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Medicare Provider Numbers

The Medicare provider number (MPN) application process applies to GP registrars when they join or renew placements under the Australian General Practice Training (AGPT) Program. This work now resides with the Access Policy Section in the Rural Access Branch of DOH.

PRELIMINARY MATTERS

Medicare has advised that the majority of delays relating to MPN applications from GP registrars are due to inconsistencies between the name used on the AGPT program placement documentation and the name used on the MPN application form. Any delays that currently apply to assessing these applications can be significantly reduced if GP registrars always fill in documentation using their name as it appears on their current registration with the Australian Health Practitioners Regulation Agency (AHPRA). This will ensure the expeditious location and processing of MPN applications when required from GP registrars.

THE APPLICATION PROCESS

In broad terms, there are two separate application processes that apply when a GP registrar requires Medicare access for a training practice:

  • The AGPT placement process, which satisfies 3GA 6E of the Health Insurance Act 1973 (the Act).
  • The provider number application process.

THE PLACEMENT PROCESS

This process requires an approved Regional Training Organisation (RTO) to submit a complete AGPT placement form to the Access Policy Section of DOH. The placements are always submitted electronically to agptmpnapplications@health.gov.au. The Access Policy Section of Health provides an auto-confirmation that the placement has been received in response to this email.

The placements are assessed within 72 hours of receipt by the Department of Human Services (DHS). In cases where the Access Policy Section cannot process the placement, the RTO will be contacted for further information. This contact will occur within 72 hours of the Access Policy Section receiving the placement and such subsequent contact generally leads to the placement being processed.

THE MPN PROCESS

The MPN process for GP registrars is more complicated and warrants careful consideration. It is firstly important to understand that DHS – Medicare does not always require a MPN application to be submitted when a GP registrar is granted a new placement on the AGPT program.

WHEN IS A MPN APPLICATION REQUIRED?

A MPN application must be submitted by a GP registrar when undertaking a new AGPT placement if:

  • The registrar is subject to section 19AB of the Act and requires a section 19AB(3) exemption from the Access Policy Section of Health for the new placement
  • The registrar is not subject to section 19AB but they have not held a prior AGPTP placement at the practice location.

In cases where the registrar is not subject to section 19AB, DHS – Medicare can arrange Medicare access for a new semester placement without a formal MPN application if the doctor has had a prior AGPTP placement for the practice. DHS – Medicare can arrange Medicare access without a formal application in these cases because the registrar:

  • Is not subject to an exclusion on their Medicare eligibility under section 19AB;
  • The existence of the prior AGPT placement means there is no need to establish a business relationship between the registrar and employer for the purpose of paying Medicare rebates.

In cases where the above two conditions are satisfied, DHS – Medicare can extend Medicare access once the AGPT placement process has been completed and the registrar submits a letter requesting that the extension be processed.

WHAT MPN FORM DOES THE REGISTRAR NEED TO SUBMIT?

When the GP registrar is seeking Medicare access for the first AGPT semester, they will need to complete an Application for an initial Medicare provider number for a medical practitioner form (HW019).

When the registrar is seeking Medicare access for any subsequent AGPT semester, and it can be established from the rules set out above that an MPN application is required, they will need to complete an Application for an additional location Medicare provider number for a medical practitioner.

WHERE ARE THE PROVIDER NUMBER APPLICATION SENT?

MPN Application forms need to be sent to:

By email:

provider.registration@humanservices.gov.au

By mail:

Medicare Australia
Provider Eligibility Section
GPO Box 9822
in your capital city

By fax:

NSW/ACT (02) 9895 3439
QLD (07) 3004 5634
VIC/NT (03) 9605 7984
SA/TAS (08) 8274 9307
WA (08) 9214 8201

WHAT HAPPENS WHEN A REGISTRAR REQUIRES A SECTION 19AB EXEMPTION?

In cases where the registrar requires a section 19AB exemption for Medicare access, DHS – Medicare will apply to the Access Policy Section for this as part of the MPN application process. There is no separate application form that needs to be completed by the registrar to ensure this application takes place. DHS – Medicare will be able to identify that a registrar is subject to section 19AB by the information they provide when completing the MPN.

The section 19AB assessment process occurs without contacting the applicant doctor to advise that an exemption application has been received on their behalf. The Access Policy Section does not provide this information to ensure expedient assessment of applications. The Access Policy Section will only contact an applicant registrar if additional information is required to grant the exemption. The registrar is notified in writing once the exemption is granted. DHS is advised immediately so that a provider number can be granted to the registrar.

If a registrar or RTo is seeking confirmation of an exemption application, the Access Policy Section can be contacted at 19AB@health.gov.au

FAQs

Q: How will I know my application has been received?

A: Registrars can seek confirmation of receipt of their application by calling 132 150. This contact is effective where the registrar applies using their name as it appears on their AHPRA registration and their application can be found by DHS–Medicare.

 

Q: How long will it take to process my application?

A: It can take up to 28 days to process especially in peak periods.

 

Q: My application has been delayed, why?

A: DHS–Medicare has advised that the majority of delays relating to MPN applications from GP registrars are due to inconsistencies between the name used on the AGPT placement documentation and the name used on the MPN application form. Any delays that currently apply to assessing these applications can be significantly reduced if GP registrars always fill in documentation using their name as it appears on their current registration with the Australian Health Practitioners Regulation Agency (AHPRA).

 

Q: Is there any way to check the status of my registrar’s Medicare provider number application?

A: You can check where DHS are currently at in relation to processing Medicare provider number applications by date of submission via this link.

Note there is currently no way to check the status of a specific Medicare provider number application online or by phone. DHS staff can only confirm receipt of the application if the registrar who submitted the application contacts them.