137-148 for more information. Will eligible expenses associated with a data center or administrative office located on the site of a non-rural hospital with 400 or more beds count towards that hospital’s funding cap for recurring and non-recurring costs? Only the Doctor can sign on the form. See HCF Order at paras. Expenses related to network design, engineering, operations, installation, and construction of the network are eligible for support under the Healthcare Connect Fund. Are applicants guaranteed a certain amount of funding through the Healthcare Connect Fund? Transitioning from the Pilot Program to Healthcare Connect Fund. Applicants must file an RFP with their Form 461 if they are (1) applicants who are required to issue an RFP under applicable state, Tribal, or local procurement rules or regulations; (2) consortium applicants that seek more than $100,000 in program support in a funding year; or (3) consortium applicants that seek support for infrastructure (i.e., HCP-owned facilities) as well as services. Consortium applicants must keep their Form 460s current to reflect their current membership. See HCF Orderat paragraphs 351-361 for additional details. This is true even if a consortium requests more than $100,000 in funding in a year to add new sites to its network using its original bid solicitation. Provider Recognition, Registration and Operations Email: ProvopsAncillary@bupa.com.au Should you require any further information regarding provider recognition, registration and provider operations, please call the team on 1800 060 239. 31-43 and 318-322 for additional information. 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. Are applicants who submit RFPs with the Form 461 required to provide information on the proposed utilization for each location in the RFP? However, any new sites added to the network must be a majority rural in the aggregate. 351-359 for more details. 178-184 for additional details on cost allocation for ineligible entities. 151-155 for more information on upfront expenses. 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 Accordingly, any months outside of the three funding years would not be covered by the commitment. See HCF Order at paras. Providers can complete this form to register with WorkSafe to provide services to injured workers. It is essential that you register the associated Provider Number you are using when submitting claims. Simplified Billing Provider Registration for Latrobe. Can non-rural HCPs receive Healthcare Connect Fund support? 236. Yes. • 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) Skilled Nursing Facility Pilot Program. See HCF Order at para. 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. Do all applicants have to provide evidence that they have satisfied the 35 percent contribution requirement? 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. 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. What is the $150 million cap on payments for upfront charges and multi-year commitments in the Healthcare Connect Fund? See HCF Order at para. Joining HIF 11. 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. The FCC Form 461 is the way by which applicants can seek bids for supported services. 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. Privacy Restrictions: You are only allowed to use this portal to access information related to your job. See HCF Order, para. All users within a provider office are required to follow HIPAA and all applicable federal and state regulations, including minimum necessary requirements. The fee will be invoiced in EUR. Letters of Agency (LOAs) provide a Consortium Leader with the authority to act on behalf of the HCPs in its network. A consortium applicant may also file a Form 460 on behalf of any site on its network to determine that site’s eligibility, at the option of the HCP (see paragraph above). 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. 02-60, Report and Order, 27 FCC Rcd. This means that from this date, ARHG member funds will not accept provider registrations directly from medical providers. 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 … Applicants are free to include additional information to demonstrate a project’s sustainability, but the sustainability plan must at minimum address the following: (1) projected sustainability period; (2) principal factors in determining sustainability; (3) terms of membership in the network; (4) ownership structure; (5) sources of future support; and (6) management structure of the network. 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)? See HCF Order at paras. 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. See HCF Order at paras. 16678 (2012). If an applicant qualifies for a competitive bidding exemption, this should be indicated on the Forms 461 and 462. 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. HCPs are required to contribute the remaining 35 percent to participate in the program. 11224-07-20E APPLICATION FOR PROVIDER RECOGNITION 1/3 Download/save the form first onto your computer. Both individual applicants and consortium applicants should submit a separate form for each service provider or vendor, and that form should list the relevant information for all service(s) or circuit(s) for which the applicant is seeking support at the time. 208-212 for additional information on LOAs. Only the Doctor can sign on the form. No. LOAs used in the Pilot Program are specific to that program and cannot be used to seek funding in the Healthcare Connect Fund. 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). USAC will use the FCC Form 460 to determine whether a site is eligible to receive support through the Healthcare Connect Fund. For Pilot projects, the first annual report will be due on September 30, 2013. Register Online. Rural Health Care Support Mechanism, WC Docket No. Applicants in the Healthcare Connect Fund can only receive a multi-year funding commitment that covers a period of up to three funding years. 351-359. 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. See HCF Order at paras. No. http://www.usac.org/rhc/telecommunications/tools/Rural/search/search.asp. Equipment that is not directly associated with broadband services (such as computers, end user wireless devices, smartphones, tablets, and video/audio/web conferencing equipment or services) is not eligible for support through the Healthcare Connect Fund. If adding additional HCP sites was not a part of the original bid solicitation, the applicant must conduct a new competitive bidding process. INET Login for Registered Users. … For providers. You can also use this generic form to update changes to the email, contact, postal and/or banking information. Yes, as long as the existing contract meets the requirements for an evergreen contract. The Form 462 should identify the service(s), rates, service provider(s) or vendor(s), and date(s) of the service provider (vendor) selection. See HCF Order at paras. Professional Contact Details . See HCF Order at para. Any new provider numbers issued by the Health Insurance Commission must be registered accordingly. 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). See 47 CFR § 54.679. You can register with WorkSafe to provide your services to workers under Victorian workers compensation legislation. 3, (fn. 271-271 for more information about requirements for service providers. 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). 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. Yes, the Healthcare Connect Fund permits site and service substitutions in limited circumstances. Provider First Name* Provider Middle Name . 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. See response to Question 23. All practitioners submitting claims via Simplified Billing must be registered with Latrobe Health Services. 345-350 for additional details on the SNF Pilot. Equipment support is not available for networks that are not dedicated to health care. More details about the annual report will be forthcoming. Provider Registration Officer HBF Health Operations – Provider Support GPO Box C101 Perth WA 6809 Applications can be emailed to provreg@hbf.com.au or faxed to (08) 9265 6282. HBF policy as the treating provider. 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? Welcome to the TennCare Registration Home page for new and existing providers. Do non-rural “grandfathered” sites on Pilot project networks count toward their non-rural/rural percentage? 13 16 42 Can consortia add new HCPs to their networks without going through the competitive bidding process? Register to participate in the GU Health No Gap and Known Gap network. See HCF Order at paras. Registration HCF conference pass: One day €375; Two days €650; VAT included. Part A: Medical Provider Details Simplified Billing Provider Registration Form To enable submission of medical claims through the Simplified Billing process, all providers must be registered with Latrobe. Please allow approximately 14 days for processing. 279-293 for additional information. VIII. Service providers who elect the direct reimbursement option under the revised offset rule may also make the election on Form 498. Contact USAC for additional details at rhc-assist@usac.org. 177, bullet 5, for additional information. Routine maintenance is scheduled between 5:00AM to 8:00AM daily. ACCOUNT DETAILS Please fill in the banking details below. 208-212 for additional information on LOAs. What are Letters of Agency (LOA) and when do they need to be filed? This is a subscription site and requires registration with the Health Safety Net prior to using this site. What HCPs are eligible to receive support under the Healthcare Connect Fund? See Question 29 above for more details on competitive requirement for applicants seeking funds over $100,000 in a year. What does it mean if a contract has been designated as “evergreen”? 213-302 for additional information on the application process. 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. An HCP’s 35 percent contribution requirement can come from any eligible source. 234-238 and 261-265 for additional information. However, non-rural hospital sites with 400 or more licensed beds may receive no more than $30,000 per year in support for recurring charges and no more than $70,000 in support for non-recurring charges every five years, exclusive of any costs shared by the network. From 1 October 2020 Linked Servicing Providers must register for HCF’s Medicover No or Known Gap scheme arrangement to receive the extra benefits assigned to those schemes. Provider Recognition, Registration and Operations Email: ProvopsAncillary@bupa.com.au Should you require any further information regarding provider recognition, registration and provider operations, please call the team on 1800 060 239. See HCF Order at paras. 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 57-67 for additional details. 313-315 for additional information on site and service substitutions. Title Date of Birth . 238 for additional details. See HCF Order at paras. A multi-year funding commitment is any funding commitment that extends beyond a single funding year. A consortium can change the entity it has designated as its Consortium Leader by amending the Form 460 with the new Consortium Leader designation. Mental Health Reforms (Staff Only) 19. When can Pilot Program participants seek funding from the Healthcare Connect Fund and what forms should they use to submit their funding requests? See HCF Order at para. 4. 285-289 for additional information. 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. However, only consortium applicants must submit with their funding requests evidence of a viable source for their 35 percent contribution. 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. Are a lead entity’s administrative costs related to managing a consortium eligible for support? Pilot projects also may be required to provide additional information. A consortium is considered to be “majority rural” if more than 50 percent of the eligible HCP sites participating in the consortium are rural within the Commission’s rural health care definition of rural. See HCF Order at paras. The Telecommunications Program will continue to operate alongside the new Healthcare Connect Fund. ... WorkSafe Victoria reserves the right to cease a provider number if the Authority is unable to contact you (either by mail, email or phone). Under the program, eligible rural HCPs, and those non-rural HCPs that are members of a consortium that has a majority rural HCP sites, can receive a 65 percent discount from the fund on all eligible expenses. 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. nib logo. 9) and paras. Claims will be held until we receive confirmation of your registration to the Medicover Gap Scheme. Use our online portal to register new providers or notify us of a provider that has moved on from your practice. 365-368 for more information. See HCF Order at paras. You can also use this generic form to update changes to the email, contact, postal and/or banking information. However, the RFP should provide sufficient information to enable an effective competitive bidding process, including describing the HCP service needs and defining the scope of the project and the network costs (if applicable). Provider Registration This form is used by Doctors to register for participation in Access Gap Cover. nib logo. 239-242 for additional details. 198-212 for information about requirements and responsibilities of Consortium Leaders. What is the Skilled Nursing Facilities (SNF) Pilot Program? 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? A consortium applicant must file a Form 460 identifying all of the sites on its network. Can Pilot projects use existing LOAs for HCP sites on their networks to seek funding from the Healthcare Connect Fund? Download and complete the Provider registration for Electronic … See HCF Order at paras. This form is used by Doctors to register for participation in Access Gap Cover. See Question 51 below for additional details. Before joining GMHBA Health Insurance we recommend you read through the fund rules and our important information guide. Do Pilot projects need to update their sustainability plans to reflect changes in membership? Does the Healthcare Connect Fund provide support for non-recurring installation charges for broadband services? See HCF Order at paras. Provider Last Name* AHPRA Registration Number* Check AHPRA Registration Number . Public and not-for-profit health care providers are eligible to receive support under the Healthcare Connect Fund. Provider registration and additional practice application Please print in black ink, using capital letters and mark check boxes with an X. Member Information 47. See HCF Order at paras. Step 3: Complete digitally1by typing in … Hospital Cover 22. USAC will advise each Pilot project on the composition of its network. 57 for additional details. 3-4 for additional details. To register you must satisfy the eligibility requirements for … Register Online. When do applicants need to file an annual report and what should be included in it? 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. See HCF Order at paras. This includes eligible sites, ineligible sites, off-site data centers and off-site administrative offices. Pilot projects must submit new LOAs as they transition sites into the Healthcare Connect Fund. Part-time eligible HCPs will be counted as a single site when USAC is determining the rurality of a network, and if they are located in a rural area, they will be considered rural for this purpose. What will happen to the Telecommunications Program (the “Primary” Program)? All sites, whether considered eligible or ineligible HCPs, must file a Form 460, even if they were previously determined to be eligible under the Telecommunications, Internet Access, or Pilot programs. See HCF Order at para. 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. Examples of ineligible sources include (but are not limited to) in-kind or implied contributions; a local exchange carrier (LEC) or other telecom carrier, utility, contractor, consultant, vendor, or other service provider; other universal service funding; and for-profit entities. All applicants must certify that they have satisfied the 35 percent contribution requirement before receiving support through the Healthcare Connect Fund. You may need to download Adobe Acrobat Reader DC before you start. Overseas Visitors Cover 16. * 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. Accordingly, HCPs who have or intend to have an ownership interest, indefeasible right of use (IRU), or capital lease interest in facilities funded by the Healthcare Connect Fund must file a sustainability plan. Yes, but only if the applicant is a member of a consortium. For example, if the Pilot project adds ten new sites to its network, the majority of those ten new sites must be rural. nib's no-gap MediGap network of registered medical specialists. Yes, as long as adding new HCPs was contemplated in the original request for competitive bids. No. Can Pilot Program participants that have negotiated a long-term contract beyond the period of their Pilot awards seek to have their contracts designated as “evergreen” without going through the competitive bidding process? For the purposes of determining whether a network is majority rural, non-rural grandfathered sites (those in existing Pilot project networks before the implementation of the Healthcare Connect Fund) do not count toward the urban/rural composition of a Pilot project network. This page is for providers and their authorised representatives to register for the GU Health Medical Gap Network, access updated information, schedules and forms. Expenses associated with data centers and administrative offices that support multiple HCPs in a network should not be attributed to a particular HCP. Until those details are released, please seeHCF Order at paras. This chart is reproduced immediately below. 156-163 for more information. For example, if a consortium has four sites, upfront payments for the consortium must be prorated over at least three years if the amount of upfront payments requested is more than $200,000. Access the HCF provider portal for Ancillary, Dental, Hospital or Medical services Maternity Cover 6. Providers can complete this form to register with WorkSafe to provide services to injured workers. Please email Simplified Billing sbenquiry@lhs.com.au to submit this form, or if you have any questions regarding the Simplified Billing process. Section 1: Provider Details . Ineligible HCP sites also may participate in a consortium, but they will not receive support (they must pay “fair share”). Recognised Provider’s registration or membership of the Professional Body; or (b) of any material change in the way they provide goods or services to Members or any other information which could impact on their recognition as a ‘recognised provider’ with HCF including the Recognised Provider’s compliance with clauses 4.1(m) and 4.1(n). 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. USAC will continue to use SharePoint until the existing “My Portal” site is modified for applicants seeking funding from the Healthcare Connect Fund. This information may be distributed to Bupa customers, including without limitation, in any Bupa approved media or materials, including on any Bupa 261-265 for a discussion of evergreen contracts. If the data center or administrative office supports other HCPs in the network in addition to the hospital, then its expenses should be tracked separately and should not count towards the hospital’s funding caps. MEDICAL PROVIDER DECLARATION See Question 33 above. Amend Online HICAPS Accounts Online Registration INET Login for Registered Users. See HCF Order at paras. Applicants using a request for proposal (RFP) to solicit bids must still file a Form 461. The Healthcare Connect Order does not specify what information should be included in an applicant’s RFP. 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. A new contract entered into by an HCP or consortium as a result of competitive bidding will be designated as evergreen if it meets all of the following requirements: (1) signed by the individual HCP or consortium lead entity; (2) specifies the service type, bandwidth and quantity; (3) specifies the term of the contract; (4) specifies the cost of services to be provided; and (5) includes the physical addresses or other identifying information of the HCPs purchasing from the contract. Upfront payments are all expenses related to HCP-owned infrastructure, carrier infrastructure upgrades, pre-paid leases, and IRUs. In addition, the Form 460 is used to register ineligible HCP sites, off-site data centers, and off-site administrative offices. 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. From Thursday 1 August 2019, the Australian Regional Health Group (ARHG) will process all provider applications on behalf of Latrobe Health Services. Yes, existing Pilot projects can 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. Can applicants purchase indefeasible rights of use (IRUs) through the Healthcare Connect Fund? 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. Upfront payments for sites within a consortium may vary, and upfront payments for a specific site may exceed $50,000 without requiring amortization as long as the average upfront payment per site in a consortium does not exceed $50,000. What types of equipment are eligible in Healthcare Connect? Provider Registration. Only eligible HCPs sites will be used to determine whether a network is majority rural. However, if the Pilot project would like to add new HCP sites to its network, any new sites it adds must be a majority rural in the aggregate. The SNF Pilot program is an initial step to test how to support broadband connections for SNFs. Can Pilot Projects use support from the Healthcare Connect Fund to add new sites to their networks? For example, if 60 out of 100 HCPs participating in a Pilot project network are non-rural, those non-rural sites can be “grandfathered” and can receive funding in the Healthcare Connect Fund. 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).
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