For Hospital Providers

Most private hospitals do not register with us directly. As a member fund of the Australian Health Service Alliance (AHSA), Doctors’ Health Fund recognises all hospitals contracted under the AHSA national network.

If your hospital already has an agreement with AHSA, you are automatically recognised by Doctors’ Health Fund.

You do not need to take further steps unless:

• Your hospital is new and seeking to join the AHSA contract network, or
• Your hospital is delivering services outside the AHSA framework (rare). If either situation applies, please contact AHSA direct

You can submit a claim to us via ECLIPSE, email on providers@doctorshealthfund.com.au or post.

We are listed under The Doctors’ Health Fund, please look for us under T in the ECLIPSE system. Please note that some rare systems will have us listed under AMA.

Our remittances for manual claims are posted to the nominated postal address provided to us by AHSA. You should receive it within the normal postal timeframes after the benefit payment has been finalised.

We cannot generate remittances for ECLIPSE claims. Please contact your software provider if you are not receiving remittances.

We receive all provider details directly from AHSA. If the details have been updated with them, then you do not need to do anything further. If you do not hold an AHSA agreement, we will only be able to process a one-off payment. Please email us with confirmation of the relevant bank account details.

Please be aware that we are unable to send cheques.

Please access the AHSA ex gratia forms from AHSA Forms. Complete and return by email to Doctors Health Fund together with a supporting letter from a treating specialist explaining the clinical necessity. Depending on the request, it may require a review by our clinical advisors and our leadership team. Please allow up to ten business days for the review.

As part of AHSA contracting requirements, hospitals must provide:

• Hospital Casemix Protocol (HCP) data
• AN-SNAP data
• Data submissions that meet AHSA formatting, validation and reporting standards
• Corrections or resubmissions when validation flags require updates

All specifications and due dates are published through the AHSA Hospital Resource Centre.

High-cost drug and prosthesis requests are processed according to AHSA guidelines and forms, available via the Hospital Resource Centre.

If you’re an AHSA-contracted hospital, your administrative details are managed through AHSA.

If you need to update billing contacts, bank details, or remittance addresses update your information via AHSA.

Depending on the episode, you may need to submit:

• Acute Care Certificates
• Psychiatric Certificates
• Rehabilitation Admission/Discharge Certificates
• Pre-Existing Ailment forms completed by member

These forms follow AHSA national templates and guidelines.

Hospital eligibility queries follow the standard AHSA process and can be made:

• Via ECLIPSE
• Via your hospital’s eligibility systems using AHSA fund codes
• Via direct contact with Doctors’ Health Fund if manual confirmation is required

If a claim is rejected or requires adjustment:

1. Review the ECLIPSE return/error message
2. Correct any data validation issues (HCP/AN-SNAP or coding discrepancies)
3. Resubmit through ECLIPSE AHSA publishes detailed guidance on validation reports and corrections

Yes — members have access to the full AHSA agreement hospital network.

Yes. Certificates are required for:

• Stays exceeding 35 days (Acute Care Certificate)
• Ongoing rehabilitation or psychiatric treatment

These must use AHSA-approved forms.

Please contact DHF Claims Team on phone 1800 226 126 or via email, providers@doctorshealthfund.com.au

For contracting or schedule queries: contact AHSA (as per their hospital support contacts)