Ophthalmological Society Of Australia

The Australian Society of Ophthalmologists Limited was formed in 1982 to represent the medico-political interests of ophthalmologists. The ASO enjoys a strong affiliation with the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) and the Australian Medical Association (AMA). Today the ASO is the peak professional body for ophthalmologists and its membership comprises the majority of Fellows practicing within Australia. In addition to representing medico-political interests ASO works to improve ophthalmic practice management and assist members. The ASO is governed by elected Directors and supported by secretariat staff. In December 2015 the ASO received confirmation from the Federal Health Department that a private health insurer seeking to obtain signed pre-approvals for MBS listed procedures is contrary to the Private Health Insurance Act. The Department provided the following advice to the ASO. The Private Health Insurance Act 2007 requires private health insurers to pay benefits for hospital treatment when a member undergoes a procedure, which is covered by their complying health insurance product (CHIP) and a Medicare benefit is payable. This requirement is set out under section 72-1of the Act and states that an insurance policy that covers hospital treatment meets the benefit requirement rules in Division 72 if the policy meets the requirements in the table in subsection. The table in section 72-1(2) of the Act states in item 2 that there must be a benefit for hospital treatment covered under the CHIP for which a Medicare benefit is payable. Therefore, if a member of a fund is insured for a certain treatment under a CHIP, and receives hospital treatment that includes a procedure for which a Medicare benefit is payable and paid for that treatment, it is the Department’s view that the fund must pay the benefit linked to that procedure. Any patient that is denied a private health insurance reimbursement that meets the provisions of the Act should contact the private health insurance ombudsman.