AHSA collects, uses and discloses information in order to provide business functions on behalf of our participating health funds. We do this in accordance with the Australian Privacy Principles (APP), contained within the Privacy Act 1988, as amended.

In addition to the privacy information detailed here, AHSA also has a General Privacy Policy.

Privacy under Access Gap Cover

AHSA collects personal information from doctors participating in Access Gap Cover (AGC), such as name, address and bank account details (for Direct Credit payments into a nominated bank account), as outlined in the AHSA Provider Details and Direct Credit Authority Form. AHSA collects this information on behalf of its participating health funds (see Disclosure below).

Collection, disclosure and use of information provided

As a condition of Access Gap Cover registration and of making a claim under the Access Gap Cover scheme, doctors agree that AHSA and AHSA participating funds may in their discretion:

• Collect information from the doctor registration form and other doctor communications with AHSA and AHSA participating funds (including, without limitation, forms and communications received before this condition came into effect and information from claims that submitted).
  
  This includes personal information (such as name, practice address, and other contact details); field of practice and additional qualifications or specialties, and information (including past claims data) relating to the charges rendered, the services provided (including where a doctor operates and their surgical partners) and doctor participation in the Access Gap Cover scheme (together, "the information").

• Disclose the information and other information about a doctor to the public, including members of AHSA participating funds and referring doctors, including for the purposes of identifying Access Gap Cover providers, and setting out information relating to the charges rendered, quality of service and statistical information relating to their participation in the Access Gap Cover scheme.

• Use the information for internal statistical analysis.

Privacy under MPPAs and HPPA/PAs

AHSA collects medical provider numbers of individual doctors that are part of an agreement with a company/group of doctors (Medical Purchaser Provider Agreement, or MPPA) or specific hospital (Hospital Purchaser Provider Agreements with Practitioner Agreement, or HPPA/PA). Where doctors are paid individually, AHSA also collects bank account details; otherwise AHSA only collects bank account details of the company/hospital.

By being part of the agreement, MPPA and HPPA/PA doctors' consent to having their name, practice location, billing contact details and specialty made available to the general public.

Please note that "made available to general public" means that these details:

• Will appear on a web search.
• Will be included on General software
• May be provided over the telephone or printed out and supplied to health fund members upon request.

AHSA uses medical claim data to ascertain doctors charging patterns to assist with negotiating rates for MPPAs and HPPA/PAs.

Privacy under Hospital-Substitute Treatment (H-ST) arrangements

AHSA will collect, disclose and use H-ST information in a similar manner as MPPAs and HPPA/PAs.

Services Australia Provider Directory Data

AHSA receives periodic updates to provider numbers in the Services Australia Provider Directory Data file from Medicare Australia. This allows AHSA to keep up to date with provider changes which assists us to meet Australian Privacy Principles relating to the accuracy and completeness of information.

Collection of Data

AHSA collects medical claims data of member health funds for all doctors, regardless of whether the claim was paid under Access Gap Cover, MPPA, HPPA/PA or where there is no agreement. This data includes fields such as provider number, member (patient) number, agreement type, charge and benefit for each MBS item number.

AHSA also collects de-identified medical claim data linked to episodes, as part of the Hospital Casemix Protocol (HCP), to meet statutory reporting obligations.

Use of information

AHSA uses this information to:

• Maintain a comprehensive database of AGC, HPPA/PA, H-ST and MPPA doctors, to ensure these doctors receive important information, such as new schedules or new agreements;
• Enable AHSA to administer gap cover arrangements on behalf of member funds; and
• Ensure that funds are able to pay claims directly into doctor’s bank accounts, where relevant.

Disclosure of information

AHSA co-ordinates all forms of medical agreements and/or arrangements for doctors on behalf of our participating funds. Therefore, relevant information (such as bank and contact details) is disclosed to ALL participating funds, even if doctors bill only some of them.

AHSA uses the medical claim data for statistical purposes internally.

AHSA discloses medical claim data to Healthshare. This allows members to search for specialists for transparency on possible patient gaps.

AHSA discloses medical data to the Department of Health for the Medical Costs Finder | Australian Government Department of Health website. The MCF is a tool to help patients and doctors identify the typical costs of commonly sought specialist services and procedures in the private health system.

AHSA discloses de-identified medical claim data to the Commonwealth Department of Health, to meet HCP statutory reporting obligations. As provider numbers are NOT included, this information is de-identified for both doctors and members (patients).

Accuracy of information

To ensure accuracy of information, participating doctors must notify the AHSA as soon as possible if:

• Bank account details are changed; or
• It is discovered that bank account details have been provided or entered incorrectly; or
• Address, e-mail or telephone numbers have changed.

AHSA manages this information centrally on behalf of participating funds - it is recommended that doctors notify AHSA of changes to ensure that all funds have access to the correct information. Doctors can thereby avoid the need to individually inform each AHSA fund of changes.

Doctors on the AHSA Doctor Search are advised to search for themselves on the web and notify AHSA immediately if there are any problems. Alternatively, email the Access Gap Cover team at access@ahsa.com.au or call 1800 664 277 (Option 1).