Private Health Fund – Preferred Provider Status

Some private health funds have their own network of "Preferred Providers" or "Members Providers" or "Members Choice Providers", eg. BUPA (MBF & HBA are now part of this group) and Medibank Private, while others run their own dental clinics, eg. HCF, NIB and AHM.

For many people, the biggest confusion often comes with the "Preferred Providers" or "Members Providers" system.

Please note that these schemes are purely commercial agreements between the Private Health Funds and the dentists involved, particularly with respect to marketing and fee setting (where our past experience showed that the power of negotiation was often rather one-sided). There are no specific indications of the clinical standards or capabilities of the clinicians.

We are part of the CBHS Choice Network providers, and none else.

It is a conscious decision that we made because of the strong preventive-focused approach that CBHS takes in formulating the agreement.

We believe very strongly that the best care you can receive, should be one that is free from any indirect influences from a third party, and based solely on what you truly need. That is how it should be, shouldn't it?

You may ask, "If you're not a Members Provider, will my health fund still pay a benefit if I see you for treatment?"

The answer is "Yes, it will still pay a benefit."

Despite the fact that some Private Health Funds may pay an amount different from what they would have paid their Members Providers dentists, they will all pay a benefit/rebate for recognised dental treatment done by any qualified dentist.

"So does that mean there will be a gap payment?"

Yes. However, we do have certain special packages in place to encourage and help patients look after themselves. Please see Fees for more details.

Should you require more information on private health insurance, or wish to compare health insurance policies, please visit the Australian Government website www.privatehealth.gov.au or call 1300 737 299

There is also a Private Health Insurance Ombudsman. Please see www.phio.org.au or call 1800 640 695