Done correctly, the registrations you set up now will support every claim you submit for the rest of your career. Done poorly, they produce errors, delays, and rejected claims at the worst possible times.
The steps are not difficult, but they have a specific order, and each one depends on the last. Here is how to go through them properly.
The checklist:
- Register with PRODA to access Medicare’s online services
- Add your bank account so Medicare knows where to send payments
- Register every location where you will see private patients
- Obtain a provider number for each location
- Register with the major health funds as a recognised provider
Step 1: PRODA Registration
PRODA stands for Provider Digital Access: a single secure login for Medicare’s online provider portal (HPOS, Health Professional Online Services) and other government services. You cannot register bank details, manage provider numbers, or process ECLIPSE claims without it.
How to register
- Create your PRODA account: Go to proda.humanservices.gov.au and register with your personal details. You will need a valid Australian mobile number for two-factor authentication.
- Verify your identity (3 documents): PRODA uses the Document Verification Service. You will need to verify using three documents: typically Medicare card, driver’s licence, and passport. All three must match the name on your Medicare provider record.
- Link to HPOS: Once your PRODA account is active, navigate to “Link your online accounts” and connect to HPOS (Health Professional Online Services). This is the Medicare portal where you will manage everything from banking to provider numbers.
- Locate your Healthcare Provider Identifier (HPI-I): Inside HPOS you can view your HPI-I (your individual Healthcare Provider Identifier). You will need this number for health fund registrations. Keep it handy.
Name matching matters
The name on your PRODA account must exactly match your Medicare provider enrolment. If you have recently changed your name (e.g. marriage), update your Medicare provider record first before attempting PRODA verification, otherwise it will fail.
Step 2: Banking Details
Medicare pays you directly. You need to tell them where.
Your bank details are stored at the individual provider level, not at the practice level: each doctor has their own banking record in Medicare’s system, regardless of where they work.
What you will need: BSB number, account number, and the exact account name as it appears on your bank statements. Joint accounts are acceptable provided your name appears on the account.
Where to do it: Log in to HPOS via PRODA. Navigate to My Details → Bank Account Details and add your account. Changes take effect within 1–2 business days.
Using a business bank account?
Many specialists have payments directed to a practice entity or company account. This is fine. Just ensure the account name reflects the entity name exactly as registered, and that you have the appropriate arrangement in place for your tax structure. Speak to your accountant about this before you start billing.
Changing bank details later
You can update your bank details in HPOS at any time. There is a brief processing delay, so if you change accounts, make sure existing outstanding payments have cleared first. You cannot maintain two active bank accounts in the system simultaneously.
Step 3: Practice Locations
In Medicare’s system, provider numbers are location-specific: every site needs its own registration. If you consult at three different rooms (say, a public hospital, a private hospital consulting suite, and your own rooms), you will have three different provider numbers.
You cannot bill without a location-specific provider number
Submitting a claim with the wrong provider number, or a provider number from a different location, is an incorrect claim. Always match the provider number to the location where the service was delivered.
What counts as a practice location?
Any address where you regularly see private patients. Common examples include:
Requires registration
Consulting rooms (owned or rented), private hospital rooms, day surgery suites, telehealth-primary locations, and any recurring sessional consulting address.
Special cases
If you provide services across multiple hospital sites, each hospital address is a separate location. Public hospitals have their own provider numbers; confirm with the billing office.
How to register a practice location
- Confirm the address: Use the physical street address of the rooms. If you are in a shared medical centre, confirm the exact address format with the practice manager, as variations in address format can create issues later.
- Submit via HPOS or paper form: In HPOS, navigate to Provider → Manage Locations. Alternatively, submit a paper HW001 form (Application for a Medicare Provider Number) to Services Australia. HPOS is faster; processing typically takes 5–10 business days.
- Receive your provider number: Once approved, you will receive a provider number for that location. It will appear in your HPOS portal. Store these carefully; you will need them for every claim you submit at that location.
Starting a new role?
Do not wait until your first private patient to register the location. Processing takes up to two weeks. Register as soon as you know the address where you will be working.
Step 4: Provider Numbers
Your provider number is the unique identifier that links a claim to you, at a specific location.
Once a practice location is registered, Medicare issues a provider number for that site. This 8-character alphanumeric code (e.g. 2354781B) appears on every Medicare and health fund claim you submit from that location. It is how Medicare knows who performed the service, where, and under what specialty.
Vocational registration matters
Your provider number and the MBS items you can claim depend on your vocational registration. Fellows of specialist colleges (FRACP, FRACS, FANZCA, etc.) access specialist MBS items. If your Fellowship is pending, confirm with Services Australia what you are entitled to claim in the interim.
Managing multiple provider numbers
Most specialists accumulate several provider numbers over their career. Keep a record that clearly maps each provider number to its corresponding address. This is not just an administrative convenience. Submitting a claim under the wrong provider number is a billing error, and patterns of such errors can attract a compliance review.
Active locations
Provider numbers for current consulting locations. These should be updated in your billing software and shared with any billing service you use.
Ceased locations
When you leave a practice location, notify Medicare via HPOS to cease that provider number. Old numbers on claims will reject.
When your provider number is delayed
There is no workaround for a missing provider number. You simply cannot submit a valid Medicare or ECLIPSE claim without one. If you are waiting on a new number, you have a few options:
- Call Services Australia’s Provider Registration line: Direct escalation via phone often resolves pending applications faster than waiting for the standard processing cycle.
- Issue a fee invoice with a delayed claim: You can give the patient an itemised invoice and submit the claim retrospectively once your provider number is issued. Most health funds allow backdating within a reasonable window.
Step 5: Health Fund Registration
Medicare registration is automatic with your provider number. Health funds are a separate process, and each fund is different.
Register with the major funds so your patients can claim directly through ECLIPSE. Without fund registration you can still bill patients, but they must claim manually.
Fund registration overview
| Health Fund | How to Apply | Notes |
|---|---|---|
| Medibank Private | Online via Medibank’s provider portal | Largest fund by membership. Priority to register first. |
| Bupa | Bupa Provider Registration online form | Second largest. Often requires copy of Fellowship certificate. |
| HCF | HCF Provider Services (phone or online) | Strong in NSW/ACT. Separate process from Medibank/Bupa. |
| nib | nib Provider portal | Growing membership base. Online application available. |
| HBF | HBF Provider Relations | WA-focused fund, essential if you practise in Western Australia. |
| AHM | Via Medibank (AHM is a Medibank subsidiary) | Registration through Medibank usually covers AHM. |
| CBHS / TUH / others | Contact each fund directly | Smaller funds: register as your patient base warrants. |
What funds typically ask for
- Medicare provider number(s): Your current provider number for each location where you intend to submit fund claims.
- Specialist Fellowship certificate: Confirmation of your vocational registration: FRACGP, FRACP, FRACS, FANZCA, etc.
- AHPRA registration number: Your current AHPRA number and registration status. Funds will verify this independently but require it on the application.
- Professional indemnity insurance: Certificate of currency from your insurer (MDA National, Avant, MPS, etc.). Most funds require a minimum coverage level; check each fund’s requirements.
- Bank account details: Each fund makes its own direct payments, so you will provide banking details separately to each fund during their registration process.
Health fund banking ≠ Medicare banking
Your bank details registered with Medicare (in HPOS) are separate from the bank details you register with each health fund. If you change bank accounts, you need to update both: Medicare in HPOS, and each fund individually. Forgetting even one fund means those payments go astray.
Timeline Summary
- 1
8–10 weeks before your first private patient
Register with PRODA. Start your health fund applications; these have the longest processing times.
- 2
6–8 weeks before
Register your practice locations in HPOS. Allow at least 2 weeks for provider number processing.
- 3
4–6 weeks before
Confirm provider numbers have been issued. Follow up on any health fund applications. Add banking details to HPOS.
- 4
2 weeks before
Set up your billing software or billing service. Enter provider numbers, confirm ECLIPSE connectivity. Do a test claim if possible.
- 5
Day one: you are ready
Confirm all registrations are active. Brief your front-desk team on patient claiming. Start seeing patients.
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