy Restrictions: You are only allowed to use this portal to access information related to your job. nib logo. For purposes of the FCC’s rural health care programs, an eligible HCP must be located in an FCC-approved rural location to be considered “rural.”  Individual HCPs can determine whether they are located in a rural area through a look-up tool on USAC’s website http://www.usac.org/rhc/telecommunications/tools/Rural/search/search.asp. No. For providers not yet registered, after clicking the 'Provider' link, click the 'Web Registration' link located in the left menu bar to register for web access. Additionally, if an applicant is interested in extending its “evergreen contract,” it should keep in mind that the rules of the program permit applicants to voluntarily extend the contract for up to five years. In addition, the Form 460 is used to register ineligible HCP sites, off-site data centers, and off-site administrative offices. Healthcare Connect Fund (HCF) Program FCC Form 460 Guide How to file an FCC Form 460 (Eligibility and Registration Form) as an individual health care provider (HCP). This includes eligible sites, ineligible sites, off-site data centers and off-site administrative offices. See HCF Order at para. See HCF Order at para. Consortia in the Pilot Program can find out which of their HCPs are rural by accessing their Form 465 Attachment datasheet in SharePoint, exporting to Excel, and reviewing the column titled “Rural.”  USAC will also provide each Pilot project a complete listing of all HCPs in its consortium that have received a funding commitment and the physical location information and rurality determination for each HCP. Online Member Centre 11. APPLICATION FOR PROVIDER RECOGNITION Complete and fax to 02 8296 4758, alternatively you can email provider_relations@hcf.com.au or mail Provider Relations, GPO Box 4242, Sydney NSW 2001 1 PROVIDER DETAILS (PLEASE USE CAPITAL LETTERS AND A BLACK PEN) Title First name Surname USAC will advise each Pilot project on the composition of its network. 208-212 for additional information on LOAs. 9). See Question 29 above for more details on competitive requirement for applicants seeking funds over $100,000 in a year. … The Commission has stated that it does not anticipate that it will reach the $400 million funding cap for all rural health care programs in the foreseeable future. IX. Register to participate in the GU Health No Gap and Known Gap network. What are eligible sources of funding that an HCP may use for its 35 percent contribution requirement? Yes, as long as adding new HCPs was contemplated in the original request for competitive bids. Information to be completed in the form includes: service application type; applicant details, including practice, business or company details; banking details; provider registration requirements; applicant consent and declaration USAC will start accepting funding requests from existing Pilot projects on April 1, 2013, and support will be available beginning July 1, 2013. 271-271 for more information about requirements for service providers. The conference pass covers: Participation for both conference days Contact USAC at rhc-assist@usac.org for help determining whether HCPs in your network are rural. nib logo. Providers can complete this form to register with WorkSafe to provide services to injured workers. Consortia can provide evidence that they have satisfied their contribution requirement by submitting a letter that is signed by an officer, director, or other authorized employee of the Consortium Leader identifying the source of the funding, the type of eligible source, and if necessary, documentation of the funding. This chart is reproduced immediately below. Provider Registration This form is used by Doctors to register for participation in Access Gap Cover. Use our online portal to register new providers or notify us of a provider that has moved on from your practice. The Healthcare Connect Fund provides support for reasonable and customary installation charges for broadband services up to an undiscounted rate of $5,000 (i.e., up to $3,250 in support). However, if adding new sites was contemplated in the original bid solicitation, applicants do not need to complete the competitive bidding process again to add new HCPs to the network. Do not complete the form before downloading it. Service providers who elect the direct reimbursement option under the revised offset rule may also make the election on Form 498. If participating in a consortium, an HCP may opt to allow the consortium to file a Form 460 on its behalf to determine its eligibility. See HCF Order at paras. HBF policy as the treating provider. 238 for additional details. Can an applicant use one Form 461 to make more than one request for services (e.g., a request for a network operations center (NOC) and a request for circuits)? • Providing false or misleading information on this form will result in immediate revocation of my registration as an HBF Provider and will be subject to disciplinary action I (full name) http://www.usac.org/rhc/telecommunications/tools/Rural/search/search.asp. 279-293 for additional information. Claiming is easy and quick through Eclipse, the in-patient claiming system developed by Medicare Australia that enables providers, health insurers and Medicare to exchange and pay claims electronically. 351-359 for more details. Do non-rural “grandfathered” sites on Pilot project networks count toward their non-rural/rural percentage? 02-60, Report and Order, 27 FCC Rcd. How can a Pilot project determine the non-rural/rural composition of its network? This is a subscription site and requires registration with the Health Safety Net prior to using this site. It is essential that you register the associated Provider Number you are using when submitting claims. Do all applicants have to provide evidence that they have satisfied the 35 percent contribution requirement? Individual providers can submit key information to obtain a Medicaid ID for a new provider and existing providers can enter key information which will allow us to receive updates electronically. USAC expects that the new “My Portal” website will be available for Healthcare Connect Fund applicants by the fall of 2013. Once new forms for the Healthcare Connect Fund are available, Pilot projects will no longer be permitted to use existing Pilot Program forms to add new sites to their network. Provider Last Name* AHPRA Registration Number* Check AHPRA Registration Number . 208-212 for additional information on LOAs. INET Login for Registered Users. See HCF Order at paras. If the data center or administrative office only supports the 400-or-more bed hospital located on the same site, then its expenses will count towards the hospital’s funding caps for recurring and non-recurring services. Are a lead entity’s administrative costs related to managing a consortium eligible for support? Download and complete the Provider registration for Electronic … Funding requests for all applicants are processed on a first-come, first-served basis, unless USAC has established a filing window, in which case all applications received within the window will be deemed to have been filed at the same time. Routine maintenance is scheduled between 5:00AM to 8:00AM daily. No. However, if a data center or administrative office in a network supports only one HCP, expenses associated with that data center or administrative office should be attributed only to the HCP it supports. 99-104 for additional information. However, if an applicant requested a 36-month funding commitment for services that started on January 1, 2014, USAC could issue only a commitment for services for the remaining six months of funding year 2013, and all of funding years 2014 and 2015. How can a consortium change the entity it has designated as its Consortium Leader? The purpose of the Healthcare Connect Fund is to expand HCP access to broadband services, particularly in rural areas, and to encourage the formation of state and regional broadband networks linking health care providers. Are costs related to network design eligible for support? Yes, as long as the existing contract meets the requirements for an evergreen contract. Can non-rural HCPs receive Healthcare Connect Fund support? Should eligible expenses associated with a data center or administrative office that supports multiple HCPs in a network be attributed to the network or to a particular HCP? An individual applicant must file a Form 460 for itself and a separate Form 460 for each associated off-site administrative office or data center. The Healthcare Connect Fund (fund) provides support for high-capacity broadband connectivity to eligible health care providers (HCPs) and encourages the formation of state and regional broadband HCP networks. Can Pilot projects use existing LOAs for HCP sites on their networks to seek funding from the Healthcare Connect Fund? Mental Health Reforms (Staff Only) 19. Joining HIF 11. See HCF Order at paras. 62 for additional details. Although the applicant’s contract would also cover six months of funding year 2016, it would not be covered by the multi-year funding commitment. Eligible sources include the applicant or eligible HCP participants; state grants, funding, or appropriations; federal funding, grants, loans, or appropriations; Tribal government funding; and other grant funding, including private grants. Claims will be held until we receive confirmation of your registration to the Medicover Gap Scheme. The SNF Pilot program is an initial step to test how to support broadband connections for SNFs. See HCF Order at paras. Under the two-step LOA process, a Consortium Leader must first obtain LOAs from members to seek bids for services, and then obtain LOAs to apply for funding in the program. The SNF Pilot will focus on determining how the Commission can best utilize program support to assist SNFs that are using broadband connectivity to work with eligible HCPs to optimize care for patients in SNFs through the use of electronic health records, telemedicine, and other broadband-enabled health care applications. 3 (fn. The Healthcare Connect Fund will replace the Internet Access Program and will provide support for services now eligible for support under the Internet Access Program.
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