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Medical specialists

Information for medical specialists about billing, claiming and nib MediGap.

nib MediGap

At nib we have built the MediGap network to help eliminate out of pocket costs for nib customers for inpatient medical and surgical fees. If you’re a medical specialist, you can register to become a MediGap specialist, which means you agree not to charge the nib customer any out of pocket costs for their inpatient service. The benefits to you as a provider include receiving faster payment from nib, not having to chase your patients for payment of their invoice, and being listed in our MediGap specialist search directory.

To find out more please visit the MediGap page. If you are interested in registering with MediGap, please complete our MediGap form.

If you are a medical specialist (such as Diagnostic or Imaging specialist) there are a few things we want you to know to help you service our nib customers, bill nib customers (or submit claims directly with us) and how to get in contact with us if you have any questions.

If you are a medical specialist that does not wish to register for nib MediGap or if you are not eligible (such as Pathologist) we can still pay you directly. So that we can simplify payments to you, we are switching from cheque payments to direct deposit into your account. If you would like to receive payments electronically, please register for direct billing.

Innovative digital tools

We are helping our customers find medical specialists by directing them to search for a specialist who is registered to participate in MediGap.

Customers can search for a MediGap specialist in our Going to Hospital tool in Online Services, our Find a Provider search on the nib website or within the nib App.

Frequently Asked Questions

If you have received a cheque but cannot match this with a claim, please contact us to discuss your options to submit claims via Direct Billing.

Direct billing is a safe and convenient way to receive payments from nib direct to your bank account. No need to bother with billing your patients and then chasing them for the money, or billing them for the entire amount upfront. Provided you are set up with ECLIPSE, you can submit your bill via Patient Claim and nib will pay you directly.

nib’s Direct Billing enables providers to confirm a customer’s eligibility and submit claims for nib customers that hold Overseas Students Health Cover (OSHC). This method reduces or in some cases eliminates an out-of-pocket expense for the customer and participation means that you will be listed as an nib Preferred Provider which may increase your business.

ECLIPSE is the electronic payment method developed by Medicare. It offers a secure, quicker connection between health professionals, Medicalre and private health insurers. It offers providers direct communication with Human Services and private health insurers in the one transaction.

You can claim by registering for ECLIPSE and Direct Billing

Contact us

Mailing Address

Provider Relation nib

nib Health Funds Limited

22 Honeysuckle Drive

Newcastle NSW 2300

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