HBF to change its ‘preferred provider’ scheme

19 October 2018

The recent announcement by HBF to replace its long-standing preferred provider scheme is a great achievement for ADA WA Branch who have been instrumental in helping to bring these changes into effect and a small win for dentists everywhere.

The ADA has always maintained that preferred provider schemes are not in the best interests of patients or dentists and have called on all health funds to dismantle their schemes and pay the same rebate for the same treatment under the same policies. This position was echoed in the findings of the Senate Inquiry into the value and affordability of private health insurance which recommended that Commonwealth legislation be amended to prohibit the current practice of differential rebates for the same treatments provided under the same product in the same jurisdiction.

Details of the new ‘Member Plus’ arrangements which will take effect on 1 January 2019, were presented to WA dentists at a public meeting in mid-October and at first glance appears promising.  

Participation is open to every dentist in WA but does require that billing is processed through electronic claiming systems.  One annual scale and clean will be fully funded with limits on what participating dentists can charge for other diagnostic and preventative treatments.  

All HBF members receiving any service contained in the ADA Schedule of Dental Services will receive the same rebate irrespective of which dentist they visit. Same policy-same treatment-same rebate irrespective of whether their dentist participates in the scheme or not.

These new arrangements appear to be much fairer for patients and practitioners and the ADA hopes that other funds are taking note and planning to follow suit. The ADA has repeatedly offered health funds the opportunity to sit down and work together to create more suitable policies for dental patients.

ADA will also be talking further to the Federal Government about the HBF model as we continue to lobby for improved arrangements around extras health insurance cover.