Blog Series – All you wanted to know about health funds but were afraid to ask – Deciphering the item numbers – Part 1 – Item no’s 100-555
The item numbers that we use to identify treatments are owned by the Australian Dental Association. The definitions of the item numbers are also decided by the Dental Association. This means that any restrictions that imposed by health funds are decided by the health fund not the dental association.
At Seymour Dental we are NOT contracted by any health fund but we do our best to anticipate any issues of claiming from the health fund. These include yearly limits, restrictions on when the next treatment can take place, frequency limits and treatment restrictions. This depends on the type of cover the patient takes out with the health fund. Each health fund is different.
We advise our patients when they check the health fund for what they are covered for, to always obtain the person’s name, time & date of contact and where in the world they are! We have found that if there is any dispute then the health will need to abide by what they have said. So it’s important to check with the health fund what rebates you will get before starting treatment. The dentist cannot find out on your behalf due to privacy issues.
The categories of item numbers are below, including their descriptions and meanings. Also there are some common features, and warnings that can arise with some health funds.
Item no. 011-282 – Diagnostic services, Preventive, Prophylactic and Bleaching Services, Periodontics
Item no. 221 – Clinical periodontal analysis and recording – Part 1
Item no. 221 -Clinical periodontal analysis and recording – Part 2
Item no. 221 -Clinical periodontal analysis and recording – Part 3
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Blog Series – All you wanted to know about health funds but were afraid to ask – Deciphering the item numbers - Part 2 - Item no.’s 600-779