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Modalities and settlement

Modalities

Modalities are the types of allied health service a provider offers, for example dental or optical. Allied health providers are issued a provider number for the modality they specialise in. Pass the modality with each claim, in the serviceType field of the JS library request or the serviceType parameter of the .NET library methods.

ModalityDescription
0Dental technician
1Osteopath
3Endodontist
4Oral surgeon
5Orthodontist
6Paedodontist (paediatric)
7Periodontist
8 or 9Prosthodontist. The .NET library documentation lists 8 and the JS library documentation lists 9.
BAcupuncturist / Chinese medicine
CChiropractor
DGeneral dentist
EDietitian
FPodiatrist
GMedical doctors (including GP claims for overseas cover)
HOccupational therapist
J or 2Myotherapy. The .NET library documentation lists J and the JS library documentation lists 2.
MRemedial massage therapist
OOptometrist
PPhysiotherapist
QCounselling
SSpeech pathologist
UExercise physiology
VAudiology
YPsychologist
ZOptical dispenser

The JS library and .NET library documentation disagree on the Prosthodontist and Myotherapy codes. Check them against the HealthPoint reference data, which lists the modalities each health fund supports, before you rely on either.

The HealthPoint health funds by modality (PDF) and the HealthPoint reference data list the modalities each fund supports. For the funds themselves, see Supported health funds.

Settlement

HealthPoint issues a single, aggregated settlement for all approved claims the following business day. HCF is the exception, and issues a separate settlement. The settlement claims period is 00:00:00 to 23:59:59 Australian Eastern time, adjusted for daylight saving.